Leg Extensor Power Research Articles

Yoga meditation (YoMed) and its effect on proprioception and balance function in elders who have fallen: A randomized control study

ObjectiveYoga has been shown to improve muscle strength, flexibility, and balance. However, the impact of meditation on dynamic factors such as gait, reactive balance and proprioception has yet to be examined. The purpose of this study was to test if a novel yoga meditation program (YoMed) is as effective as a standard proprioceptive training in improving proprioception, balance and power in older individuals who have fallen. DesignSixteen older persons were randomly assigned to either the YoMed Group (YM) or Proprioception Training Group (PT). Each group received 45 min of training, 3 days per week, for 6 weeks. Pretest and post-test outcome measures were used to quantify the comparative effects of the interventions. SettingResearch Laboratory. InterventionsYoga meditation and proprioceptive training. Main outcome measuresThe Balance Error Scoring System (BESS), the Tenetti Balance and Gait Assessment, dynamic posturography, joint position sense, joint kinesthesia and leg extensor power. ResultsThe primary findings of the study were that neither the YM or PT intervention groups showed statistical improvements in any variable with the exception of the dynamic posturography overall score (DMA), which showed a significant improvement by the YM group (d = 1.238; p = 0.049). Additionally changes in a number of variables that did not reach significance demonstrated effect sizes in the medium to high range. ConclusionThese results indicate the potential for the YoMed program to be used as a clinical intervention in older individuals. Given these results a longer study using a larger sample size and individuals at higher risk of falling is warranted.

Exercise induced effects on muscle function and range of motion in patients with hip osteoarthritis.

Patients with hip osteoarthritis have impairments in muscle function (muscle strength and power) and hip range of motion (ROM), and it is commonly believed that effective clinical management of osteoarthritis should address these impairments to reduce pain and disability. Therefore, the purpose of this study was to compare the short- and long-term effects of 4months of physiotherapist-supervised strength training, physiotherapist-supervised Nordic Walking (NW), or unsupervised home-based exercise (HBE) on muscle function and hip ROM in patients diagnosed with hip osteoarthritis. Secondary outcome analyses from an observer-blinded three-armed parallel-design randomized controlled trial in 60+-year-old patients with clinical hip osteoarthritis (American College of Rheumatology criteria) who were not on a waiting list for hip replacement. One hundred and fifty-two patients were randomized to either 4months of physiotherapist-supervised, moderate, progressive, strength training (n=50), physiotherapist-supervised NW (n=50), or unsupervised HBE (n=52). Maximal isometric hip and thigh muscle strength and leg extensor power and active hip ROM were assessed at baseline 2, 4, and 12months. Intention-to-treat-analyses did not show any significant between-group differences for improvements in muscle strength and power or ROM at any time points. Short-term significant (p<.05) increases in muscle strength were present in the physiotherapist-supervised exercise groups and in the long-term for muscle power in the NW-group. All exercise modes resulted in significant increases of ROM but long-term improvements were only shown for NW and HBE. Four months of physiotherapist-supervised, progressive, moderate, and strength training was less effective than hypothesized for improving muscle strength and power in patients with hip osteoarthritis who are not awaiting hip replacement. Our results may indicate that in these patients, improvements in disability are not necessarily dependent on improvements in strength and power or ROM.

Short- and long-term reliability of leg extensor power measurement in middle-aged and older adults

ABSTRACTMuscular power is important for maintaining physical functioning with aging. Proper quantification of the reliability of muscular power tests is crucial to inform monitoring of individuals and sample size planning for interventional studies. This study evaluated short- and long-term reliability of leg extensor power measurement in 72 adults (age 62.7 ± 8.6 years). Participants completed four repeat trials on the Nottingham leg extensor power rig, with a further trial twelve weeks later. Mean change, typical error, and intraclass correlation coefficients (ICC) were calculated. For short-term reliability, mean change in power output was trivial after two trials (1.2–4.8%). Typical errors were small following four trials in the dominant leg of males (10.9–5.8%), three in the non-dominant leg of males (9.9–6.2%) and the dominant leg of females (10.0–9.6%) and two in the non-dominant leg in females (8.3%). Intraclass correlation coefficients (ICCs) were very high (0.88–0.96). For long-term reliability, mean change remained trivial (1.0–2.5%), typical errors remained small (5.8–8.6%), and ICCs very high (0.94–0.96). The leg extensor power rig is a reliable method for assessing lower body muscular power, both short- and long-term, with only minimal habituation effects.

Physical activity as intervention for age-related loss of muscle mass and function: protocol for a randomised controlled trial (the LISA study)

IntroductionPhysical and cognitive function decline with age, accelerating during the 6th decade. Loss of muscle power (force×velocity product) is a dominant physical determinant for loss of functional ability, especially if...

Body Composition, Neuromuscular Performance, and Mobility: Comparison Between Regularly Exercising and Inactive Older Women.

The purpose of this study was to evaluate the differences in body composition, neuromuscular performance, and mobility in healthy, regularly exercising and inactive older women, and examine the relationship between skeletal muscle indices and mobility. Overall, 32 healthy older women participated. They were divided into groups according to their physical activity history as regularly exercising (n = 22) and inactive (n = 10) women. Body composition, hand grip strength, leg extensor muscle strength, rapid force development, power output, and mobility indices were assessed. Regularly exercising women had lower fat mass and higher values for leg extensor muscle strength and muscle quality, and also for mobility. Leg extensor muscle strength and power output during vertical jumping and appendicular lean mass per unit of body mass were associated with mobility in healthy older women. It was concluded that long-term regular exercising may have beneficial effects on body composition and physical function in older women.

Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study

Purpose: To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers.Methods: Seventy-two patients (60–87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63–82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy.Results: The symptomatic extremity in patients was significantly (p < 0.05, paired t-test) weaker compared with the non-symptomatic extremity for five hip muscles (8–17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p < 0.05) comparable to that found in patients, but had no asymmetry in leg extensor power.Conclusions: Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis.Implications for RehabilitationEven in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present.Between-leg differences in leg extensor power (force × velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry.Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity.Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip replacement.

What is a Clinically Meaningful Improvement in Leg-Extensor Power for Mobility-limited Older Adults?

Muscle power is a key predictor of physical function in older adults; however, clinically meaningful improvements in leg-extensor muscle power have yet to be identified. The purpose of this study is to establish the minimal clinically important improvement (MCII) and substantial improvement (SI) for leg-extensor power and muscle contraction velocity in mobility-limited older adults. Data were extracted from three randomized trials of leg-extensor muscle power training interventions (3- to 6-month duration). Measurements of leg-extensor power and velocity were obtained using dynamic bilateral leg press at 40% and 70% of the one-repetition maximum. Anchor-based MCIIs were calculated using selected items extracted from the Late Life Function and Disability Instrument. Standard error of measurement and effect size methods were used to calculate the distribution-based MCII. Data from 164 participants (mean age: 76.6 ± 5.6 years; Short Physical Performance Battery score: 7.8 ± 1.3) were used in this analysis. The respective MCII and SI estimates for 40% leg-extensor power were 18.3 (9%) and 30.5 (15%) W, and 23.1 (10%) and 41.6 (18%) W for 70% leg-extensor power. The respective MCII and SI estimates for 40% average velocity were 0.03(7%) and 0.08(18%) m/s, and 0.02(6%) and 0.05(15%) m/s for 70% average velocity. This is the first study to establish a clinically meaningful improvement of leg-extensor power (9%-10%) and velocity (6%-7%) in mobility-limited older adults. These findings should be used to aid in the design and interpretation of clinical trials and interventions that target improvements in muscle power in this high-risk population.

Association between accelerometer-measured physical activity and muscle capacity in middle-aged postmenopausal women.

Greater muscle strength and power are associated with better physical function in middle-aged and older women. The aim of the present study was to determine whether accelerometer-measured physical activity was associated with muscle strength and power in middle-aged postmenopausal women. Postmenopausal women (N = 60; mean [SD] age, 58.9 [3.9] y) were assessed for physical activity (step count and moderate to vigorous physical activity [MVPA]) via accelerometer, for body composition via dual-energy x-ray absorptiometry, for concentric isokinetic knee torque at 60°/s and 180°/s using isokinetic dynamometry, and for leg extensor power with the Nottingham power rig. In linear regression analysis, daily step count was independently associated with isokinetic knee torque at 60°/s (standardized β = 0.32, P = 0.01), isokinetic knee torque at 180°/s (standardized β = 0.32, P = 0.01), and total leg extensor power (β = 0.36, P = 0.01) after adjustment for covariates. Daily MVPA had similar associations with isokinetic knee torque at 60°/s (β = 0.38, P < 0.01), isokinetic knee torque at 180°/s (β = 0.41, P < 0.01), and leg power (β = 0.31, P = 0.02). Analysis of covariance indicated that women who engaged in MVPA for 30 minutes or more per day produced significantly greater isokinetic knee torque (60°/s and 180°/s) and leg extensor power compared with women not meeting this guideline (all P < 0.05). These findings suggest that daily step count and MVPA are independently associated with muscle strength and power in middle-aged postmenopausal women. Future studies should determine whether interventions that increase habitual physical activity in middle-aged women are associated with concomitant improvements in muscle capacity.

Effect of resistance training using bodyweight in the elderly: Comparison of resistance exercise movement between slow and normal speed movement

The present study investigated whether a slow movement protocol can be applied to resistance training using bodyweight. In addition, the intervention program combined plyometric exercise with resistance exercise to improve physical function overall. A total of 39 active elderly adults participated in a 16-week intervention. The program consisted of five resistance exercises and four plyometric exercises using their own bodyweight with a single set for each exercise. Participants were assigned to one of two experimental groups. One group carried out resistance exercise with slow movement and tonic force generation (3-s concentric, 3-s eccentric and 1-s isometric actions with no rest between each repetition). The other group as a movement comparison followed the same regimen, but at normal speed (1-s eccentric and 1-s concentric actions with 1-s rest between each repetition). Muscle size, strength and physical function were measured before and after the intervention period. After the intervention, strengths of upper and lower limbs, and maximum leg extensor power were significantly improved in both groups. Muscle size did not change in either group. There were no significant differences in any of the parameters between groups. The intervention program using only own bodyweight that comprised resistance exercise with slow movement and plyometric exercise can improve physical function in the elderly, even with single sets for each exercise. However, there was no enhanced muscle hypertrophic effect. Further attempts, such as increasing performing multiple sets, would be required to induce muscle hypertrophy. Geriatr Gerontol Int 2015; 15: 1270-1277.

Adiposity, physical activity, and muscle quality are independently related to physical function performance in middle-aged postmenopausal women

Poor physical function performance is associated with risks for disability in late life; however, determinants of physical function are not well characterized in middle-aged women. The aim of this cross-sectional study was to examine the contributions of body composition, physical activity, muscle capacity, and muscle quality to physical function performance. Postmenopausal women (N = 64; mean [SD] age, 58.6 [3.6] y) were assessed for body composition via dual-energy x-ray absorptiometry, for physical activity via accelerometer (steps per day), and for physical function via Timed Up and Go, 30-second chair stand, and 6-minute walk. Leg strength was assessed using isokinetic dynamometry at 60° second. Leg power was assessed with the Nottingham Leg Extensor Power Rig. Muscle quality was calculated as (1) the ratio of leg strength at 60° second to upper leg lean mass and (2) the ratio of leg power to total lower body lean mass. Regression analyses revealed the following: (1) age and muscle quality calculated with leg power are independently related to Timed Up and Go, explaining 12% and 11% of the variance, respectively (P < 0.05); (2) age and muscle quality calculated with leg strength are independently related to 30-second chair stand, explaining 12% and 10% of the variance, respectively (P < 0.05); and (3) number of medical conditions, muscle quality calculated with leg strength, steps per day, and adiposity are independent predictors of 6-minute walk, collectively explaining 51% of the variance. In postmenopausal women, a more optimal body composition (including lower adiposity and higher lean mass) and higher levels of physical activity are associated with better physical function performance at midlife.

Reliability and relationships among handgrip strength, leg extensor strength and power, and balance in older men

PurposeTo quantify the reliability of isometric leg extension torque (LEMVC), rate of torque development (LERTD), isometric handgrip force (HGMVC) and RFD (HGRFD), isokinetic leg extension torque and power at 1.05rad·s−1 and 3.14rad·s−1; and explore relationships among strength, power, and balance in older men. MethodsSixteen older men completed 3 isometric handgrips, 3 isometric leg extensions, and 3 isokinetic leg extensions at 1.05rad·s−1 and 3.14rad·s−1 during two visits. Intraclass correlation coefficients (ICCs), ICC confidence intervals (95% CI), coefficients of variation (CVs), and Pearson correlation coefficients were calculated. ResultsLERTD demonstrated no reliability. The CVs for LERTD and HGRFD were ≤23.26%. HGMVC wasn't related to leg extension torque or power, or balance (r=0.14–0.47; p>0.05). However, moderate to strong relationships were found among isokinetic leg extension torque at 1.05rad·s−1 and 3.14rad·s−1, leg extension mean power at 1.05rad·s−1, and functional reach (r=0.51–0.95; p≤0.05). ConclusionsLERTD and HGRFD weren't reliable and shouldn't be used as outcome variables in older men. Handgrip strength may not be an appropriate surrogate for lower body strength, power, or balance. Instead, perhaps handgrip strength should only be used to describe upper body strength or functionality, which may compliment isokinetic assessments of lower body strength, which were reliable and related to balance.

SAT0451 Supervised Strength Training, NORDIC Walking or Unsupervised Home Based Exercise in Older People with Hip Osteoarthritis? A Randomized Trial

BackgroundHip osteoarthritis (OA) is a leading cause of pain and functional limitations (1). Current international guidelines recommend exercise as part of the core management for people with Hip OA but...

Block-step asymmetry 5 years after large-head metal-on-metal total hip arthroplasty is related to lower muscle mass and leg power on the implant side

BackgroundMetal-on-metal articulations mimic the human hip anatomy, presumably lower dislocation rates and increase the range-of-motion. This study aims to measure the muscle mass and power of both legs in patients with unilateral metal-on-metal total hip arthroplasty, and to investigate their effect on block-step test, spatio-temporal gait parameters and self-reported function. MethodsTwenty-eight patients (7 women), mean age 50 (28–68) years, participated in a 5–7year follow-up. Patients had received one type unilateral large-head metal-on-metal total hip articulation, all of which were well-functioning at follow-up. Mean muscle mass was measured by the total-body Dual energy X-ray Absorption scans, and muscle power was measured in a leg extensor power rig. Block-step test and spatio-temporal gait parameters were measured with an inertial measurement unit. Self-reported function was assessed by the Hip Disability and Osteoarthritis Outcome Score. FindingsWe found a significant difference between the mean muscle mass of the implant-side leg and the non-implant-side leg in hip, thigh and calf areas (P<0.008) and in mean muscle power (P=0.025). Correlations between mean muscle mass and mean muscle power were significant for both the implant-side leg (r=0.45, P=0.018) and the non-implant-side leg (r=0.51, P=0.007). The difference in mean muscle power between legs correlated with block-step test asymmetry during ascending (r=0.40, P=0.047) and descending (r=0.53, P=0.006). Correlations between self-reported function and power of the implant-side leg were not significant. InterpretationsYoung patients have not fully regained muscle mass, muscle power and function 5–7years after metal-on-metal total hip arthroplasty.

Association of vitamin D level, leg extensor power, and neuromuscular function in mobility‐limited older adults (863.7)

Purpose: Low vitamin D level is associated with poor muscle strength in older adults, but little is known about its relationship with muscle power and neuromuscular function in a mobility‐limited population. This study examines the cross‐sectional relationship between vitamin D level, leg power, and neuromuscular activation in mobility‐limited older adults.Methods: Sixty‐two mobility‐limited older adults completed the study (age= 77.2±4.7 years; Short Physical Performance Battery score = 7.8±1.2). Leg extensor peak power was assessed using bilateral leg press exercise and rate of vastus lateralis neuromuscular activation was assessed using surface electromyography.Results: As vitamin D level increased, a decrease was seen in muscle power (r= ‐0.27, p= .04) and neuromuscular activation (r= ‐.45, p= .06). Neuromuscular activation was significantly higher in subjects with vitamin D &lt;30 ng/ml compared to those 蠅30 (.24±.09 vs. .11±.14, respectively; p= .02).Conclusion: This data suggests a negative association between vitamin D level, leg power and neuromuscular function, though further analysis is needed to confirm these findings.Grant Funding Source: USDA (58‐1950‐0‐014)

The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction.

Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94%) of the noninjured leg, decreasing to 64% (95% CI 60–69%) 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P = 0.020). Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity.

Intra-rater reliability and agreement of muscle strength, power and functional performance measures in patients with hip osteoarthritis.

To investigate the reliability and agreement of measures of lower extremity muscle strength, power and functional performance in patients with hip osteoarthritis at different time intervals, and to compare these with the same measures in healthy peers. Intra-rater test-retest separated by 1, 2, or 2.5 weeks in patients, and 1 week in healthy peers. Patients with hip osteoarthritis (age range 61-83 years) with 1 (n = 37), 2 (n = 35), or 2.5 weeks (n = 15) between tests, and 35 healthy peers (age range 63-82 years). Maximal isometric hip and thigh strength, leg extensor power, and functional performance (8-foot Up & Go, stair climbing, chair stand and 6-min walk) were measured in patients, and quadriceps strength, leg extensor power and functional performance were measured in healthy peers. Systematic error, reliability and agreement were calculated. Most hip strength measurements for the most symptomatic extremity, and nearly all strength measurements for the least symptomatic lower extremity, declined after 1 week (p < 0.05), but not after a 2.5-week interval. In healthy peers, quadriceps strength was unchanged. Regardless of the time interval, leg extensor power was unchanged, while functional performances improved at retest for all participants. In patients with hip osteoarthritis leg extensor power is unaffected by the time interval between tests, in contrast to muscle strength and functional performance.

Functional adaptation of tendon and skeletal muscle to resistence training in three patients with genetically verified clasic Ehlers Danlos Syndrome

tendon and skeletal muscle function adapts to physical training of resistive nature, but it is unknown to what extent persons with genetically altered connective tissue - who have a higher than normal tendon extensibility - will obtain any effect upon their tendon and muscle when undergoing muscle strength training. We investigated patients with classical Ehlers Danlos Syndrome (EDS) (collagen type V defect) who display articular hypermobility, skin extensibility and tissue fragility. subjects underwent strength training 3 times a week for 4 months and were tested before and after intervention in regards to muscle strength, tendon mechanical properties, and muscle function. three subjects completed the scheduled 48 sessions and had no major adverse events. Mean isometric leg extension force and leg extensor power both increased by 8 and 11% respectively (358 to 397 N, and 117 to 123 W). The tendon stiffness was tested and an average increase in response to physical training, from 1795 to 2519 N/mm was found. On average, the training loads both in upper and lower body exercises increased by around 30% over the training period. When testing balance, the average sway-area of the participants decreased by 26% (0.144 to 0.108 m(2)). On the subscale of CIS20 the participants lowered their average subjective fatigue score from 33 to 25. in this small pilot study, heavy resistance training was both feasible and effective in classic Ehlers Danlos patients, and the results indicated that both tendon and skeletal muscle properties can be improved also in this patient group when they are subjected to resistance training.

Muscle ‘regenerative potential’ determines physical recovery following total knee replacement

ObjectivesLower limb muscle power is thought to influence outcome following total knee replacement (TKR). Post-operative deficits in muscle strength are commonly reported, although not explained. We hypothesised that post-operative recovery of lower limb muscle power would be influenced by the number of satellite cells in the quadriceps muscle at time of surgery. MethodsBiopsies were obtained from 29 patients undergoing TKR. Power output was assessed pre-operatively and at six and 26 weeks post-operatively with a Leg Extensor Power Rig and data were scaled for body weight. Satellite cell content was assessed in two separate analyses, the first cohort (n = 18) using immunohistochemistry and the second (n = 11) by a new quantitative polymerase chain reaction (q-PCR) protocol for Pax-7 (generic satellite cell marker) and Neural Cell Adhesion Molecule (NCAM; marker of activated cells).ResultsA significant improvement in power output was observed post-operatively with a mean improvement of 19.7 W (95% confidence interval (CI) 14.43 to 30.07; p < 0.001) in the first cohort and 27.5 W (95% CI 13.2 to 41.9; p = 0.002) in the second. A strong correlation was noted between satellite cell number (immunohistochemistry) and improvement in patient power output (r = 0.64, p = 0.008). Strong correlation was also observed between the expression of Pax-7 and power output (r = 0.79, p = 0.004), and the expression of NCAM and power output (r = 0.84, p = 0.001). The generic marker explained 58% of the variation in power output, and the marker of activated cells 67%.ConclusionsMuscle satellite cell content may determine improvement in lower limb power generation (and thus function) following TKR.

Incorporating topography in a cellular automata model to simulate residents evacuation in a mountain area in China

In China, both the mountainous areas and the number of people who live in mountain areas occupy a significant proportion. When production accidents or natural disasters happen, the residents in mountain areas should be evacuated and the evacuation is of obvious importance to public safety. But it is a pity that there are few studies on safety evacuation in rough terrain. The particularity of the complex terrain in mountain areas, however, makes it difficult to study pedestrian evacuation. In this paper, a three-dimensional surface cellular automata model is proposed to numerically simulate the real time dynamic evacuation of residents. The model takes into account topographic characteristics (the slope gradient) of the environment and the biomechanics characteristics (weight and leg extensor power) of the residents to calculate the walking speed. This paper only focuses on the influence of topography and the physiological parameters are defined as constants according to a statistical report. Velocity varies with the topography. In order to simulate the behavior of a crowd with varying movement velocities, and a numerical algorithm is used to determine the time step of iteration. By doing so, a numerical simulation can be conducted in a 3D surface CA model. Moreover, considering residents evacuation around a gas well in a mountain area as a case, a visualization system for a three-dimensional simulation of pedestrian evacuation is developed. In the simulation process, population behaviors of congestion, queuing and collision avoidance can be observed. The simulation results are explained reasonably. Therefore, the model presented in this paper can realize a 3D dynamic simulation of pedestrian evacuation vividly in complex terrain and predict the evacuation procedure and evacuation time required, which can supply some valuable information for emergency management.

The Effects of High-Load Strength Training With Protein- or Nonprotein-Containing Nutritional Supplementation in Patients Undergoing Dialysis

The aim of this study was to investigate the effects of high-load strength training and protein intake in patients undergoing dialysis with a focus on muscle strength, physical performance, and muscle morphology. This was a randomized controlled study conducted in three dialysis centers. Subjects for the study included 29 patients undergoing dialysis. The participants went through a control period of 16 weeks before completing 16 weeks of strength training. Before the training period, the participants were randomly assigned to receive a protein or a nonprotein drink after every training session. Muscle strength and power were tested using the good strength equipment and the leg extensor power rig. Physical performance and function were assessed using a chair stand test and the Short Form 36 questionnaire. Muscle fiber type size and composition were analyzed in biopsies obtained from the m. vastus lateralis. All variables remained unchanged during the control period. After training, muscle strength and power, physical performance, and physical function increased significantly. Muscle fiber composition was changed by a relative decrease in type 2x muscle fiber number whereas muscle size at the fiber level was unchanged. There were no effects of combining the training with protein intake. High-load strength training is associated with improvements in muscle strength and power, physical performance, and quality of life. The effects were surprisingly not associated with muscle hypertrophy, and the results did not reveal any additional benefit of combining the training with protein intake. The positive results in muscle strength and physical performance have clinically relevant implications in the treatment of patients undergoing dialysis.