Preservation of eccentric strength in older adults: Evidence, mechanisms and implications for training and rehabilitation

Abstract

Overall reductions in muscle strength typically accompany the aging process. However, older adults show a relatively preserved capacity of producing eccentric strength. The preservation of eccentric strength in older adults is a well-established phenomenon, occurring indiscriminately across different muscle groups, independent of age-related architectural changes in muscle structure and velocity of movement. The mechanisms for the preservation of eccentric strength appear to be mechanical and cellular in origin and include both passive and active elements regulating muscle stiffness. The age-related accumulation of non-contractile material in the muscle-tendon unit increases passive stiffness, which might offer mechanical advantage during eccentric contractions. In addition, the preserved muscle tension and increased instantaneous stiffness of old muscle fibers during stretch increase active stiffness, which might enhance eccentric strength. The fact that the preservation of eccentric strength is present in people with chronic conditions when compared to age-matched healthy controls indicates that the aging process per se does not exclusively mediate the preservation of eccentric strength. Physical inactivity, which is common in elderly and people with chronic conditions, is a potential factor regulating the preservation of eccentric strength. When compared to concentric strength, the magnitude of preservation of eccentric strength in older adults ranges from 2% to 48% with a mean value of 21.6% from all studies. This functional reserve of eccentric strength might be clinically relevant, especially to initiate resistance training and rehabilitation programs in individuals with low levels of strength.

Fig. 1

Common patterns of strength decline over the lifespan for concentric, isometric and eccentric strength. The percentage of decline is estimated after normalizing to isometric strength at 20 years of age. Note the smaller proportionate decline of eccentric strength with aging (Adapted from Vandervoort et al., 2009 with permission).

Fig. 2

Potential neurological mechanisms for the preservation of eccentric strength in older adults

Fig. 3

Potential mechanical mechanisms for the preservation of eccentric strength in older adults

Fig. 4

Potential cellular mechanisms for the preservation of eccentric strength in older adults