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Pearson LT, Behm DG, Goodall S, Mason R, Stuart S, Barry G. Effects of maximal-versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2022; 14:129. [PMID: 35842655 PMCID: PMC9287903 DOI: 10.1186/s13102-022-00526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
Abstract
The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT’s) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move ‘as fast as possible’ during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: − 1.74 [95% CI − 2.79, − 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: − 1.21, [95% CI − 2.17, − 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: − 0.84, [95% CI − 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: − 0.57, [95% CI − 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality (“low” PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible.
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Affiliation(s)
- Liam T Pearson
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK.
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Canada
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Rachel Mason
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK.,Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
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Azharuddin M, Zia NU. Correlation between sit-to-stand ability, dynamic balance, gait speed, and quality of life in stroke population: a non-randomized pilot study. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2021. [DOI: 10.1186/s43161-021-00043-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
“Sit to stand” being a prerequisite for walking, the inability of patients to perform it can result in institutionalization, impaired functioning and mobility in activities of daily living. There was a need to find out whether “sit to stand” ability correlates with gait speed, dynamic balance, and quality of life in stroke patients. It is a pilot study in which sixteen sub-acute and chronic stroke (˃ 6 months) patients aged 45 to 65 years with the ability to walk at least 10 m, Mini Mental State Examination (MMSE) score ˃ 27 were included. Patients with musculoskeletal impairments of lower extremity which would affect walking were excluded from the study. Each patient performed five times sit to stand (5TSTS) from a standard chair and time taken was recorded. Timed up and go (TUG) test and 10-m walk test (10MWT) were used to measure the dynamic balance and gait speed respectively. Stroke Adapted Sickness Impact Profile-30 (SASIP-30) scale was used to determine the quality of life of the patients.
Results
Correlation between the outcomes of the variables was analyzed using Pearson correlation co-efficient. The 5TSTS scores showed strong positive correlation to TUG (r = 0.823, P < .000) and SASIP-30 (r = 0.841, P < .000). However, moderately strong negative relationship was found between 5TSTS and gait speed (r = −0.639, P < .008).
Conclusion
The study concludes that change in the 5TSTS performance can affect motor functions like dynamic balance and gait as well as quality of life. Exercise training focusing on sit-to-stand ability may also influence activities of daily living (ADLs) after stroke.
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Frydendal T, Christensen R, Mechlenburg I, Mikkelsen LR, Overgaard S, Ingwersen KG. Total hip arthroplasty versus progressive resistance training in patients with severe hip osteoarthritis: protocol for a multicentre, parallel-group, randomised controlled superiority trial. BMJ Open 2021; 11:e051392. [PMID: 34686555 PMCID: PMC8543646 DOI: 10.1136/bmjopen-2021-051392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Hip osteoarthritis (OA) is the leading cause for total hip arthroplasty (THA). Although, being considered as the surgery of the century up to 23% of the patients report long-term pain, and deficits in physical function and muscle strength may persist after THA. Progressive resistance training (PRT) appears to improve multiple outcomes moderately in patients with hip OA. Current treatment selection is based on low-level evidence as no randomised controlled trials have compared THA to non-surgical treatment. The primary aim of this trial is to investigate whether THA followed by standard care is superior to 12 weeks of supervised PRT followed by 12 weeks of optional unsupervised PRT for improving hip pain and function in patients with severe hip OA. METHODS AND ANALYSIS This is a protocol for a multicentre, parallel-group, assessor-blinded, randomised controlled superiority trial conducted at four hospitals across three healthcare regions in Denmark. 120 patients aged ≥50 years with clinical and radiographic hip OA found eligible for THA by an orthopaedic surgeon will be randomised to THA followed by standard care, or 12 weeks of PRT (allocation 1:1). The primary outcome will be change in patient-reported hip pain and function, measured using the Oxford Hip Score, from baseline to 6 months after initiating the treatment. Key secondary outcomes will be change in the Hip disability and Osteoarthritis Outcome Score subscales, University of California Los Angeles Activity Score, 40 m fast-paced walk test, 30 s chair stand test and occurrence of serious adverse events. Patients declining participation in the trial will be invited into a prospective observational cohort study. ETHICS AND DISSEMINATION The trial has been approved by The Regional Committees on Health Research Ethics for Southern Denmark (Project-ID: S-20180158). All results will be presented in peer-reviewed scientific journals and international conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04070027).
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Affiliation(s)
- Thomas Frydendal
- Department of Physio- and Occupational Therapy, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, Odense, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lone Ramer Mikkelsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Gordon Ingwersen
- Department of Physio- and Occupational Therapy, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Cruvinel Júnior RH, Ferreira JSSP, Beteli RI, Silva ÉQ, Veríssimo JL, Monteiro RL, Suda EY, Sacco ICN. Foot-ankle functional outcomes of using the Diabetic Foot Guidance System (SOPeD) for people with diabetic neuropathy: a feasibility study for the single-blind randomized controlled FOotCAre (FOCA) trial I. Pilot Feasibility Stud 2021; 7:87. [PMID: 33766146 PMCID: PMC7995736 DOI: 10.1186/s40814-021-00826-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/18/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Diabetic neuropathy dramatically affects musculoskeletal structure and function of the lower limbs by impairing their muscle strength and mobility. Specific muscle strengthening through physiotherapy strategies appears to be promising; however, adherence to physiotherapy treatment is low in people with chronic diseases. Thus, an internet-based foot-ankle exercise program was created as a potential telerehabilitation alternative for people with diabetes to improve their self-monitoring and self-care management. This study assessed the feasibility, safety, acceptability, and changes in foot health and neuropathy symptoms in people with diabetes after 12 weeks of the intervention program with the Sistema de Orientação ao Pé diabético - Diabetic Foot Guidance System (SOPeD). METHODS Fourteen individuals were recruited and randomized to either the usual care (control group) or usual care plus an internet-based foot-ankle exercise program through SOPeD (intervention group) three times per week for 12 weeks. For feasibility, we assessed contact and recruitment rates per week; program adherence, determined as completing over 70% of the 36 sessions; and participant satisfaction and safety assessed through a questionnaire and scored on a 5-point Likert scale. We assessed changes in neuropathy symptoms and foot health and functionality from baseline to 12 weeks estimating differences or median of differences and 95% confidence intervals in the intervention group. RESULTS In 24 weeks, of the 822 patients in the database, 192 were contacted, 65 were assessed for eligibility, and 20 were considered eligible. The recruitment rate was 0.83 participants per week. Fourteen out of the 20 eligible participants agreed to participate, resulting in recruitment success of 70%. Adherence to the program was 66.7%, and there was no dropout. Participants' median level of satisfaction was 5.0 (IQR: 4.5-5.0) and perceived safety was 5.0 (IQR: 5.0-5.0). CONCLUSION The internet-based foot-ankle exercise program using SOPeD is feasible, satisfactory, and safe. Although this study had moderate adherence and a zero-dropout rate, recruitment needs to be improved in the larger trial. TRIAL REGISTRATION ClinicalTrials.gov, NCT04011267 . Registered on 8 July 2019.
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Affiliation(s)
- Ronaldo H Cruvinel Júnior
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Jane S S P Ferreira
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Raquel I Beteli
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Érica Q Silva
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Jady L Veríssimo
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Renan L Monteiro
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
- Department of Physical Therapy, Federal University of Amapá, Amapá, Brazil
| | - Eneida Y Suda
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
- Department of Physical Therapy, Ibirapuera University, São Paulo, SP, Brazil
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil.
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Elam C, Aagaard P, Slinde F, Svantesson U, Hulthén L, Magnusson PS, Bunketorp-Käll L. The effects of ageing on functional capacity and stretch-shortening cycle muscle power. J Phys Ther Sci 2021; 33:250-260. [PMID: 33814713 PMCID: PMC8012187 DOI: 10.1589/jpts.33.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022] Open
Abstract
[Purpose] To examine the effects of age and gender in an ageing population with respect
to functional decline and the relationship between muscle power and functional capacity.
[Participants and Methods] The cohort (N=154) was subdivided into youngest-old
(65–70 years.; n=62), middle-old (71–75 years.; n=46), and oldest-old (76–81 years.;
n=46). Measures of mechanical muscle function included countermovement jump height, muscle
power, leg strength and grip strength. Functional performance-based measures included
heel-rise, postural balance, Timed Up and Go, and gait speed. [Results] The oldest-old
performed significantly worse than the middle-old, whereas the youngest-old did not
outperform the middle-old to the same extent. Increased contribution of muscle power was
observed with increasing age. Males had consistently higher scores in measures of
mechanical muscle function, whereas no gender differences were observed for functional
capacity. [Conclusion] The age-related decline in functional capacity appears to
accelerate when approaching 80 years of age and lower limb muscle power seems to
contribute to a greater extent to the preservation of functional balance and gait capacity
at that stage. Males outperform females in measures of mechanical muscle function
independent of age, while the findings give no support for the existence of gender
differences in functional capacity.
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Affiliation(s)
- Cecilia Elam
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Frode Slinde
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Sweden
| | - Ulla Svantesson
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
| | - Lena Hulthén
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Peter S Magnusson
- Department of Physical Therapy, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Denmark.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Lina Bunketorp-Käll
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
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Effects of Power on Balance and Fall Prevention in Aging and Older Adults. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Askow AT, McKenna CF, Box AG, Khan NA, Petruzzello SJ, De Lisio M, Phillips SM, Burd NA. Of Sound Mind and Body: Exploring the Diet-Strength Interaction in Healthy Aging. Front Nutr 2020; 7:145. [PMID: 32984401 PMCID: PMC7485317 DOI: 10.3389/fnut.2020.00145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/23/2020] [Indexed: 12/26/2022] Open
Abstract
Strength is a vital component of healthy aging. However, “strength” comes in different forms (includes both physical and mental aspects) and can look different at various phases of adult life. Healthy eating and regular exercise are clearly important pillars for strength. This paper proposes a framework that underlines the value of protein foods and resistance exercise for aging strong.
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Affiliation(s)
- Andrew T Askow
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Colleen F McKenna
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Allyson G Box
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Michael De Lisio
- Department of Cellular and Molecular Medicine, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Bårdstu HB, Andersen V, Fimland MS, Aasdahl L, Raastad T, Cumming KT, Sæterbakken AH. Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: a cluster-randomized controlled trial. Eur Rev Aging Phys Act 2020; 17:11. [PMID: 32782626 PMCID: PMC7414534 DOI: 10.1186/s11556-020-00243-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022] Open
Abstract
Background Aging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults' real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care. Methods This open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80-90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition. Results Twelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56-64 (6-7 clusters) in RTG and 20-42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9-24%, p = 0.01-0.03) compared to CG. No effects were seen for rate of force development or body composition. Conclusion This study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care. Trial registration ISRCTN1067873.
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Affiliation(s)
- Hilde Bremseth Bårdstu
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vidar Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Lene Aasdahl
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristoffer T Cumming
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Vestfold, Norway.,Faculty of Health and Welfare, Østfold University College, Fredrikstad, Norway
| | - Atle Hole Sæterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway
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Carvalho LP, Pion CH, El Hajj Boutros G, Gaudreau P, Chevalier S, Bélanger M, Morais JA, Aubertin-Leheudre M. Effect of a 12-week mixed power training on physical function in dynapenic-obese older men: does severity of dynapenia matter? Aging Clin Exp Res 2019; 31:977-984. [PMID: 30293107 DOI: 10.1007/s40520-018-1048-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/24/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Mobility disability affects nearly 15% of people aged 65 or over worldwide. Excess weight or obesity (OB), along with an accentuated loss of muscle strength (dynapenia), is recognized to be one of the most common risk factors for mobility impairment among the elderly. OBJECTIVE To investigate the effect of a 12-week mixed power training (MPT high-velocity resistance training mixed with functional exercises) on physical function in obese older men exhibiting different severities of dynapenia. METHODS Community-dwelling older men (69 ± 6 years) were assigned to the study if they were considered obese (OB, fat mass ≥ 25% body weight, BW) and to one of the two groups according to severity of dynapenia [(handgrip strength-HS)/BW]: type 1(OB-DY1) or type 2(OB-DY2), < 1 or 2SD from a young reference group. Participants followed a 12-week MPT, three times/week, 75 min/session. Main outcomes included the performance on the 4-m and 6-min walking tests, Timed Up and Go, stair and balance tests. RESULTS AND DISCUSSION At baseline, OB-DY1 performed better than OB-DY2 in all functional tests (p < 0.05). Following the intervention, medium-to-large training effect size (ES) were observed for fat (ES = 0.21) and lean (ES = 0.32, p < 0.001) masses, functional performance (ES 0.11-0.54, p < 0.05), HS (ES = 0.10, p < 0.05) and lower limb muscle strength (ES = 0.67, p < 0.001) and power (ES = 0.60, p < 0.05). Training-by-group interaction showed that OB-DY1 lost more FM (ES = 0.11, p = 0.03) and OB-DY2 improved more HS (ES = 0.19, p = 0.006) than their counterparts. CONCLUSIONS Seniors with obesity and severe dynapenia have poorer physical function than those in the early stage of dynapenia. Both seem to benefit from a high-velocity resistance training mixed with functional exercises, although by slightly different pathways.
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Affiliation(s)
- Livia P Carvalho
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada.
| | - Charlotte H Pion
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
- Département de Biologie, Université du Québec à Montréal, Montreal, Canada
| | - Guy El Hajj Boutros
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
| | - Pierrette Gaudreau
- Centre Hospitalier de l'Université de Montréal, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Stéphanie Chevalier
- McGill University Health Centre, Research Institute and Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Marc Bélanger
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
| | - José A Morais
- McGill University Health Centre, Research Institute and Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Mylène Aubertin-Leheudre
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
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11
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Buskard A, Zalma B, Cherup N, Armitage C, Dent C, Signorile JF. Effects of linear periodization versus daily undulating periodization on neuromuscular performance and activities of daily living in an elderly population. Exp Gerontol 2018; 113:199-208. [PMID: 30316811 DOI: 10.1016/j.exger.2018.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/05/2018] [Accepted: 09/28/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Periodization is a systematic training calendar designed to provide variations in performance targeting, while maximizing results and reducing the potential for overtraining. When provided across multiple weeks, termed a mesocycle, it may also incorporate active recovery periods using specified drills designed to translate neuromuscular gains into targeted functional abilities. There are a number of models that can be used when applying periodization to resistance training (RT). Among the most common are the linear (LP) and daily fixed non-linear (NLP) models. It is currently unknown whether an optimal periodization strategy exists that will maximize benefits for older adults; therefore, we compared the impact of these two periodization models on neuromuscular and functional measures in a group of older persons living independently in the community. METHODS Thirty-six older adults, 58-80 years of age, were randomly assigned to either a LP (n = 16; 69.3 ± 4.6 y) or NLP (n = 14; 68.9 ± 6.7 y) group. The LP group performed 12 weeks of training comprised of separate 4-week strength and power training cycles, each followed by a 2-week recovery period incorporating translational exercises. The NLP group performed the strength, power, and translational training on three separate days during the week. Neuromuscular testing included seated chest press and leg press strength and power tests, while physical function testing included the gallon jug shelf test, laundry transfer test, floor stand-up, chair-to-stand test, and 8 foot timed up-and-go. RESULTS 3 (time) × 2 (sex) × 2 (group) repeated measures ANOVA revealed both periodization strategies were equally effective at inducing neuromuscular and functional improvements and that men generally produced more strength and power than women. CONCLUSIONS Both LP and NLP can be used to improve strength, power, and functional performance in healthy untrained older adults when strength, power and functional training cycles are involved. Therefore, personal preference and variety should be considered when deciding which approach to use, provided high-speed power and translational recovery components are included.
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Affiliation(s)
- Andrew Buskard
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America
| | - Brian Zalma
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America
| | - Nicholes Cherup
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America
| | - Catherine Armitage
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America
| | - Craig Dent
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America
| | - Joseph F Signorile
- University of Miami, Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sports Sciences, Coral Gables, FL, United States of America; University of Miami Miller School of Medicine, Center on Aging, 1695 N.W. 9th Avenue Suite 3204, Miami, FL 33136, United States of America.
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12
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Pinho JP, Mezêncio B, Hernandez AJ, Bonato J, Masuko W, Soncin R, Claudino JG, Serrão JC, Amadio AC. MODERATE INTENSITY IS A BETTER STIMULUS TO INDUCE QUADRIPECS FEMORIS POWER IN ELDERLY ADULTS. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182403181345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: The best strategy for improving knee extensor power, a major functional capacity indicator in older adults, is power training. Nonetheless, the training intensity required to induce optimal gains is yet to be found. Objective: Our purpose was to compare knee extensor peak power responses between low, moderate, and high intensity load conditions (30%, 50% and 70% of 1RM). Methods: Thirteen sedentary elderly women performed six knee extensions in each load condition, calculating knee extensor mechanical work/power output and knee extension peak angular velocity. Results: No difference in peak power was found between the high (207.0 ± 68.1 W) and moderate (206.1 ± 71.6 W) load conditions (p = 0.994), and both had higher values (p ≤0.004) than the low intensity condition (135.6 ± 56.3 W). Conclusion: Moderate load at 50% of 1RM appears to be the preferred strategy for inducing knee extensor power output because in contrast with the high intensity condition, the moderate load yielded higher angular peak velocity, which is also a functional indicator. Level of Evidence ll; Therapeutic studies - Investigating treatment results.
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13
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Tan QLL, Chye LMY, Ng DHM, Chong MS, Ng TP, Wee SL. Feasibility of a community-based Functional Power Training program for older adults. Clin Interv Aging 2018; 13:309-316. [PMID: 29503535 PMCID: PMC5826088 DOI: 10.2147/cia.s157911] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose Community-based programs can increase and sustain physical activity participation in older adults, even for those who are physically frail. We studied the feasibility and potential effect of a 12-week structured Functional Power Training (FPT) program involving high velocities and low loads for older adults conducted in a common area of their housing estate. Patients and methods The structured FPT program was conducted in collaboration with a health promotion social enterprise and a community service provider based in a public housing site. We recruited nine inactive residents as participants to the single, group-based, twice-weekly program. Attendance and adverse event(s) were recorded throughout the program. The Short Physical Performance Battery, Timed Up and Go (TUG), and 30s Sit-to-Stand tests were used to assess functional outcomes pre- and postprogram. The FRAIL Scale was used to assess their frailty status, and a postprogram experience survey was conducted. Results Eight subjects (aged 74±10 years) completed the program with an average overall attendance of 90.3%, with at least five participants present for each session. Changes in functional outcomes showed a moderate-to-large effect with significant improvement in TUG (p<0.01). In addition, participants either reversed or maintained their frailty status (p<0.01). Overall, the program was perceived to be well structured, engaging, as well as providing physical and psychosocial benefits. No exercise-related adverse events occurred during the program, and participants were keen to recommend this program to others. Conclusion Community-based structured FPT is safe and feasible for frail older adults, with the potential to improve function and reverse frailty status.
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Affiliation(s)
- Queenie Lin Ling Tan
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore
| | - Lilian Min Yen Chye
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore
| | - Daniella Hui Min Ng
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore
| | - Mei Sian Chong
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore
| | - Tze Pin Ng
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore.,Department of Psychological Medicine, National University of Singapore, Singapore
| | - Shiou Liang Wee
- Frailty Research Program, Geriatric Education and Research Institute (GERI), Singapore.,Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore
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14
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Differences in muscle adaptation to a 12-week mixed power training in elderly men, depending on usual protein intake. Exp Gerontol 2018; 104:78-85. [PMID: 29421607 DOI: 10.1016/j.exger.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Normal aging is often associated with a decline of muscle mass (MM), strength (MS) and quality (MQ: MS/MM), leading to functional incapacities. This aging-related deterioration of muscles may involve a decreased protein intake. Mixed power training has been recently shown to induce positive effects on MM, MS and MQ. However, to our knowledge, no study has examined if muscle adaptations following mixed power training could be influenced by the daily amount of protein ingested in elderly men. METHODS Twenty-one men completed the intervention and were divided into 2 groups based on their usual protein intake: PROT 1.1- (<1.1 g·kg-1·d-1 [n = 10; 73 ± 3 years]) and PROT 1.2+ (>1.2 g·kg-1·d-1 [n = 11; 73 ± 3 years]). Body composition (DXA: lean and fat masses), MS (1-maximal repetition on leg-press and handgrip strength), MQ (MS/body mass and MS/lower limb lean mass), functional capacities (Short Physical Performance Battery/Senior Fitness Test), dietary intake (3-day food record) and energy expenditure (accelerometer; 7 days) were measured. Mixed power training intervention consisted in power and functional exercises (12 weeks; 3 times/week; 1 h/session). RESULTS Lower limb MS increase in the PROT 1.2+ group was greater from that of the PROT 1.1- group when normalized to lower limbs lean mass (p = 0.036). In addition, a trend for greater gain in lower limb MS normalized to body mass (p = 0.053) was observed in the PROT 1.2+. CONCLUSION To optimize mixed power training effects on muscle function, healthy older men should ingest daily at least 1.2 g·kg-1·d-1 of protein. These beneficial effects of a higher usual protein intake were observed especially for MQ, which is one of the best predictors of functional capacities in older adults.
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15
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Skeletal Muscle Power Measurement in Older People: A Systematic Review of Testing Protocols and Adverse Events. J Gerontol A Biol Sci Med Sci 2017; 73:914-924. [DOI: 10.1093/gerona/glx216] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/26/2017] [Indexed: 12/25/2022] Open
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16
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Straight CR, Lindheimer JB, Brady AO, Dishman RK, Evans EM. Effects of Resistance Training on Lower-Extremity Muscle Power in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med 2016; 46:353-64. [PMID: 26545362 DOI: 10.1007/s40279-015-0418-4] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Resistance training (RT) has been investigated as a potential intervention strategy for improving muscle function, but the effects on lower-extremity muscle power in middle-aged and older adults have not been systematically reviewed. OBJECTIVE The aim of this meta-analysis is to provide a quantitative estimate of the effect of RT on lower-extremity muscle power in middle-aged and older adults and to examine independent moderators of this relationship. METHODS Randomized controlled trials that examined the effects of RT on either leg press (LP) or knee extension (KE) muscle power in adults aged ≥50 years were included. Data were aggregated with meta-analytic techniques, and multi-level modeling was used to adjust for nesting effects. A total of 52 effects from 12 randomized controlled trials were analyzed with a random-effects model to estimate the effect of RT on lower-extremity muscle power. A multiple-regression analysis was conducted to examine independent moderators of the mean effect. RESULTS The adjusted aggregated results from all studies indicate that RT has a small-to-moderate effect on lower-extremity muscle power (Hedges' d = 0.34, 95% confidence interval [CI] 0.25-0.43), which translated to 54.90 watts (95 % CI 40.37-69.43). Meta-regression analyses indicated that high-velocity RT was superior to traditional RT (Δ = 0.62 vs. 0.20, respectively) for increasing lower-extremity muscle power. In addition, training volume significantly moderated the effect of RT on muscle power. CONCLUSION The findings from this meta-analysis indicate that RT is an efficacious intervention strategy for improving LP and KE muscle power in adults aged ≥50 years. Training mode and volume independently moderate the effect of RT on lower-extremity muscle power, and should be considered when prescribing RT exercise for middle-aged and older adults.
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Affiliation(s)
- Chad R Straight
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA.
| | - Jacob B Lindheimer
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA
| | - Anne O Brady
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA
| | - Ellen M Evans
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA
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17
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Ramirez-Campillo R, Diaz D, Martinez-Salazar C, Valdés-Badilla P, Delgado-Floody P, Méndez-Rebolledo G, Cañas-Jamet R, Cristi-Montero C, García-Hermoso A, Celis-Morales C, Moran J, Buford TW, Rodriguez-Mañas L, Alonso-Martinez AM, Izquierdo M. Effects of different doses of high-speed resistance training on physical performance and quality of life in older women: a randomized controlled trial. Clin Interv Aging 2016; 11:1797-1804. [PMID: 28008239 PMCID: PMC5167493 DOI: 10.2147/cia.s121313] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to compare the effects of two frequencies of high-speed resistance training (HSRT) on physical performance and quality of life of older women. METHODS A total of 24 older women participated in a 12-week HSRT program composed of either two or three sessions/week (equated for volume and intensity). Women were randomized into three arms: a control group (CG, n=8), a resistance training group performing two sessions/week (RT2, n=8), and a resistance training group performing three sessions/week (RT3, n=8). The training program for both experimental groups included exercises that required high-speed concentric muscle actions. RESULTS No baseline differences were observed among groups. Compared with the CG, both training groups showed similar small to moderate improvements (P<0.05) in muscle strength, power, functional performance, balance, and quality of life. CONCLUSION These results suggest that equated for volume and intensity, two and three training sessions/week of HSRT are equally effective for improving physical performance and quality of life of older women.
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Affiliation(s)
- Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences
- Laboratory of Measurement and Assessment in Sports, Research Nucleus in Health, Physical Activity and Sports, Universidad de Los Lagos, Osorno
- Unit of Integrative Physiology, Laboratory of Exercise Sciences, MEDS Clinic, Santiago, Chile
| | - Daniela Diaz
- School of Occupational Therapy, Faculty of Health, Universidad Santo Tomás, Osorno
| | | | - Pablo Valdés-Badilla
- Institute of Physical Activity and Health, Universidad Autónoma de Chile, Temuco
| | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera
| | | | - Rodrigo Cañas-Jamet
- Laboratory of Physiology, Department of Biological Sciences, Faculty of Biological Sciences, Universidad Andres Bello, Viña del Mar
- School of Kinesiology, Faculty of Medicine, Universidad Diego Portales, Santiago
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso
| | - Antonio García-Hermoso
- Laboratory of Physical Activity Sciences, Sport and Health, Faculty of Medical Sciences, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow
| | - Jason Moran
- Centre for Sports and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK
| | - Thomas W Buford
- Department of Aging and Geriatric Research, Institute of Aging, University of Florida, College of Medicine, Gainesville, Florida, USA
| | | | | | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, Navarre, Spain
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18
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Tiggemann CL, Dias CP, Radaelli R, Massa JC, Bortoluzzi R, Schoenell MCW, Noll M, Alberton CL, Kruel LFM. Effect of traditional resistance and power training using rated perceived exertion for enhancement of muscle strength, power, and functional performance. AGE (DORDRECHT, NETHERLANDS) 2016; 38:42. [PMID: 27009295 PMCID: PMC5005907 DOI: 10.1007/s11357-016-9904-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/11/2016] [Indexed: 06/05/2023]
Abstract
The present study compared the effects of 12 weeks of traditional resistance training and power training using rated perceived exertion (RPE) to determine training intensity on improvements in strength, muscle power, and ability to perform functional task in older women. Thirty healthy elderly women (60-75 years) were randomly assigned to traditional resistance training group (TRT; n = 15) or power training group (PT; n = 15). Participants trained twice a week for 12 weeks using six exercises. The training protocol was designed to ascertain that participants exercised at an RPE of 13-18 (on a 6-20 scale). Maximal dynamic strength, muscle power, and functional performance of lower limb muscles were assessed. Maximal dynamic strength muscle strength leg press (≈58 %) and knee extension (≈20 %) increased significantly (p < 0.001) and similarly in both groups after training. Muscle power also increased with training (≈27 %; p < 0.05), with no difference between groups. Both groups also improved their functional performance after training period (≈13 %; p < 0.001), with no difference between groups. The present study showed that TRT and PT using RPE scale to control intensity were significantly and similarly effective in improving maximal strength, muscle power, and functional performance of lower limbs in elderly women.
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Affiliation(s)
- Carlos Leandro Tiggemann
- Department of Sports, School of Physical Education, Faculty of Serra Gaúcha, Caxias do Sul, Brazil.
- Exercise Research Laboratory, School of Physical Education, Univates University Center, Lajeado, Brazil.
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Caroline Pieta Dias
- Department of Sports, School of Physical Education, Faculty of Serra Gaúcha, Caxias do Sul, Brazil
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Regis Radaelli
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jéssica Cassales Massa
- Department of Sports, School of Physical Education, Faculty of Serra Gaúcha, Caxias do Sul, Brazil
| | - Rafael Bortoluzzi
- Department of Sports, School of Physical Education, Faculty of Serra Gaúcha, Caxias do Sul, Brazil
| | - Maira Cristina Wolf Schoenell
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Matias Noll
- Goiano Federal Institute of Education, Science and Technology, Ceres, Brazil
| | - Cristine Lima Alberton
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Sports, School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Luiz Fernando Martins Kruel
- Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Hermann A, Holsgaard-Larsen A, Zerahn B, Mejdahl S, Overgaard S. Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty--a randomized controlled trial. Osteoarthritis Cartilage 2016; 24:91-8. [PMID: 26285180 DOI: 10.1016/j.joca.2015.07.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 07/19/2015] [Accepted: 07/30/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the efficacy and feasibility of progressive explosive-type resistance training (RT) in patients with osteoarthritis (OA) of the hip scheduled for total hip arthroplasty (THA). METHOD Randomized controlled trial (1:1) in patients diagnosed with hip OA and scheduled for THA. The intervention group (IG) performed supervised preoperative progressive explosive-type RT twice a week for 10 weeks; four exercises (hip/thigh) performed in three series each (8-12 repetition maximum). The control group (CG) received 'care as usual'. Efficacy was reported as the between-group difference in the Hip Osteoarthritis Outcome Score (HOOS) (primary endpoint; ADL function), and leg muscle power at post intervention follow-up immediate before surgery. Intention-to-treat analyses were performed in a multilevel regression model adjusting for baseline, sex, age and weight. Feasibility was reported as adherence, exercise related pain and adverse effects. Post-surgical follow up will be reported separately. ClinicalTrials.gov registration: NCT01164111. RESULTS Eighty patients (age 70.4 ± 7.6 years, BMI 27.8 ± 4.6, 52 females (65%) were included. Adherence was high (93%) with acceptable exercise related pain (VAS score ≤ 5) reported in 83% of sessions and no adverse events. Changes in HOOS 'function' was 10.0 points 95%CI [4.7; 15.3] higher in IG compared to CG (P < 0.001). For all the remaining HOOS subscales IG scored significantly better (P < 0.03) and had higher leg extension muscle power (P < 0.0001) compared to CG. CONCLUSION Progressive explosive-type RT was feasible in the included group of hip OA patients scheduled for THA and resulted in significant improvement in self-reported outcomes and increased leg muscle power.
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Affiliation(s)
- A Hermann
- Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Orthopedic Surgery, Herlev University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.
| | - A Holsgaard-Larsen
- Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark
| | - B Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev University Hospital, Denmark
| | - S Mejdahl
- Department of Orthopedic Surgery, Herlev University Hospital, Denmark
| | - S Overgaard
- Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark
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Medina-Perez C, de Souza-Teixeira F, Fernandez-Gonzalo R, Hernandez-Murua JA, Antonio de Paz-Fernandez J. Effects of high-speed power training on muscle strength and power in patients with multiple sclerosis. ACTA ACUST UNITED AC 2016; 53:359-68. [DOI: 10.1682/jrrd.2014.08.0186] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 07/16/2015] [Indexed: 11/05/2022]
Affiliation(s)
| | - Fernanda de Souza-Teixeira
- Department of Physical Education and Health, School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
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21
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Regnaux J, Lefevre‐Colau M, Trinquart L, Nguyen C, Boutron I, Brosseau L, Ravaud P. High-intensity versus low-intensity physical activity or exercise in people with hip or knee osteoarthritis. Cochrane Database Syst Rev 2015; 2015:CD010203. [PMID: 26513223 PMCID: PMC9270723 DOI: 10.1002/14651858.cd010203.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Exercise or physical activity is recommended for improving pain and functional status in people with knee or hip osteoarthritis. These are complex interventions whose effectiveness depends on one or more components that are often poorly identified. It has been suggested that health benefits may be greater with high-intensity rather than low-intensity exercise or physical activity. OBJECTIVES To determine the benefits and harms of high- versus low-intensity physical activity or exercise programs in people with hip or knee osteoarthritis. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; issue 06, 2014), MEDLINE (194 8 to June 2014) , EMBASE (198 0 to June 2014), CINAHL (1982 to June 2014), PEDro (1929 to June 2014), SCOPUS (to June 2014) and the World Health Organization (WHO) International Clinical Registry Platform (to June 2014) for articles, without a language restriction. We also handsearched relevant conference proceedings, trials, and reference lists and contacted researchers and experts in the field to identify additional studies. SELECTION CRITERIA We included randomized controlled trials of people with knee or hip osteoarthritis that compared high- versus low-intensity physical activity or exercise programs between the experimental and control group.High-intensity physical activity or exercise programs training had to refer to an increase in the overall amount of training time (frequency, duration, number of sessions) or the amount of work (strength, number of repetitions) or effort/energy expenditure (exertion, heart rate, effort). DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility and extracted data on trial details. We contacted authors for additional information if necessary. We assessed the quality of the body of evidence for these outcomes using the GRADE approach. MAIN RESULTS We included reports for six studies of 656 participants that compared high- and low-intensity exercise programs; five studies exclusively recruited people with symptomatic knee osteoarthritis (620 participants), and one study exclusively recruited people with hip or knee osteoarthritis (36 participants). The majority of the participants were females (70%). No studies evaluated physical activity programs. We found the overall quality of evidence to be low to very low due to concerns about study limitations and imprecision (small number of studies, large confidence intervals) for the major outcomes using the GRADE approach. Most of the studies had an unclear or high risk of bias for several domains, and we judged five of the six studies to be at high risk for performance, detection, and attrition bias.Low-quality evidence indicated reduced pain on a 20-point Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scale (mean difference (MD) -0.84, 95% confidence interval (CI) -1.63 to -0.04; 4% absolute reduction, 95% CI -8% to 0%; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 14 to 22) and improved physical function on the 68-point WOMAC disability subscale (MD -2.65, 95% CI -5.29 to -0.01; 4% absolute reduction; NNTB 10, 95% CI 8 to 13) immediately at the end of the exercise programs (from 8 to 24 weeks). However, these results are unlikely to be of clinical importance. These small improvements did not continue at longer-term follow-up (up to 40 weeks after the end of the intervention). We are uncertain of the effect on quality of life, as only one study reported this outcome (0 to 200 scale; MD 4.3, 95% CI -6.5 to 15.2; 2% absolute reduction; very low level of evidence).Our subgroup analyses provided uncertain evidence as to whether increased exercise time (duration, number of sessions) and level of resistance (strength or effort) have an impact on the exercise program effects.Three studies reported withdrawals due to adverse events. The number of dropouts was small. Only one study systematically monitored adverse effects, but four studies reported some adverse effects related to knee pain associated with an exercise program. We are uncertain as to whether high intensity increases the number of adverse effects (Peto odds ratio 1.72, 95% CI 0.51 to 5.81; - 2% absolute risk reduction; very low level of evidence). None of the included studies reported serious adverse events. AUTHORS' CONCLUSIONS We found very low-quality to low-quality evidence for no important clinical benefit of high-intensity compared to low-intensity exercise programs in improving pain and physical function in the short term. There was insufficient evidence to determine the effect of different types of intensity of exercise programs.We are uncertain as to whether higher-intensity exercise programs may induce more harmful effects than those of lower intensity; this must be evaluated by further studies. Withdrawals due to adverse events were poorly monitored and not reported systematically in each group. We downgraded the evidence to low or very low because of the risk of bias, inconsistency, and imprecision.The small number of studies comparing high- and low-intensity exercise programs in osteoarthritis underscores the need for more studies investigating the dose-response relationship in exercise programs. In particular, further studies are needed to establish the minimal intensity of exercise programs needed for clinical effect and the highest intensity patients can tolerate. Larger studies should comply with the Consolidated Standards of Reporting Trials (CONSORT) checklist and systematically report harms data to evaluate the potential impact of highest intensities of exercise programs in people with joint damage.
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Affiliation(s)
- Jean‐Philippe Regnaux
- INSERM U1153METHODS teamParisFrance
- EHESP Rennes, Sorbonne Paris CitéParisFrance
- French Cochrane CenterParisFrance
| | - Marie‐Martine Lefevre‐Colau
- French Cochrane CenterParisFrance
- INSERM U1153ECaMO teamParisFrance
- Sorbonne Paris Cité, Faculté de MédecineParis Descartes UniversityParisFrance
- AP‐HP (Assistance Publique des Hôpitaux de Paris), Hôpital CochinRheumatic and musculoskeletal disease Institute, Department of Physical Medicine and Rehabilitation,ParisFrance
| | - Ludovic Trinquart
- Hôpital Hôtel‐DieuFrench Cochrane Centre1 place du Parvis Notre‐DameParisFrance75004
| | - Christelle Nguyen
- Hôpital Cochin, Assistance publique‐Hôpitaux de Paris, Université Paris‐DescartesService de Médecine Physique et de Réadaptation27, Rue du Faubourg Saint‐JacquesParisFrance75014
| | - Isabelle Boutron
- INSERM U1153METHODS teamParisFrance
- French Cochrane CenterParisFrance
- Sorbonne Paris Cité, Faculté de MédecineParis Descartes UniversityParisFrance
- AP‐HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel DieuCentre d'Épidémiologie Clinique1, place du Parvis Notre‐DameParisFrance
| | - Lucie Brosseau
- University of OttawaSchool of Rehabilitation Sciences, Faculty of Health Sciences451 Smyth RoadOttawaONCanadaK1H 8M5
| | - Philippe Ravaud
- INSERM U1153METHODS teamParisFrance
- French Cochrane CenterParisFrance
- Sorbonne Paris Cité, Faculté de MédecineParis Descartes UniversityParisFrance
- AP‐HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel DieuCentre d'Épidémiologie Clinique1, place du Parvis Notre‐DameParisFrance
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Goisser S, Kemmler W, Porzel S, Volkert D, Sieber CC, Bollheimer LC, Freiberger E. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review. Clin Interv Aging 2015; 10:1267-82. [PMID: 26346071 PMCID: PMC4531044 DOI: 10.2147/cia.s82454] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity.
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Affiliation(s)
- Sabine Goisser
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics (IMP), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Simone Porzel
- Nutricia GmbH, Danone Medical Nutrition, Erlangen, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Leo Cornelius Bollheimer
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
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Jin EH, Park S, So JM. The effect of muscle power training with elastic band on blood glucose, cytokine, and physical function in elderly women with hyperglycemia. J Exerc Nutrition Biochem 2015; 19:19-24. [PMID: 25960951 PMCID: PMC4424442 DOI: 10.5717/jenb.2015.19.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of this study was to identify the effects of muscle power training with elastic band on body composition, glucose relation factor, and physical function in elderly women with hyperglycemia. [Methods] A total of 16 elderly women volunteered to participate in this study as subjects, and they were randomly assigned into one of the following two groups: muscle power training group (MPT: n = 8) and control group (CON: n = 8). The muscle power training group took exercise program using elastic band for 12 weeks, and the other group did not receive any exercise program during the same period. Before and after the experiment, both of the two groups received measurement in body composition (BMI, %Fat, skeletal muscle mass), glucose, cytokine (interleukin 6, adiponectin), and physical function (IPPB, grip strength). With these methods, the following conclusions were achieved. [Results] The results showed significant increases in adiponectin (p = 0.006), interleukin 6 (p = 0.018), SPPB (p = 0.024), and grip strength (P=.014). Blood glucose was significantly decreased in exercise group than contruo group. [Conclusion] It shows that the muscle power training with elastic band can give positive effects in elderly women with hyperglycemia.
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Affiliation(s)
- Eun Hee Jin
- Department of Sports Science, Sungkyunkwan University, Suwon, Korea
| | - Sok Park
- Department of Sports and Health Management, Mokwon University, Daejeon, Korea
| | - Jae Moo So
- Department of physical education, Konkuk University, Seoul, Korea
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Velocity during Strength and Power Training of the Ankle Plantar and Dorsiflexor Muscles in Older Patients Attending Day Hospital Rehabilitation. Rehabil Res Pract 2015; 2015:586843. [PMID: 25802760 PMCID: PMC4352762 DOI: 10.1155/2015/586843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 11/18/2022] Open
Abstract
Power training has been proposed as a more effective type of resistance training for older adults for functional performance. It is not yet known whether older adults respond appropriately to instructions for power versus strength training. The purpose of this study was to determine the velocity during strength and power training, with elastic resistance bands, in older adults attending a geriatric rehabilitation day program. It was hypothesized that power training would be faster than strength training, but that there would be large interindividual differences. Nine older patients (70 to 86 years) performed power and strength training of the ankle dorsiflexor and plantar flexor muscles using elastic resistance bands. Training sessions were filmed to assess the velocity of training. Power training occurred at faster velocities as compared to strength training (P < 0.01) for both muscle groups. However, a wide variation was observed between participants in the training velocities. Older adults attending geriatric rehabilitation do have the potential to develop faster contractions during power training as compared to strength training. Nevertheless, the actual velocities achieved differed between individuals. This could explain some of the mixed findings of studies on power training. Hence, researchers should monitor velocity when comparing different types of resistance training.
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Physical exercise and sarcopenia in older people: position paper of the Italian Society of Orthopaedics and Medicine (OrtoMed). CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2015; 11:215-21. [PMID: 25568656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Sarcopenia is the age-associated loss of skeletal muscle mass and function. It is a major clinical problem for older people and research in understanding of pathogenesis, clinical consequences, management, and socioeconomic burden of this condition is growing exponentially. The causes of sarcopenia are multifactorial, including inflammation, insulin resistance, changing endocrine function, chronic diseases, nutritional deficiencies and low levels of physical activity. Operational definition of sarcopenia combines assessment of muscle mass, muscle strength and physical performance. The diagnosis of sarcopenia should be based on having a low appendicular fat free mass in combination with low handgrip strength or poor physical functioning. Imaging techniques used for estimating lean body mass are computed tomography, magnetic resonance imaging, bioelectrical impedance analysis and dual energy X-ray absorptiometry, the latter considered as the preferred method in research and clinical use. Pharmacological interventions have shown limited efficacy in counteracting the age-related skeletal muscle wasting. Recent evidence suggests physical activity and exercise, in particular resistance training, as effective intervention strategies to slow down sarcopenia. The Italian Society of Orthopaedics and Medicine (Or-toMed) provides this position paper to present the update on the role of exercise on sarcopenia in the elderly.
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Ramírez-Campillo R, Castillo A, de la Fuente CI, Campos-Jara C, Andrade DC, Álvarez C, Martínez C, Castro-Sepúlveda M, Pereira A, Marques MC, Izquierdo M. High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women. Exp Gerontol 2014; 58:51-7. [DOI: 10.1016/j.exger.2014.07.001] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/03/2014] [Accepted: 07/08/2014] [Indexed: 11/28/2022]
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Pelletier D, Gingras-Hill C, Boissy P. Power training in patients with knee osteoarthritis: a pilot study on feasibility and efficacy. Physiother Can 2014; 65:176-82. [PMID: 24403682 DOI: 10.3138/ptc.2012-05] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To explore the feasibility and efficacy of using a power training exercise programme for the quadriceps femoris (QF) in elderly women with knee osteoarthritis (OA). METHOD A one-group quasi-experimental design with pre- and post-intervention measurements was conducted on 17 older adult women with knee OA pain. A bilateral QF exercise programme (24 sessions over 8 weeks) consisting of 3 series of 10 repetitions of flexion-extension as fast as possible at 40% of their one-repetition maximum (1RM) was performed in an outpatient physiotherapy clinic. The primary outcome measures were the knee function and associated problems using the Knee injury Osteoarthritis Outcome Score (KOOS) questionnaire and the weekly mean pain score from pain diaries using a visual analogue scale (VAS). QF strength (QFS), power (QFP) and work (QFW) were measured with an isokinetic dynamometer as secondary outcomes. RESULTS Significant improvements (p<0.05) were noted on the five categories of the KOOS. Significant decrease (p<0.01) was noted in pain intensity on VAS. QFP and QFW increased significantly on both sides (p<0.05). Exercise compliance was 99.5% for 16 participants. CONCLUSIONS A short power-training exercise programme is a feasible training modality for patients with knee OA, and significant functional improvements can be achieved. Further studies must be conducted to better understand the effects of the programme parameters and the generalizability of the findings.
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Affiliation(s)
- Denis Pelletier
- Faculty of Physical Education and Sports, Department of Kinesiology ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
| | - Cédric Gingras-Hill
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
| | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
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Barros CC, Caldas CP, Batista LA. Influência do treinamento da potência muscular sobre a capacidade de execução de tarefas motoras em mulheres idosas. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2013. [DOI: 10.1590/s1809-98232013000300017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: A manutenção da capacidade de geração de potência muscular é fator preponderante para a independência física e funcional do idoso. OBJETIVO: Avaliar o efeito de um programa de treinamento contra resistência em velocidade (PTCRV) sobre a potência muscular e o desempenho em tarefas motoras em idosas. MÉTODOS: 58 voluntárias sedentárias e fisicamente independentes foram divididas em dois subgrupos: 31 pertencentes ao grupo intervenção (GI), 68,7±5,2 anos de idade e 27 ao grupo controle (GC) 67,7±3,8 anos de idade. O GI foi submetido a um programa de 24 sessões, três vezes semanais, de treinamento contra resistência em velocidade. Foram avaliadas a carga (CR), a potência (PT) e a velocidade (VL) no exercício extensão de joelhos (EJ) e no teste motor de levantar-se da cadeira (LC), utilizando o sistema computadorizado Tendo Weightlifting Analyzer (TWA). Foi avaliado também o tempo de execução das tarefas motoras: marcha em velocidade de conforto (MVC) e marcha em velocidade máxima (MVM). Para comparação das variáveis estudadas, aplicou-se o teste t, admitindo-se p=0,05. RESULTADOS: Foi observado no GI para o exercício EJ ganho significativo na capacidade de geração da potência (49,56±13,52w / 66,87±16,27w, p=0,0002). No teste LC, houve aumento significativo na capacidade de geração da potência (370,71±106,26w / 434,52±107,15w, p=0,02185) e da velocidade (0,61±0,14m/s / 0,72±0,14m/s, p=0,00274). Nos testes motores, MVC e MVM, houve redução significativa no tempo de execução (4,56±0,63s / 4,20±0,50s, p=0,01560) e (3,45±0,40s / 3,23±0,34s, p=0,02222), respectivamente. No GC não foi observada melhora significativa em nenhum dos testes aplicados. CONCLUSÃO: O PTCRV contribuiu para melhorar os níveis de potência muscular, além de melhorar o desempenho nas tarefas motoras no grupo estudado.
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Patten C, Condliffe EG, Dairaghi CA, Lum PS. Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke. J Neuroeng Rehabil 2013; 10:1. [PMID: 23336711 PMCID: PMC3562202 DOI: 10.1186/1743-0003-10-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 01/07/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training) affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. METHOD Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP) and HYBRID (combined FTP and power training) in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome), upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. RESULTS PRIMARY OUTCOME Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049), regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03). SECONDARY OUTCOMES A greater proportion of participants achieved minimally important differences (MID) following HYBRID vs. FTP (p = .03). MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05). Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p < .05) and effects were retained 6-months post-intervention (p's < .05). EMG position threshold and burst duration were significantly reduced at fast speeds (≥120º/s) (p's < 0.05) and passive torque was reduced post-washout (p < .05) following HYBRID. CONCLUSIONS Functional and neuromechanical gains were greater following HYBRID vs. FPT. Improved stretch reflex modulation and increased neuromuscular activation indicate potent neural adaptations. Importantly, no deleterious consequences, including exacerbation of spasticity or musculoskeletal complaints, were associated with HYBRID. These results contribute to an evolving body of contemporary evidence regarding the efficacy of high-intensity training in neurorehabilitation and the physiological mechanisms that mediate neural recovery.
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Affiliation(s)
- Carolynn Patten
- Brain Rehabilitation R&D Center (151A), Malcolm Randall VA Medical Center, 1601 SW Archer Rd, Gainesville, FL, 32608, USA
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Elizabeth G Condliffe
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Christine A Dairaghi
- Rehabilitation Research Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Peter S Lum
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, USA
- Veterans Affairs Medical Center, Washington, DC, USA
- Center for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC, USA
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Clark DJ, Patten C. Eccentric Versus Concentric Resistance Training to Enhance Neuromuscular Activation and Walking Speed Following Stroke. Neurorehabil Neural Repair 2013; 27:335-44. [DOI: 10.1177/1545968312469833] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Impaired voluntary neuromuscular activation of agonist muscles is a primary determinant of weakness and motor dysfunction following stroke. Objective. To determine whether eccentric resistance training (ECC) resistance training is superior to concentric resistance training (CON) resistance training to enhance neuromuscular activation, strength, and walking speed after stroke. Methods. A total of 34 adults poststroke participated in a staged intervention comprising (1) either CON-only or ECC-only resistance training of the paretic leg followed by (2) gait training. Changes in voluntary neuromuscular activation and power were assessed for both the trained paretic and untrained nonparetic legs. Self-selected and fast walking speeds were also assessed. Results. In response to resistance training, the ECC group experienced larger improvements in neuromuscular activation of paretic leg muscles, rectus femoris and vastus medialis ( P < .005), and the largest gains in paretic leg power (+74% for ECC contractions, P < .0001). ECC also had greater cross-education of increased power to the untrained nonparetic leg (12%-14%, P = .006). Over the course of gait training, much of the gain in paretic leg activation in the ECC group was lost, such that the net change in agonist activation was comparable between the CON and ECC groups when the full intervention was completed. Nevertheless, improvement in walking speed postintervention was more prevalent in the ECC than CON group. Conclusion. ECC resistance training was more effective for improving bilateral neuromuscular activation, strength, and walking speed following stroke. Future research should assess whether a longer duration ECC training program can provide further benefit.
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Affiliation(s)
- David J. Clark
- Malcom Randall VA Medical Center, Gainesville, FL, USA
- University of Florida, Gainesville, FL, USA
| | - Carolynn Patten
- Malcom Randall VA Medical Center, Gainesville, FL, USA
- University of Florida, Gainesville, FL, USA
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Gremeaux V, Gayda M, Lepers R, Sosner P, Juneau M, Nigam A. Exercise and longevity. Maturitas 2012; 73:312-7. [PMID: 23063021 DOI: 10.1016/j.maturitas.2012.09.012] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
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Forbes SC, Little JP, Candow DG. Exercise and nutritional interventions for improving aging muscle health. Endocrine 2012; 42:29-38. [PMID: 22527891 DOI: 10.1007/s12020-012-9676-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 04/07/2012] [Indexed: 12/16/2022]
Abstract
Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.
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Affiliation(s)
- Scott C Forbes
- Physical Education and Recreation, University of Alberta, Edmonton, Canada
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Training implications of maximal forces on a computer-controlled and motor-driven leg press by age group, sex, footplate direction, and speed. Exp Gerontol 2012; 47:295-303. [DOI: 10.1016/j.exger.2012.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 12/23/2011] [Accepted: 01/13/2012] [Indexed: 11/18/2022]
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Pereira A, Izquierdo M, Silva AJ, Costa AM, Bastos E, González-Badillo JJ, Marques MC. Effects of high-speed power training on functional capacity and muscle performance in older women. Exp Gerontol 2012; 47:250-5. [PMID: 22234287 DOI: 10.1016/j.exger.2011.12.010] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/17/2011] [Accepted: 12/23/2011] [Indexed: 11/26/2022]
Abstract
The purpose of the study was to examine the effects of 12 weeks high-speed power training on isometric contraction (handgrip strength), maximal strength (1RM), muscle power (walking velocity, counter movement jump and ball throwing) and functional tasks of the arm and leg muscles (sit-to-stand and get-up and go). Fifty-six older women were divided into an experimental group and a control group [EG, n=28, 62.5 (5.4) years; CG: n=28, 62.5 (4.3) years]. The EG was submitted to a high-speed power training that consisted of 40% of one repetition maximum (1<RM) to 75% of 1RM); 3 sets 4-12 reps, countermovement jump and medicine ball (1.5 kg) throwing. Over the 12-week training period, the EG significantly increased dynamic and isometric strength performance (57% to 61%), muscle power (range from 14% to 40%) (P<0.05) and function (P<0.05). No significant magnitudes of increase were observed in the CG. These data indicate that high-speed power training is an effective exercise approach leading to large gains in upper and lower extremity muscle performance and function capacity.
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Affiliation(s)
- Ana Pereira
- University of Trás-os-Montes and Alto Douro, Department of Sport Sciences, Vila Real, Portugal
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Drey M, Zech A, Freiberger E, Bertsch T, Uter W, Sieber CC, Pfeifer K, Bauer JM. Effects of Strength Training versus Power Training on Physical Performance in Prefrail Community-Dwelling Older Adults. Gerontology 2012; 58:197-204. [DOI: 10.1159/000332207] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 08/10/2011] [Indexed: 11/19/2022] Open
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Tschopp M, Sattelmayer MK, Hilfiker R. Is power training or conventional resistance training better for function in elderly persons? A meta-analysis. Age Ageing 2011; 40:549-56. [PMID: 21383023 DOI: 10.1093/ageing/afr005] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to determine the effects of power training with high movement velocity compared with conventional resistance training with low movement velocity for older community-dwelling people. DESIGN systematic review of randomised controlled trials. DATA SOURCES the Cochrane Central Register of Controlled TRIALS, PubMed (Medline), EMBASE, CINAHL, PEDro and Scholar-Google. TRIALS all randomised or quasi-randomised trials investigating power training with high movement velocity versus conventional resistance training with low movement velocity in elderly persons over the age of 60 years. The primary outcomes were measures of functional outcomes; secondary outcomes were balance, gait, strength, power, muscle volume and adverse effects. RESULTS eleven trials were identified involving 377 subjects. The pooled effect size for the follow-up values of the functional outcomes was 0.32 in favour of the power training (95% CI 0.06 to 0.57) and 0.38 (95% CI -0.51 to 1.28) for the change value. The pooled effect from three studies for self-reported function was 0.16 in favour of power training (95% CI -0.17 to 0.49). CONCLUSION power training is feasible for elderly persons and has a small advantage over strength training for functional outcomes. No firm conclusion can be made for safety.
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Affiliation(s)
| | - Martin Karl Sattelmayer
- School of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Valais, Switzerland
| | - Roger Hilfiker
- School of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Valais, Switzerland
- Institute Health and Social Work, University of Applied Sciences Western Switzerland, Sion, Valais, Switzerland
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Granacher U, Muehlbauer T, Zahner L, Gollhofer A, Kressig RW. Comparison of Traditional and Recent Approaches in the Promotion of Balance and Strength in Older Adults. Sports Med 2011; 41:377-400. [DOI: 10.2165/11539920-000000000-00000] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Juhakoski R, Tenhonen S, Malmivaara A, Kiviniemi V, Anttonen T, Arokoski JPA. A pragmatic randomized controlled study of the effectiveness and cost consequences of exercise therapy in hip osteoarthritis. Clin Rehabil 2010; 25:370-83. [PMID: 21078702 DOI: 10.1177/0269215510388313] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the short- and long-term effectiveness of exercise training in relation to pain, function and direct costs to health care systems attributable to hip osteoarthritis. DESIGN Prospective, two-year randomized controlled trial. SETTING An outpatient primary health care setting. SUBJECTS One hundred and twenty men and women aged from 55 to 80, with radiologically diagnosed hip osteoarthritis with associated clinical symptoms. INTERVENTIONS The combined exercise and general practitioner (GP) care group received 12 supervised (once per week) exercise sessions at the baseline and four additional booster sessions one year later. Both groups received standard GP care. MAIN MEASURES The WOMAC Osteoarthritis Index, physical functioning score of RAND-36 (SF-36), the use and health care system costs of doctor visits and physiotherapy associated with hip osteoarthritis, number of total hip replacements, the use of analgesic and non-steroidal anti-inflammatory drugs (NSAIDs), performance-based outcome scores and body mass index (BMI). RESULTS There were no differences between the groups with respect to WOMAC hip pain, physical functioning score of RAND-36, performance-based outcome scores or BMI. The effect of the exercise intervention on WOMAC function was statistically significant at 6 months (mean = -7.5; 95% confidence interval (CI) -13.9 to -1.0; P = 0.02) and 18 months (mean = -7.9; 95% CI -15.3 to -0.4; P = 0.04). There were no statistically significant differences in the total health care system costs between the groups. CONCLUSION The mostly home-based exercise training programme provided in this study did not result in reduced hip pain over the two-year follow-up period.
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Affiliation(s)
- Riikka Juhakoski
- Department of Physical and Rehabilitation Medicine, Mikkeli Central Hospital, Mikkeli
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41
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Pöllänen E, Fey V, Törmäkangas T, Ronkainen PHA, Taaffe DR, Takala T, Koskinen S, Cheng S, Puolakka J, Kujala UM, Suominen H, Sipilä S, Kovanen V. Power training and postmenopausal hormone therapy affect transcriptional control of specific co-regulated gene clusters in skeletal muscle. AGE (DORDRECHT, NETHERLANDS) 2010; 32:347-363. [PMID: 20640546 PMCID: PMC2926854 DOI: 10.1007/s11357-010-9140-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 03/15/2010] [Indexed: 05/29/2023]
Abstract
At the moment, there is no clear molecular explanation for the steeper decline in muscle performance after menopause or the mechanisms of counteractive treatments. The goal of this genome-wide study was to identify the genes and gene clusters through which power training (PT) comprising jumping activities or estrogen containing hormone replacement therapy (HRT) may affect skeletal muscle properties after menopause. We used musculus vastus lateralis samples from early stage postmenopausal (50-57 years old) women participating in a yearlong randomized double-blind placebo-controlled trial with PT and HRT interventions. Using microarray platform with over 24,000 probes, we identified 665 differentially expressed genes. The hierarchical clustering method was used to assort the genes. Additionally, enrichment analysis of gene ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways was carried out to clarify whether assorted gene clusters are enriched with particular functional categories. The analysis revealed transcriptional regulation of 49 GO/KEGG categories. PT upregulated transcription in "response to contraction"-category revealing novel candidate genes for contraction-related regulation of muscle function while HRT upregulated gene expression related to functionality of mitochondria. Moreover, several functional categories tightly related to muscle energy metabolism, development, and function were affected regardless of the treatment. Our results emphasize that during the early stages of the postmenopause, muscle properties are under transcriptional modulation, which both PT and HRT partially counteract leading to preservation of muscle power and potentially reducing the risk for aging-related muscle weakness. More specifically, PT and HRT may function through improving energy metabolism, response to contraction as well as by preserving functionality of the mitochondria.
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Affiliation(s)
- Eija Pöllänen
- Gerontology Research Centre, University Jyväskylä, Jyväskylä, Finland.
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Steib S, Schoene D, Pfeifer K. Dose-response relationship of resistance training in older adults: a meta-analysis. Med Sci Sports Exerc 2010; 42:902-14. [PMID: 19996996 DOI: 10.1249/mss.0b013e3181c34465] [Citation(s) in RCA: 247] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to determine the dose-response relationship of resistance training (RT) to improve strength and function in older adults. METHODS A systematic literature search was performed in relevant databases and study reference lists to identify randomized controlled trials. Randomized controlled trials comparing the effects of different doses of strength training in older people (65 yr and older) on strength and functional outcomes were eligible. Two independent reviewers decided on study inclusion, extracted data, and assessed methodological quality. Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcomes and pooled using a random-effects model. RESULTS Twenty-nine trials with a total of 1313 subjects (mean age = 65-81 yr) are summarized in this review. Trials comparing different training intensities show strong effects of progressive resistance training (PRT) on maximal strength in a dose-dependent manner, with high-intensity (HI) PRT being more effective compared with moderate (MI)- and low-intensity (LI) PRT (SMD [HI vs LI] = 0.88, 95% CI = 0.21-1.55; SMD [HI vs MI] = 0.62, 95% CI = 0.22-1.03). PRT was also successful for improving functional outcomes, but gains were independent of training intensity. Power training (PT) was more effective for improving muscle power (SMD [PT vs PRT] = 1.66, 95% CI = 0.08-3.24) and functional outcomes than PRT. There was only little information available on training volume and frequency. DISCUSSION Higher training intensities are superior to lower intensities for improving maximal strength but not necessarily for functional performance of older adults. PT has shown to be a particularly effective method for enhancing muscle power and functional performance. More research is necessary to identify the effect of different training volumes and frequencies and the dose-response relationship for very old and frail populations.
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Affiliation(s)
- Simon Steib
- Institute of Sports Science and Sports, University of Erlangen-Nuremberg, Erlangen, Germany.
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43
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Ku YH, Han KA, Ahn H, Kwon H, Koo BK, Kim HC, Min KW. Resistance Exercise Did Not Alter Intramuscular Adipose Tissue but Reduced Retinol-binding Protein-4 Concentration in Individuals with Type 2 Diabetes Mellitus. J Int Med Res 2010; 38:782-91. [PMID: 20819415 DOI: 10.1177/147323001003800305] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Lipid accumulation in muscle is associated with diminished insulin sensitivity. It was hypothesized that resistance exercise decreases muscular adipose tissue and reduces the level of retinol-binding protein-4 (RBP4), which is linked to adipose tissue and insulin sensitivity in diabetics. Forty-four women with type 2 diabetes were randomly assigned to three groups for a period of 12 weeks: control (asked to maintain a sedentary lifestyle); resistance exercise (elastic band exercise at moderate intensity five times per week); and aerobic exercise (walking for 60 min at moderate intensity five times per week). Subcutaneous (SCAT), subfascial (SFAT) and intramuscular (IMAT) adipose tissues at mid-thigh level were assessed using computed tomography, and RBP4 level and insulin sensitivity (fractional disappearance rate of insulin, kITT) were assessed before and after intervention. Changes in SCAT, SFAT, IMAT, RBP4 and kITT were similar among the three groups. Within-group analysis revealed that body mass index and waist circumference decreased significantly in both exercise groups, but RBP4 decreased significantly only with resistance exercise. Resistance exercise did not alter muscular adipose tissue or improve insulin sensitivity.
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Affiliation(s)
- YH Ku
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - KA Han
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - H Ahn
- Diabetes Centre, Eulji Hospital, Seoul, Republic of Korea
| | - H Kwon
- Diabetes Centre, Eulji Hospital, Seoul, Republic of Korea
| | - BK Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - HC Kim
- Department of Radiology, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - KW Min
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Republic of Korea
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44
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Gschwind YJ, Bridenbaugh SA, Kressig RW. Gait Disorders and Falls. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2010. [DOI: 10.1024/1662-9647/a000004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Since approximately 30% of persons over the age of 65 fall each year, prevention of falls is a very important topic. Gait disorders and diminished ability to walk safely are associated with an increased risk of falling. In older adults, falls commonly lead to injuries, institutionalization, and early death. The resultant decline in activities of daily living further contributes to loss of mobility and independence. Gait analysis using the dual-task paradigm (e.g., walking and carrying a cup of tea) offers a sensible tool for detecting older persons prone to falling. Changes in gait patterns due to simultaneously performing a secondary attention-demanding task are interpreted as interference by competing demands for attentional resources in gait control. Exercise interventions such as Jaques-Dalcroze eurhythmics address these attentional properties and aim to decrease such interference. To fully stress physical capacities in older adults, not only does automaticity of walking have to be trained, but also simultaneous performance of additional tasks. Exercise interventions for fall prevention should focus on developing basic skeletal muscle strength as a prerequisite to training gait automaticity in dual or multiple task situations. Recommendations for further research center on new approaches to combine exercises with additional tasks to improve gait and functionality in older adults.
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Affiliation(s)
- Yves J. Gschwind
- Department of Acute Geriatrics, University Hospital Basel, Switzerland
| | | | - Reto W. Kressig
- Department of Acute Geriatrics, University Hospital Basel, Switzerland
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45
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Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults. Eur J Appl Physiol 2010; 109:517-25. [DOI: 10.1007/s00421-010-1387-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2010] [Indexed: 12/25/2022]
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46
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Candow DG, Chilibeck PD. Potential of creatine supplementation for improving aging bone health. J Nutr Health Aging 2010; 14:149-53. [PMID: 20126964 DOI: 10.1007/s12603-009-0224-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aging subsequently results in bone and muscle loss which has a negative effect on strength, agility, and balance leading to increased risks of falls, injuries, and fractures. Resistance training is an effective strategy for maintaining bone mass, possibly by increasing activity of cells involved in bone formation and reducing activity of cells involved in bone resorption. However, bone loss is still evident in older adults who have maintained resistance training for most of their life, suggesting that other factors such as nutrition may be involved in the aging bone process. Emerging evidence suggests that creatine supplementation, with and without resistance training, has the potential to influence bone biology. However, research investigating the longer-term effects of creatine supplementation and resistance training on aging bone is limited.
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Affiliation(s)
- D G Candow
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada.
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47
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Paterson DH, Jones GR, Rice CL. [Aging and physical activity data on which to base recommendations for exercise in older adults]. Appl Physiol Nutr Metab 2009; 32 Suppl 2F:S75-S171. [PMID: 19377547 DOI: 10.1139/h07-165] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An abundance of epidemiological research confirms the benefits of physical activity in reducing risk of various age-related morbidities and all-cause mortality. Analysis of the literature focusing on key exercise variables (e.g., intensity, type, and volume) suggests that the requisite beneficial amount of activity is that which engenders improved cardiorespiratory fitness, strength, power, and, indirectly, balance. Age-related declines in these components are such that physical limitations impinge on functional activities of daily living. However, an exercise programme can minimize declines, thus preventing older adults (age 65+ years) from crossing functional thresholds of inability. Cross-sectional and longitudinal data demonstrate that cardiorespiratory fitness is associated with functional capacity and independence; strength and, importantly, power are related to performance and activities of daily living; and balance-mobility in combination with power are important factors in preventing falls. Exercise interventions have documented that older adults can adapt physiologically to exercise training, with gains in functional capacities. The few studies that have explored minimal or optimal activity requirements suggest that a threshold (intensity) within the moderately vigorous domain is needed to achieve and preserve related health benefits. Thus, physical activity and (or) exercise prescriptions should emphasize activities of the specificity and type to improve components related to the maintenance of functional capacity and independence; these will also delay morbidity and mortality. An appropriate recommendation for older adults includes moderately vigorous cardiorespiratory activities (e.g., brisk walking), strength and (or) power training for maintenance of muscle mass and specific muscle-group performance, as well as "balance-mobility practice" and flexibility (stretching) exercise as needed.
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Affiliation(s)
- Donald H Paterson
- Centre canadien pour l'activité et le vieillissement, Université Western Ontario, 1490, rue Richmond N., Londres, ON N6G 2M3, Canada.
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48
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Pedrinelli A, Garcez-Leme LE, Azul Nobre RDS. THE EFFECT OF PHYSICAL TRAINING ON THE LOCOMOTOR APPARATUS IN ELDERLY PEOPLE. Rev Bras Ortop 2009; 44:96-101. [PMID: 26998458 PMCID: PMC4783589 DOI: 10.1016/s2255-4971(15)30054-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Physiological changes taking place on the locomotive apparatus as a result of aging, such as muscular mass loss, body balance loss, reduced bone mass and osteoarthrosis cause limitations to the daily activities of elderly people, compromising their quality of life and making them weaker and dependent. Aged people who regularly practice physical activities have a higher level of functional independence and a better quality of life than the sedentary ones. This article addresses the key physiological changes with aging and provides a review of current literature about the effects of physical exercises on the locomotive apparatus of elderly individuals, specifying the best ways to prescribe physical exercises to this age group.
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Affiliation(s)
- André Pedrinelli
- School of Medicine, and Assistant Physician, Sports Medicine Group, Institute of Orthopedics and Traumatology, HC-FMUSP
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49
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Caserotti P, Aagaard P, Larsen JB, Puggaard L. Explosive heavy-resistance training in old and very old adults: changes in rapid muscle force, strength and power. Scand J Med Sci Sports 2008; 18:773-82. [PMID: 18248533 DOI: 10.1111/j.1600-0838.2007.00732.x] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Age-related decline in muscle power predicts falls, motor impairments and disability. Recent guidelines suggested that training programs should be tailored to maximize muscle power. This study investigated the effects of 12 weeks of explosive-type heavy-resistance training (75-80% of 1 repetition maximum) in old (60-65 years, TG60) and very old (80-89 years, TG80) community-dwelling women. Training was performed with maximal intentional acceleration of the training load during the concentric movement phase. Maximal isometric voluntary muscle strength (MVC), rapid force capacity, assessed as rate of force development (RFD), and impulse, maximal muscle power during a countermovement jump (CMJ) and during unilateral leg extension task (LEP) were evaluated. RFD, impulse and MVC increased by 51%, 42% and 28% in TG80, and by 21%, 18% and 18% in TG60, respectively. CMJ jump height increased by 18% and 10% in TG80 and TG60, respectively, while jump peak power increased in TG60 (5%). Finally, LEP increased 28% in TG80 and 12% in TG60. These findings demonstrate that explosive-type heavy-resistance training seems to be safe and well tolerated in healthy women even in the eighth decade of life and elicits adaptive neuromuscular changes in selected physiological variables that are commonly associated with the risk of falls and disability in aged individuals.
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Affiliation(s)
- P Caserotti
- Centre of Applied and Clinical Exercise Sciences (ACES), University of Southern Denmark, Odense, Denmark.
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50
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Paterson DH, Jones GR, Rice CL. Ageing and physical activity: evidence to develop exercise recommendations for older adultsThis article is part of a supplement entitled Advancing physical activity measurement and guidelines in Canada: a scientific review and evidence-based foundation for the future of Canadian physical activity guidelines co-published by Applied Physiology, Nutrition, and Metabolism and the Canadian Journal of Public Health. It may be cited as Appl. Physiol. Nutr. Metab. 32(Suppl. 2E) or as Can. J. Public Health 98(Suppl. 2). Appl Physiol Nutr Metab 2007. [DOI: 10.1139/h07-111] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An abundance of epidemiological research confirms the benefits of physical activity in reducing risk of various age-related morbidities and all-cause mortality. Analysis of the literature focusing on key exercise variables (e.g., intensity, type, and volume) suggests that the requisite beneficial amount of activity is that which engenders improved cardiorespiratory fitness, strength, power, and, indirectly, balance. Age-related declines in these components are such that physical limitations impinge on functional activities of daily living. However, an exercise programme can minimize declines, thus preventing older adults (age 65+ years) from crossing functional thresholds of inability. Cross-sectional and longitudinal data demonstrate that cardiorespiratory fitness is associated with functional capacity and independence; strength and, importantly, power are related to performance and activities of daily living; and balance-mobility in combination with power are important factors in preventing falls. Exercise interventions have documented that older adults can adapt physiologically to exercise training, with gains in functional capacities. The few studies that have explored minimal or optimal activity requirements suggest that a threshold (intensity) within the moderately vigorous domain is needed to achieve and preserve related health benefits. Thus, physical activity and (or) exercise prescriptions should emphasize activities of the specificity and type to improve components related to the maintenance of functional capacity and independence; these will also delay morbidity and mortality. An appropriate recommendation for older adults includes moderately vigorous cardiorespiratory activities (e.g., brisk walking), strength and (or) power training for maintenance of muscle mass and specific muscle-group performance, as well as “balance-mobility practice” and flexibility (stretching) exercise as needed.
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Affiliation(s)
- Donald H. Paterson
- Canadian Centre for Activity and Aging, University of Western Ontario, 1490 Richmond Street N., London, ON N6G 2M3, Canada
- School of Kinesiology, Faculty of Health Sciences, Room 411B, Health Sciences Building, University of Western Ontario, London, ON N6A 5B9, Canada
- Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON N6A 5B9, Canada
| | - Gareth R. Jones
- Canadian Centre for Activity and Aging, University of Western Ontario, 1490 Richmond Street N., London, ON N6G 2M3, Canada
- School of Kinesiology, Faculty of Health Sciences, Room 411B, Health Sciences Building, University of Western Ontario, London, ON N6A 5B9, Canada
- Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON N6A 5B9, Canada
| | - Charles L. Rice
- Canadian Centre for Activity and Aging, University of Western Ontario, 1490 Richmond Street N., London, ON N6G 2M3, Canada
- School of Kinesiology, Faculty of Health Sciences, Room 411B, Health Sciences Building, University of Western Ontario, London, ON N6A 5B9, Canada
- Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON N6A 5B9, Canada
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