Effects of high-speed power training on functional capacity and muscle performance in older women

Physical activity in older age: perspectives for healthy ageing and frailty

Regular physical activity helps to improve physical and mental functions as well as reverse some effects of chronic disease to keep older people mobile and independent. Despite the highly publicised benefits of physical activity, the overwhelming majority of older people in the United Kingdom do not meet the minimum physical activity levels needed to maintain health. The sedentary lifestyles that predominate in older age results in premature onset of ill health, disease and frailty. Local authorities have a responsibility to promote physical activity amongst older people, but knowing how to stimulate regular activity at the population-level is challenging. The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty. The evidence shows that regular physical activity is safe for healthy and for frail older people and the risks of developing major cardiovascular and metabolic diseases, obesity, falls, cognitive impairments, osteoporosis and muscular weakness are decreased by regularly completing activities ranging from low intensity walking through to more vigorous sports and resistance exercises. Yet, participation in physical activities remains low amongst older adults, particularly those living in less affluent areas. Older people may be encouraged to increase their activities if influenced by clinicians, family or friends, keeping costs low and enjoyment high, facilitating group-based activities and raising self-efficacy for exercise.

Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life

In elderly populations, diabetes is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass. In addition, diabetes mellitus increases risk for accelerated aging and for the development of frailty syndrome. This disease is also associated with a polypathological condition, and its complications progressively affect quality of life and survival. Exercise interventions, including resistance training, represent the cornerstones of diabetes management, especially in patients at severe functional decline. This review manuscript aimed to describe the beneficial effects of different exercise interventions on the functional capacity of elderly diabetics, including those at polypathological condition. The SciELO, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched from 1980 to 2015 for articles published from original scientific investigations. In addition to the beneficial effects of exercise interventions on glycemic control, and on the cardiovascular risk factors associated with diabetes, physical exercise is an effective intervention to improve muscle strength, power output, and aerobic power and functional capacity in elderly diabetic patients. Thus, a combination of resistance and endurance training is the most effective exercise intervention to promote overall physical fitness in these patients. In addition, in diabetic patients with frailty and severe functional decline, a multicomponent exercise program including strength and power training, balance exercises, and gait retraining may be an effective intervention to reduce falls and improve functional capacity and quality of life in these patients.

A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease

Strength training has, in recent years, been shown to be beneficial for people with Parkinson disease and multiple sclerosis. Consensus regarding its utility for these disorders nevertheless remains contentious among healthcare professionals. Greater clarity is required, especially in regards to the type and magnitude of effects as well as the response differences to strength training between individuals with Parkinson disease or multiple sclerosis. This study examines the effects, magnitude of those effects, and response differences to strength training between patients with Parkinson disease or multiple sclerosis. A comprehensive search of electronic databases including Physiotherapy Evidence Database scale, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL was conducted from inception to July 2014. English articles investigating the effect of strength training for individuals with neurodegenerative disorders were selected. Strength training trials that met the inclusion criteria were found for individuals with Parkinson disease or multiple sclerosis. Individuals with Parkinson disease or multiple sclerosis were included in the study. Strength training interventions included traditional (free weights/machine exercises) and nontraditional programs (eccentric cycling). Included articles were critically appraised using the Physiotherapy Evidence Database scale. Of the 507 articles retrieved, only 20 articles met the inclusion criteria. Of these, 14 were randomized and 6 were nonrandomized controlled articles in Parkinson disease or multiple sclerosis. Six randomized and 2 nonrandomized controlled articles originated from 3 trials and were subsequently pooled for systematic analysis. Strength training was found to significantly improve muscle strength in people with Parkinson disease (15%-83.2%) and multiple sclerosis (4.5%-36%). Significant improvements in mobility (11.4%) and disease progression were also reported in people with Parkinson disease after strength training. Furthermore, significant improvements in fatigue (8.2%), functional capacity (21.5%), quality of life (8.3%), power (17.6%), and electromyography activity (24.4%) were found in individuals with multiple sclerosis after strength training. The limitations of the study were the heterogeneity of interventions and study outcomes in Parkinson disease and multiple sclerosis trials. Strength training is useful for increasing muscle strength in Parkinson disease and to a lesser extent multiple sclerosis.

Functional capacity, muscle fat infiltration, power output, and cognitive impairment in institutionalized frail oldest old

This study examined the neuromuscular and functional performance differences between frail oldest old with and without mild cognitive impairment (MCI). In addition, the associations between functional capacities, muscle mass, strength, and power output of the leg muscles were also examined. Forty-three elderly men and women (91.9±4.1 years) were classified into three groups--the frail group, the frail with MCI group (frail+MCI), and the non-frail group. Strength tests were performed for upper and lower limbs. Functional tests included 5-meter habitual gait, timed up-and-go (TUG), dual task performance, balance, and rise from a chair ability. Incidence of falls was assessed using questionnaires. The thigh muscle mass and attenuation were assessed using computed tomography. There were no differences between the frail and frail+MCI groups for all the functional variables analyzed, except in the cognitive score of the TUG with verbal task, which frail showed greater performance than the frail+MCI group. Significant associations were observed between the functional performance, incidence of falls, muscle mass, strength, and power in the frail and frail+MCI groups (r=-0.73 to r=0.83, p<0.01 to p<0.05). These results suggest that the frail oldest old with and without MCI have similar functional and neuromuscular outcomes. Furthermore, the functional outcomes and incidences of falls are associated with muscle mass, strength, and power in the frail elderly population.

Muscle power training in the institutionalized frail: a new approach to counteracting functional declines and very late-life disability

Skeletal muscle power decreases earlier than muscle strength with advancing age and is more strongly associated with functional test performance than muscle strength in elderly populations. In addition, some studies have shown that resistance training designed to improve muscle power output (high speed of movement) enhances several functional outcomes in the healthy elderly. Therefore, muscle power has emerged as a factor that is also potentially associated with functional limitations in frail elderly adults. The purpose of this review was to provide recent evidence regarding the association between skeletal muscle power and functional capacity in physically frail individuals. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus and ScienceDirect databases were searched from 1990 to 2014. Recently, it has been shown that functional capacity among frail elderly adults could be improved by performing resistance training at a high speed of movement with a loading stimulus that optimizes muscle power output. Routine multicomponent interventions that include muscle power training should be prescribed to institutionalized oldest old because such interventions improve the overall physical status of frail elderly individuals and prevent disability and other adverse outcomes. This result is especially important in frail subjects, who urgently need to improve their functional capacities to prevent adverse outcomes such as falls, hospitalizations, disability, or even death.

Strength and endurance training prescription in healthy and frail elderly

Aging is associated with declines in the neuromuscular and cardiovascular systems, resulting in an impaired capacity to perform daily activities. Frailty is an age-associated biological syndrome characterized by decreases in the biological functional reserve and resistance to stressors due to changes in several physiological systems, which puts older individuals at special risk of disability. To counteract the neuromuscular and cardiovascular declines associated with aging, as well as to prevent and treat the frailty syndrome, the strength and endurance training seems to be an effective strategy to improve muscle hypertrophy, strength and power output, as well as endurance performance. The first purpose of this review was discuss the neuromuscular adaptations to strength training, as well as the cardiovascular adaptations to endurance training in healthy and frail elderly subjects. In addition, the second purpose of this study was investigate the concurrent training adaptations in the elderly. Based on the results found, the combination of strength and endurance training (i.e., concurrent training) performed at moderate volume and moderate to high intensity in elderly populations is the most effective way to improve both neuromuscular and cardiorespiratory functions. Moreover, exercise interventions that include muscle power training should be prescribed to frail elderly in order to improve the overall physical status of this population and prevent disability.

Strength and endurance training prescription in healthy and frail elderly

Aging is associated with declines in the neuromuscular and cardiovascular systems, resulting in an impaired capacity to perform daily activities. Frailty is an age-associated biological syndrome characterized by decreases in the biological functional reserve and resistance to stressors due to changes in several physiological systems, which puts older individuals at special risk of disability. To counteract the neuromuscular and cardiovascular declines associated with aging, as well as to prevent and treat the frailty syndrome, the strength and endurance training seems to be an effective strategy to improve muscle hypertrophy, strength and power output, as well as endurance performance. The first purpose of this review was discuss the neuromuscular adaptations to strength training, as well as the cardiovascular adaptations to endurance training in healthy and frail elderly subjects. In addition, the second purpose of this study was investigate the concurrent training adaptations in the elderly. Based on the results found, the combination of strength and endurance training (i.e., concurrent training) performed at moderate volume and moderate to high intensity in elderly populations is the most effective way to improve both neuromuscular and cardiorespiratory functions. Moreover, exercise interventions that include muscle power training should be prescribed to frail elderly in order to improve the overall physical status of this population and prevent disability.

Positive effects of resistance training in frail elderly patients with dementia after long-term physical restraint

This study investigated the effects of a multicomponent exercise intervention on muscle strength, incidence of falls and functional outcomes in frail elderly patients with dementia after long-term physical restraint, followed by 24 weeks of training cessation. Eighteen frail elderly patients with mild dementia (88.1 ± 5.1 years) performed a multicomponent exercise program, which consisted of 4 weeks of walking, balance and cognitive exercises, followed by 4 weeks of resistance exercise performed twice weekly [8-12 repetitions at 20-50 % of the one-repetition maximum (1RM)], combined with walking, balance and cognitive exercises. Before and after training, as well as after 24 weeks of training cessation, strength outcomes, Barthel Index, balance, gait ability, rise from a chair ability, dual task performance, incidence of falls and Mini-Mental State Examination were assessed. After the first 4 weeks of training, there was a significant improvement only in the balance test, whereas no additional changes were observed. However, after the second part of the training, the participants required significantly less time for the time-up-and-go test (P < 0.05), and improved the isometric hand grip, hip flexion and knee extension strength, as well as the leg press 1RM (P < 0.01). A significant reduction was also observed in the incidence of falls (P < 0.01). After 24 weeks of training cessation, abrupt decreases were observed in nearly all of the physical outcomes (P < 0.05). The exercise intervention improved strength, balance and gait ability in frail elderly patients with dementia after long-term physical restraint, and these benefits were lost after training cessation.

Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians

This randomized controlled trial examined the effects of multicomponent training on muscle power output, muscle mass, and muscle tissue attenuation; the risk of falls; and functional outcomes in frail nonagenarians. Twenty-four elderly (91.9 ± 4.1 years old) were randomized into intervention or control group. The intervention group performed a twice-weekly, 12-week multicomponent exercise program composed of muscle power training (8-10 repetitions, 40-60 % of the one-repetition maximum) combined with balance and gait retraining. Strength and power tests were performed on the upper and lower limbs. Gait velocity was assessed using the 5-m habitual gait and the time-up-and-go (TUG) tests with and without dual-task performance. Balance was assessed using the FICSIT-4 tests. The ability to rise from a chair test was assessed, and data on the incidence and risk of falls were assessed using questionnaires. Functional status was assessed before measurements with the Barthel Index. Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography. The intervention group showed significantly improved TUG with single and dual tasks, rise from a chair and balance performance (P < 0.01), and a reduced incidence of falls. In addition, the intervention group showed enhanced muscle power and strength (P < 0.01). Moreover, there were significant increases in the total and high-density muscle cross-sectional area in the intervention group. The control group significantly reduced strength and functional outcomes. Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population.

Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review

The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the following four parameters: Incidence of falls, gait, balance, and lower-body strength. Twenty studies that investigated the effects of multi-component exercise training (10), resistance training (6), endurance training (1), and balance training (3) were included in the present revision. Ten trials investigated the effects of exercise on the incidence of falls in elderly with physical frailty. Seven of them have found a fewer falls incidence after physical training when compared with the control group. Eleven trials investigated the effects of exercise intervention on the gait ability. Six of them showed enhancements in the gait ability. Ten trials investigated the effects of exercise intervention on the balance performance and seven of them demonstrated enhanced balance. Thirteen trials investigated the effects of exercise intervention on the muscle strength and nine of them showed increases in the muscle strength. The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.

Short-term strength training improves muscle quality and functional capacity of elderly women

To assess effects of a short-term strength training (ST) program on muscle quality (MQ) and functional capacity, 36 sedentary elderly women (age = 66.0 ± 8 year, height = 159.1 ± 9.2 cm, body mass = 68.3 ± 12.1 kg, body fat = 37.0 ± 4.2 %) were randomly divided into an experimental group (EG; n = 19) or a control group (CG; n = 17). The EG performed two to three sets of 12-15 repeats of leg press, knee extension, and knee flexion exercises, 2 days/week for 6 weeks. Before and after training, lower body one repetition maximum (1RM), functional performance tests, quadriceps femoris muscle thickness (MT), and muscle quality (MQ) (1RM and quadriceps MT quotient) were assessed. After training, only the EG showed significant improvements in 1RM (p < 0.05), 30-s sit-to-stand (p < 0.001), and 8 foot up-and-go (p < 0.001). In addition, only in the EG, significant increases in all quadriceps femoris MT measurements (vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris) (p ≤ 0.05), and MQ (p < 0.001) were demonstrated. No changes were observed in the CG. Furthermore, there were significant associations between individual changes in MQ and corresponding changes in 30-s sit-to-stand (r = 0.62, p < 0.001), and 8 foot up-and-go (r = -0.71, p < 0.001). In conclusion, a ST program of only 6 weeks was sufficient to enhance MQ of the knee extensors in elderly women, which resulted in beneficial changes in functional capacity.

The influence of ACE ID and ACTN3 R577X polymorphisms on lower-extremity function in older women in response to high-speed power training

Background

We studied the influence of the ACE I/D and ACTN3 R577X polymorphisms (single or combined) on lower-extremity function in older women in response to high-speed power training.

Methods

One hundred and thirty-nine healthy older Caucasian women participated in this study (age: 65.5 ± 8.2 years, body mass: 67.0 ± 10.0 kg and height: 1.57 ± 0.06 m). Walking speed (S10) performance and functional capacity assessed by the “get-up and go” (GUG) mobility test were measured at baseline (T1) and after a consecutive 12-week period of high-speed power training (40-75% of one repetition maximum in arm and leg extensor exercises; 3 sets 4–12 reps, and two power exercises for upper and lower extremity). Genomic DNA was extracted from blood samples, and genotyping analyses were performed by PCR methods. Genotype distributions between groups were compared by Chi-Square test and the gains in physical performance were analyzed by two-way, repeated-measures ANOVA.

Results

There were no significant differences between genotype groups in men or women for adjusted baseline phenotypes (P > 0.05). ACE I/D and ACTN3 polymorphisms showed a significant interaction genotype-training only in S10 (P = 0.012 and P = 0.044, respectively) and not in the GUG test (P = 0.311 and P = 0.477, respectively). Analyses of the combined effects between genotypes showed no other significant differences in all phenotypes (P < 0.05) at baseline. However, in response to high-speed power training, a significant interaction on walking speed (P = 0.048) was observed between the “power” (ACTN3 RR + RX & ACE DD) versus “non-power” muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)].

Conclusions

Thus, ACE I/D and ACTN3 R577X polymorphisms are likely candidates in the modulation of exercise-related gait speed phenotype in older women but not a significant influence in mobility traits.

How to simultaneously optimize muscle strength, power, functional capacity, and cardiovascular gains in the elderly: an update

The purpose of the present study was to review the scientific literature that investigated concurrent training adaptations in elderly populations, with the aim of identifying the optimal combination of both training program variables (i.e., strength and endurance) to avoid or minimize the interference effect in the elderly. Scielo, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched. Concurrent training is the most effective strategy by which to improve neuromuscular and cardiorespiratory functions as well as functional capacity in the elderly. The volume and frequency of training appears to play a critical role in concurrent training-induced adaptations in elderly subjects. Furthermore, new evidence indicates that the intra-session exercise order may influence the magnitude of physiological adaptations. Despite the interference effect on strength gains that is caused by concurrent training, this type of training is advantageous in that the combination of strength and endurance training produces both neuromuscular and cardiovascular adaptations in the elderly. The interference phenomenon may be observed in elderly subjects when a moderate weekly volume of concurrent training (i.e., three times per week) is performed. However, even with the occurrence of this phenomenon, the performance of three concurrent training sessions per week appears to optimize the strength gains in relative brief periods of training (12 weeks). Moreover, performing strength prior to endurance exercise may optimize both neuromuscular and cardiovascular gains.

Therapeutic effects of tai chi in patients with Parkinson's disease

Objective. The purpose of the study was to investigate the effects of a 12-week program of therapeutic Tai Chi on the motor function and physical function of idiopathic Parkinson's disease patients (PDs). Methods. The participants were 22 clinically stable PDs in Hoehn-Yahr stages 1-2 randomly assigned to a therapeutic Tai Chi group (TTC, N = 11) or a control group (CON, N = 9). Two subjects in control group did not complete the study for personal reasons. TTC was performed three days a week (60 min/session). Motor symptoms by the UPDRS were assessed, and tests of physical function were administered before and after the 12-week trial. Results. The TTC group, as compared to the CON group, showed changes in the mentation, behavior, mood, and motor scales of the UPDRS (P < 0.05, P < 0.01, resp.), with no significant main effects on the activities of daily living scale (ADL). However, there was a significant interaction between the time and intervention group on ADL (P < 0.05). There were no significant main effects for any of the physical function variables. There were significant interaction effects in balance and agility (P < 0.05, resp.). Conclusions. This study showed that TTC training had modest positive effects on the functional status of Parkinson's disease patients.

ACE I/D and ACTN3 R/X polymorphisms as potential factors in modulating exercise-related phenotypes in older women in response to a muscle power training stimuli

Genetic variation of the human ACE I/D and ACTN3 R577X polymorphisms subsequent to 12 weeks of high-speed power training on maximal strength (1RM) of the arm and leg muscles, muscle power performance (counter-movement jump), and functional capacity (sit-to-stand test) was examined in older Caucasian women [n = 139; mean age 65.5 (8.2) years; 67.0 (10.0) kg and 1.57 (0.06) m]. Chelex 100 was used for DNA extraction, and genotype was determined by PCR-RFLP methods. Muscular strength, power, and functional testing were conducted at baseline (T1) and after 12 weeks (T2) of high-speed power training. At baseline, the ACE I/D and ACTN3 R/X polymorphisms were not associated with muscle function or muscularity phenotypes in older Caucasian women. After the 12-week high-speed training program, subjects significantly increased their muscular and functional capacity performance (p < 0.05). For both polymorphisms, significant genotype-training interaction (p < 0.05) was found in all muscular performance indices, except for 1RM leg extension in the ACE I/D (p = 0.187). Analyses of the combined effects between genotypes showed significant differences in all parameters (p < 0.05) in response to high-speed power training between the power (ACTN3 RR + RX & ACE DD) versus "non-power" muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)]. Our data suggest that the ACE and ACTN3 genotypes (single or combined) exert a significant influence in the muscle phenotypes of older Caucasian women in response to high-speed power training. Thus, the ACE I/D and ACTN3 R/X polymorphisms are likely factors in modulating exercise-related phenotypes in older women, particularly in response to a resistance training stimuli.