Strength and endurance training prescription in healthy and frail elderly

Whey Protein Supplementation in Older Adults With Type 2 Diabetes Undergoing a Resistance Training Program: A Double-Blind Randomized Controlled Trial

BACKGROUND/OBJECTIVE

This study aims to analyze the effect of whey protein (WP) supplementation on glycemic control, muscle strength, quality of life, and body composition in older adults with non-insulin-dependent diabetes undergoing a resistance training program.

METHODS

A double-blind, placebo-controlled, randomized study was carried out with older adults with Type 2 diabetes. Body composition, food intake, muscle strength, glycemic profile, markers of renal function, cardiopulmonary capacity, and quality of life were evaluated. Older adults were randomized into a supplementation group with 33 g of WP consumed twice a week on days of resistance training for 12 weeks supplemented group and a placebo group.

RESULTS

In total, 39 older adults were randomized into two groups, 19 in the supplement group and 20 in the placebo group. Both groups showed improvement in muscle strength, with the WP group failing to exceed that of the control group. WP supplementation slightly increased blood urea compared with the placebo group (p = .05), but values remained within normal limits. The group that used WP showed a small improvement in mental health, according to the 12-Item Short-Form Health Survey questionnaire, but without clinically important improvements.

CONCLUSION

Both groups showed improvements in muscle strength and mass, regardless of supplementation, showing that resistance exercises performed twice a week can contribute to the nonprogression of sarcopenia in older adults with Type 2 diabetes. More studies are needed to determine the safe and effective amount of supplementation to improve muscle strength without renal impairment in older adults with diabetes.

Effect of Strength and Endurance Training Sequence on Endurance Performance

This review investigates the effect of two different concurrent training sequences on endurance performance. The sequences investigated are Endurance-Resistance (ER) and Resistance-Endurance (RE). A literature search is conducted of the SPORTDiscus and Medline databases. The included studies are randomized control trials, which compare the effect of ER and RE on at least one endurance performance variable. A PEDro scale is used to assess the methodological quality of the articles in this review. Of a total of 152 articles identified during the initial screening, 15 studies meet the inclusion criteria. These studies include 426 participants (298 males and 128 females), with 212 of the participants training with ER and 214 with RE. The results are presented as the percentage change of the mean from pre- to post-test. All the studies show an improvement in endurance from pre to post for both interventions, except for the RE group in one study. This review finds small and non-conclusive sequence effects between ER and RE, suggesting that the sequence of concurrent training is not of great importance in relation to endurance performance.

Interval aerobic/resistance exercise training depresses adrenergic-induced apoptosis of lymphocytes in sedentary males

PURPOSE

Adrenergic stimulation affects lymphocyte autophagy and apoptosis by activating β1-adrenergic receptor (β1-AR) and G protein-coupled receptor kinase 2 (GRK-2) downstream signaling. This study investigated how combined aerobic and resistance exercise training on the interval or continuous pattern influences aerobic/muscular fitness and β1-AR/GRK-2 signaling, and corresponding apoptosis/autophagy of lymphocytes in sedentary males.

METHODS

Thirty-four sedentary males were randomized into interval training (IT, age = 22.5 ± 0.6 years, fitness level = 47.5 ± 0.9 mL/min/kg, body mass index (BMI) = 22.4 ± 0.4 kg/m2, n = 17) and continuous training (CT, age = 21.6 ± 0.4 years, fitness level = 45.2 ± 1.0 mL/min/kg, BMI = 22.2 ± 0.3 kg/m2, n = 17) groups. These subjects performed IT (bicycle exercise at alternating 40% and 80%VO2 reserve (VO2R) and isokinetic exercise at alternating 60°/s and 180°/s) or CT (bicycle exercise at continuously 60%VO2R and isokinetic exercise at continuously 120°/s) for 30 min/day, 5 days/week for 6 weeks. Aerobic capacity and muscular strength/endurance were determined by the graded exercise test (GXT) and isokinetic strength test, respectively. Blood lymphocyte autophagy/apoptosis and β1-AR/GRK-2 signaling were analyzed using flow cytometry.

RESULTS

Both IT and CT groups increased isokinetic strengths at various angular velocities, whereas only IT significantly enhanced muscle endurance, indicated by lowered fatigue index from 47.0 ± 1.3% to 41.8 ± 1.6% (P < 0.05). Moreover, the IT group (143 ± 7%) revealed a higher improvement in VO2peak than CT group (132 ± 6%) (P < 0.05). Acute GXT augmented (i) GRK-2 and protein kinase A expressions, (ii) LAMP-2 upregulation and acridine orange staining, (iii) mitochondrial transmembrane potential diminishing, caspase-3 activation, and phosphatidylserine (PS) exposure caused by epinephrine in blood lymphocytes. However, the degree of epinephrine-induced lymphocyte PS exposure potentiated by GXT was suppressed from 65.2 ± 5.2% to 47.4 ± 6.5% following 6 weeks of the IT (P < 0.05).

CONCLUSION

The IT may be considered more beneficial than CT in terms of improving aerobic/muscular fitness and simultaneously ameliorating apoptosis of blood lymphocyte evoked by intense exercise or adrenergic stimulation in sedentary males.

Differences in acute neuromuscular response after single session of resistance exercise between young and older adults

AIMS

The purpose of this study was to investigate differences in the acute response after resistance exercise between young and older adults.

METHODS

Seventeen young and 18 older adults performed a single session of resistance exercise, consisting of 3 sets of 10 isometric knee extensions. Maximal voluntary contraction (MVC), motor unit (MU) activity of the vastus lateralis, and electrically elicited torque of the knee extensor were measured before and after the resistance exercise.

RESULTS

Although both groups showed the same degree of decline in MVC (young: -15.2 ± 14.3 %, older: -16.4 ± 7.9 %, p = 0.839), electrically elicited torque markedly decreased in the young group (young: -21.5 ± 7.7 %, older: -14.3 ± 9.5 %, p < 0.001), and the decrease in the MU firing rate was greater in the older group (young: -26.1 ± 24.1 %, older: -44.7 ± 24.5 %, p < 0.001). Changes in the MU firing rate following the exercise were correlated with the MU recruitment threshold in the older group (p < 0.001, rs = 0.457), but not young group (p = 0.960).

DISCUSSION

These results showed that young adults exhibited a greater acute response in the peripheral component, whereas older adults showed a greater acute response in the central component of the neuromuscular system, and the acute response in MUs with a high recruitment threshold following resistance exercise was smaller than in those with a low recruitment threshold in older adults. These findings may partly explain why there are different chronic adaptations to resistance training between young and older adults.

A Chair-Based Music-Kinetic Combined Exercise Program as an Alternative Approach for Increasing Health, Functional Capacity, and Physical Fitness Indices in Middle-Aged Pre-Menopausal Women

Lately, chairs have been widely used as a cheap, easily accessible, safe, and effective training means in different settings (e.g., in gyms, the house, workplaces, and in rehabilitation). This study investigated the effectiveness of a 10-week chair-based music-kinetic integrated combined exercise program on health, functional capacity, and physical fitness indicators of middle-aged pre-menopausal women. A total of 40 healthy women (40-53 years) were assigned to two groups: exercise (EG) and control (CG). The EG followed a 10-week (3 times/weekly; 30 training sessions) chair-based exercise program including aerobic dance, flexibility, coordination, and strength exercises with body weight or auxiliary means. Selected indicators of health, functional capacity, and physical fitness were evaluated before and after the 10 weeks. Following the program, the EG significantly reduced their body fat (-2.5%), blood pressure (by -4.5 to -5.5%), the time during the timed up-and-go (TUG) test (by -10.27%), heart rate (by -6.35 to -13.78%), and the rate of perceived exertion (by -24.45 to -25.88%), while increasing respiratory function (3.5-4%), flexibility (12.17%), balance (50.38-51.07%), maximal handgrip strength (10-12.17%), and endurance strength (43.87-55.91%). The chair-based combined music-kinetic exercise program was effective and could be safely used in different settings to improve health, functional capacity, and physical fitness in middle-aged women.

Impact of Diet and Exercise Interventions on Cognition and Brain Health in Older Adults: A Narrative Review

The ability to preserve cognitive function and protect brain structure from the effects of the aging process and neurodegenerative disease is the goal of non-pharmacologic, lifestyle interventions focused on brain health. This review examines, in turn, current diet and exercise intervention trends and the collective progress made toward understanding their impact on cognition and brain health. The diets covered in this review include the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), ketogenic diet, intermittent fasting, and weight loss management. The exercise approaches covered in this review include endurance, resistance, combined exercise programs, yoga, tai chi, and high-intensity interval training. Although valuable evidence is building concerning how diet and exercise influence cognitive performance and brain structure, many of the open questions in the field are concerned with why we see these effects. Therefore, more strategically designed intervention studies are needed to reveal the likely multiple mechanisms of action in humans.

Influence of Pennation Angle and Muscle Thickness on Mechanomyographic Amplitude-Torque Relationships and Sex-Related Differences in the Vastus Lateralis

This study examined potential sex-related differences and correlations among the pennation angle (PA), muscle thickness (MT), and mechanomyographic amplitude (MMG_RMS)-torque relationships of the vastus lateralis (VL) in 11 healthy males and 12 healthy females. The PA and MT of the VL were quantified with ultrasound. Participants performed an isometric muscle action of the knee extensors that linearly increased to 70% of maximal strength followed by a 12 s plateau. MMG was recorded from the VL. Linear regression models were fit to the log-transformed MMG_RMS-torque relationships to calculate b terms (slopes) for the linearly increasing segment. MMG_RMS was averaged during the plateau. Males exhibited greater PA (p < 0.001), MT (p = 0.027), b terms (p = 0.005), and MMG_RMS (p = 0.016). The b terms were strongly (p < 0.001, r = 0.772) and moderately correlated (p = 0.004, r = 0.571) with PA and MT, respectively, while MMG_RMS was moderately correlated with PA (p = 0.018, r = 0.500) and MT (p = 0.014, r = 0.515). The greater mechanical behavior of individuals possessing a larger PA and MT of the VL may reflect increased cross-bridge activity within the muscle fibers. Additionally, PA may help explain sex-related differences in MMG_RMS between sexes.

Effects of concurrent training sequence on VO2max and lower limb strength performance: A systematic review and meta-analysis

The aim of this study is to compare the effects of concurrent strength and endurance training sequences on VO_2max and lower limb strength performance to provide scientific guidance for training practice. We searched PubMed, EBSCO, Web of Science (WOS), Wanfang, and China National Knowledge Infrastructure (CNKI) databases up to December 2022. The included articles were randomized controlled trials that allowed us to compare the strength-endurance (S-E) sequence and endurance-strength (E-S) sequence on VO_2max, maximum knee extension strength, maximum knee flexion strength, and lower limb power. The Cochrane bias risk tool was used to evaluate the methodological quality of the included literature, and Stata 12.0 was used for the heterogeneity test, subgroup analysis, draw forest map, sensitivity analysis, and publication bias evaluation. The results have been presented as standardized mean differences (SMDs) between treatments with 95% confidence intervals and calculations performed using random effects models. Significance was accepted when p < 0.05. The studies included 19 randomized controlled trials (285 males and 197 females), 242 subjects in S-E sequence, and 240 subjects in E-S sequence in the analyses. No difference changes between S-E and E-S sequences has been observed on VO_2max in the overall analysis (SMD = 0.02, 95% CI: -0.21-0.25, p = 0.859). The S-E sequence shows a greater increase in lower limb strength performance than does the E-S sequence (SMD = 0.19, 95% CI: 0.02-0.37, p = 0.032), which was manifested in the elderly (p = 0.039) and women (p = 0.017); in training periods >8 weeks (p = 0.002) and training frequencies twice a week (p = 0.003); and with maximum knee flexion (p = 0.040) and knee extension strength (p = 0.026), while no difference was found in lower limb power (p = 0.523). In conclusion, the effect of VO_2max will not change with different concurrent training sequences. The S-E sequence improves lower limb strength more significantly, mainly in the improvement of knee flexion and knee extension. This advantage is more related to factors such as age, gender, training period, and training frequency.

Effects of Combined Versus Multicomponent Training in Physically Active Women Aged 50-75 Years

Purpose: This study aimed to compare the effects of combined training (CT) and multicomponent training (MT) on different health parameters in physically active women aged between 50 and 75 years. Method: The participants were randomly divided into two training groups (CT and MT), lasting 180 min per week, for 14 consecutive weeks of training with the level of physical activity, anthropometric measurements, blood pressure, strength, cardiorespiratory skills, coordination, flexibility, agility, and quality of life. Results: Participants who underwent CT and MT training showed positive responses regarding the assessment of body mass, waist circumference, lower limb resistance and strength, upper limb strength, and mental domain related to the quality of life. However, only participants undergoing CT were able to increase agility and cardiorespiratory capacities. Conclusion: 14 weeks of CT were more efficient to improve physical capacities in physically active women aged between 50 and 75 years when compared to MT.

Interindividual variability of adaptations following either traditional strength or power training combined to endurance training in older men: A secondary analysis of a randomized clinical trial

This study aimed to investigate the interindividual responses following two different concurrent training (CT) regimens in neuromuscular, cardiorespiratory and functional outcomes of older men. Thirty-five older men (65.8 ± 3.9 years) were randomly allocated into one of two CT groups: power training (PT) + high-intensity interval training (HIIT) (n = 17); or traditional strength training (TST) + HIIT (n = 18). Maximal dynamic strength (one-repetition maximum, 1RM), rate of force development at 100 milliseconds (RDF₁₀₀), countermovement jump power (CMJ), quadriceps femoris muscle thickness (QF MT), functional tests (sit-to-stand, timed-up-and-go, and stair climbing), and peak oxygen consumption (VO_2peak) were assessed pre-, post-8 and post-16 weeks of training. The Chi-squared test was used for assessing differences in the prevalence of responders (Rs), non-responders (NRs), and adverse responders (ARs). Similar prevalence of individual responses (Rs, NRs and ARs) between groups were observed after intervention in almost all outcomes: 1RM; power at CMJ; QF MT, and functional tests (P > 0.05). However, a significant difference in the distribution of Rs, NRs and ARs between groups was observed in the RFD₁₀₀ after 16 weeks (p = 0.003), with PT + HIIT group presenting high prevalence of Rs than TST + HIIT (100 % vs. 50 %). The inclusion of explosive-type of contractions in a concurrent training regime induces greater responsiveness in the RFD₁₀₀ in older men, while no differences compared to traditional strength training are observed in maximal strength, muscle size, VO_2peak, and functional performance.

Effects of resistance training combined with balance training on physical function among older adults: a protocol for a randomised controlled trial

INTRODUCTION

The world's population is ageing. Age-related declines in physical function negatively affect the quality of life but may be ameliorated by certain types of exercise. The purpose of this study is to investigate the effects of combining resistance training (RT) with balance training on physical function in older community-dwelling adults to provide a reference for this type of exercise compared with other exercises and to provide a theoretical basis for optimising exercise plans to improve physical function among older adults.

METHODS

This single-blind randomised controlled trial will recruit 66 community dwelling adults 60-89 years of age with normal cognition. Participants will be randomly assigned to one of three groups: RT, RT combined with balance training or a control group with usual daily activities. Exercise interventions will be conducted in three 45 min sessions per week for 24 weeks. Primary physical function outcomes will be assessed using the timed up and go test, usual walking speed, maximal walking speed, 30 s chair stand and 30 s arm curl. Secondary assessments will be conducted using the 2 min step test, back scratch test and chair sit-and-reach test. All physical function assessments will be performed at baseline and after 12 and 24 weeks of exercise interventions. Exercise intensity will be monitored to maintain moderate intensity by heart rate, ratings of perceived exertion and OMNI-Resistance Exercise Scale. Data that conform to a normal distribution will be expressed as means±SD, otherwise as medians and interquartile intervals. Pretest, mid-test and post-test outcomes will be analysed for within-group and between-group comparisons using two-way repeated measures analyses of variance.

ETHICS AND DISSEMINATION

This proposal was reviewed and approved by the Shanghai University of Sport Research Ethics Committee (102772021RT067). The results will be disseminated to the trial participants and as a peer-reviewed publication.

TRIAL REGISTRATION NUMBER

ChiCTR2200056090.

Muscle function and functional performance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a prospective observational study

This study aimed to measure changes in different properties of skeletal muscles and evaluate their contribution and relationship to changes in functional performance after pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). COPD outpatients attending 5 weeks of conventional PR were recruited. Functional performance [5-repetitions sit-to-stand (5STS), and 4-m gait speed (4mGS)], and muscle function (maximal isometric strength, power, force control, and relative concentric and eccentric activation during 5STS) were assessed after PR and 3 months of follow-up. Twenty patients (71 years; 52% of predicted FEV₁) completed the study. 4mGS and relative concentric activation during 5STS decreased respectively by 7.7% and 26% between the beginning of PR and follow-up. Quadriceps strength, power, and force control improved by 10.4%, 27.3%, and 15.2%, respectively, from the beginning of PR to follow-up the relative eccentric activation during 5STS explained 31% of the variance in 4mGS changes. In conclusion, functional performance appeared to decline after conventional PR, whereas several properties of skeletal muscles were maintained at follow-up in COPD outpatients. Of note, eccentric contractions might play a role in the improvement of functional performance. Therefore, future studies with interventional design should include eccentric training in PR programs during clinical COPD practice.

Serial vs. Integrated Outdoor Combined Training Programs for Health Promotion in Middle-Aged Males

The purpose of this study was to examine and compare the training and detraining effects of outdoor serial and integrated combined exercise programs on health, functional capacity, and physical fitness indices. Fifty-one untrained overweight/obese males (47 ± 4 years) were divided into a serial combined (SCG), an integrated combined (ICG), or a control (CG) group. The SCG and ICG implemented a 3-month training (3 sessions/week) consisting of walking and body weight exercises. The only difference between SCG and ICG was the sequence of aerobic and strength training. In SCG, the strength training was performed before aerobic training, while in ICG the aerobic and the strength training were alternated repeatedly in a predetermined order. Health, functional capacity, and physical fitness indices were measured before the training, following the termination of programs, and 1-month after training cessation. Following the training, both the SCG and ICG groups showed reduced blood pressure, heart rate, body fat, and waist-to-hip ratio (3−11%; p < 0.001), with improved respiratory function, muscle strength, aerobic capacity, flexibility, and balance (14−61%; p < 0.001). After 1-month of training cessation, significant reductions (p < 0.05) were observed in health indices and physical fitness without returning to baseline levels. However, there were no differences between SCG and ICG after training and training cessation (p > 0.05). In CG, all the above variables did not change. Furthermore, a great percentage of participants in both exercise groups (90%) reported high levels of enjoyment. In conclusion, both serial and integrated outdoor combined walking and body weight strength training programs are enjoyable and equally effective for improving health, functional capacity, and physical fitness indices in overweight/obese middle-aged males.

Improving muscle strength and physical function in older people living with sarcopenia and physical frailty: Not all exercise is created equal

Exercise is an increasingly widely used treatment for older people across a range of clinical conditions including sarcopenia and physical frailty. Whilst exercise can have many benefits for older people, adaptations to exercise are specific to the exercise mode that is performed and not all exercise is created equal. The correct type of exercise, at the correct dose, needs to be prescribed to maximise effectiveness in treating sarcopenia and physical frailty where maintaining or improving muscle strength and physical function represent key aims. Resistance exercise (RE) is the most potent approach to improving muscle strength and physical function and should be prioritised within exercise programmes delivered to this group. Resistance exercise programme design should be underpinned by the fundamental principles of exercise prescription in order to deliver an appropriate and individualised exercise dose to maximise the potential of RE as a treatment for older people living with sarcopenia and physical frailty.

Effects of Protein Supplementation Associated with Resistance Training on Body Composition and Muscle Strength in Older Adults: A Systematic Review of Systematic Reviews with Meta-analyses

BACKGROUND

There are some controversial findings regarding the benefits of combining protein supplementation with resistance training in order to optimize adaptations to training in older adults.

OBJECTIVE

The aim of this review was to summarize the evidence from meta-analyses assessing the effects of protein supplementation combined with resistance training on body composition and muscle strength in the older population.

METHODS

We included systematic reviews with meta-analyses of randomized clinical trials that examined the effects of protein and/or amino acid supplementation associated with resistance training compared with resistance training alone on lean body mass, muscle mass, and muscle strength in older people. The search was performed using the MEDLINE (PubMed), Embase, Cochrane Database of Systematic Reviews, Google Scholar, and OpenGrey databases. Methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist, and the quality of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation system. The pooled effect estimates were computed from the standardized mean difference and the 95% confidence interval achieved by each meta-analysis, using random effects models.

RESULTS

Five reviews were included, all of moderate methodological quality. In the analyses, protein supplementation combined with resistance training was associated with greater increases in lean body mass and muscle mass when compared with resistance training alone. However, no differences were observed between the interventions on muscle strength increases. The quality of evidence ranged from moderate to very low.

CONCLUSION

Protein supplementation associated with resistance training induces greater increases in lean body mass compared with resistance training alone. In addition, it is suggested that the use of protein supplementation enhances gains in muscle mass but does not promote greater increases in muscle strength.

THE EFFECT OF PROGRESSIVE RESISTANCE TRAINING ON FUNCTIONALITY AND HANDGRIP STRENGTH IN THE OLDER INDIVIDUALS OF A COMMUNITY: A QUASI-EXPERIMENTAL STUDY

BACKGROUND

Muscle weakness is associated with negative outcomes, in addition to being related to the pathogenesis of frailty and functional disability in the older individuals. Muscle strength and functionality are considered biomarkers of aging. Progressive resistance training (PRT) is a type of training that has been the subject of studies as it presents itself as a therapeutic option to fight the reduction of muscle strength and functionality in older individuals. However, few studies have assessed the clinically-relevant gains in the levels of muscle strength and functionality of older individuals after PRT, in addition to the need of testing new PRT approaches, including individualization and periodization in training programs. Therefore, this article aims to assess the effect of a individual and periodized PRT protocol on handgrip strength and functionality in older individuals. Thus, the study sample included 69 older individuals, divided into two groups: case (n = 41) and control (n = 28). The case group participated in a progressive resistance training protocol for 12 weeks, with two weekly sessions. When compared to the control group, which received only health education, the individuals in the case group had a greater magnitude of improvement in all variables related to the assessed functionality (Timed up and go test, gait speed, and handgrip strength), proving the applicability of the assessed protocol to improve strength and functionality in the older individuals people of a community.

The Effects of 32 Weeks of Multicomponent Training with Different Exercises Order in Elderly Women’s Functional Fitness and Body Composition

Background and objectives: Starting the multicomponent training sessions with aerobic-based exercises or resistance-based exercises may have different effects on functional fitness and body composition. Thus, the aim of this study was to assess the effects of the order of exercises in elderly women’s physical fitness and body composition by multicomponent training. Materials and Methods: A sample of 91 elderly females, aged between 60 and 81, were randomly divided into three groups (A, B, C). Each group performed the following order of exercises: Group A consisted of warm-up followed by aerobic training, strength training, stretching and cool down; Group B consisted of warm-up followed by strength training, aerobic training, stretching and cool down; while the control group (C) did not perform any exercise. Functional fitness and body composition were assessed at 3 moments of the 32 weeks (baseline and after each 16-week) intervention. One-way ANOVA for comparison between groups, ANOVA for repeated measures and multiple linear regression were used for statistical analysis. Results: The results showed that the functional fitness and body composition varied over the 32 weeks of multicomponent training. However, group A seems to show higher improvements in more variables. Conclusion: In the current study, group A obtained better results in most of the evaluated parameters. Thus, to improve functional fitness, warm-up, followed by aerobic training, strength training and relaxation may be the most suitable training for elderly women.

May the Force and Mass Be With You-Evidence-Based Contribution of Mechano-Biological Descriptors of Resistance Exercise

Skeletal muscle is one of the most important tissues of the human body. It comprises up to 40% of the body mass and is crucial to survival. Hence, the maintenance of skeletal muscle mass and strength is pivotal. It is well-established that resistance exercise provides a potent anabolic stimulus to increase muscle mass and strength in men and women of all ages. Resistance exercise consists of mechano-biological descriptors, such as load, muscle action, number of repetitions, repetition duration, number of sets, rest interval between sets, frequency, volitional muscular failure, and range of motion, which can be manipulated. Herein, we discuss the evidence-based contribution of these mechano-biological descriptors to muscle mass and strength.

Effects of different order of combined training on functional capacity, blood pressure, and body composition in women from 53 to 79 years old

Objective: To assess the effects of order of resistance training (RT) and high-intensity interval training (HIIT) on functional capacity, blood pressure, and body composition in middle-aged and older women. Methods: Twenty-two participants were randomly assigned to one of two groups: RT followed by HIIT (RT-HIIT, n = 10, mean age 64.5 ± 7.9 years) or HIIT followed by RT (HIIT-RT, n = 10, mean age 59.32 ± 4.44 years). Both groups trained twice a week for 8 weeks. RT was composed of 7 exercises for the upper and lower body. HIIT was composed of alternate pairings of high-intensity (> 85% of maximum heart rate [MHR]) and moderate-intensity (60% MHR) running. Results: A time effect was found for upper-body muscle endurance (HIIT-RT = +9.43%; RT-HIIT = +6.16%), agility and dynamic balance (HIIT-RT = -5.96%; RT-HIIT = -8.57%), and cardiorespiratory fitness (HIIT-RT = +5.14%; RT-HIIT = +6.13%), with no difference between groups. Body composition and blood pressure did not change throughout the investigation for either group. Conclusion: Eight weeks of a combined HIIT and RT exercise program improved functional capacity of middle-aged and older women without altering blood pressure and body composition, regardless of the order of exercises.

The Effects of Two Different Concurrent Training Configurations on Markers of Metabolic Syndrome and Fitness in Women With Severe/Morbid Obesity: A Randomised Controlled Trial

Concurrent training (CT), characterised by combining both aerobic and resistance training modalities within the same session, is recognised to improve metabolic syndrome (MetS) markers, but little is known about the effects of different configurations (i.e., order) of these exercise modalities on MetS markers and the interindividual responses. The purpose of the present study was to describe the effects, and the interindividual variability, of 20weeks of two CT configurations (i.e., high intensity interval training (HIIT) plus resistance training (RT), compared with RT plus HIIT) in women with severe/morbid obesity. Overall, 26 women with severe/morbid obesity were assigned either to HIIT+RT [n=14, mean and 95%CI, 45.79 (40.74; 50.83) or RT+HIIT (n=12), 33.6 (25.30; 41.79) years]. MetS-related outcomes were waist circumference (WC, cm), systolic (SBP, mmHg) and diastolic (DBP, mmHg) blood pressure, high-density lipoprotein cholesterol (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG). Secondary outcomes were other anthropometrics, body composition, lipids, muscle strength, and the six-minute walk test (6Mwt). There were significant differences in the prevalence of nonresponders (NRs) only for WC comparing HIIT+RT 2 (18.1%) vs. RT+HIIT group 5 (50.0%), p<0.0001, but not for SBP 4 (27.2%) vs. 4 (40.0%), DBP 8 (72.7%) vs. 7 (70.0%), FPG 8 (72.7%) vs. 9 (90.0%), HDL-c 7 (63.6%) vs. 8 (80.0%), and Tg 7 (63.6%) vs. 8 (80.0%), all p>0.05. Additionally, the RT+HIIT group showed significant reductions in WC (∆ –3.84cm, p=0.015), SBP (∆ –8.46mmHg, p=0.040), whereas the HIIT+RT group elicited significant reductions only in SBP (∆ –8.43mmHg, p=0.022). The HIIT+RT promoted a lower prevalence of NRs than the RT+HIIT configuration on WC, and overall, there were slightly more beneficial training-induced effects on markers of MetS in the RT+HIIT group compared to the HIIT+RT group.

Effects of high-intensity interval training combined with traditional strength or power training on functionality and physical fitness in healthy older men: A randomized controlled trial

Concurrent training (CT) is an efficient strategy to improve neuromuscular function and cardiorespiratory fitness in older adults, which are factors of pivotal importance for the maintenance of functional capacity with aging. However, there is a lack of evidence about the effectiveness of power training (PT) as an alternative to traditional strength training (TST) during CT. Thus, the aim of the present study was to examine the effect of 16 weeks (twice weekly) TST combined with high intensity interval training (TST + HIIT) vs. PT combined with HIIT (PT + HIIT) on functional performance, cardiorespiratory fitness and body composition in older men. Thirty five older men (65.8 ± 3.9 years) were randomly allocated into two training groups: TST + HIIT (n = 18), and PT + HIIT (n = 17). TST + HIIT performed resistance training at intensities ranging from 65% to 80% 1RM at slow controlled speed (≅ 2 s for each concentric phase), whereas PT + HIIT trained at intensities ranging from 40% to 60% of 1RM at maximal intentional speed. Both groups performed HIIT at intensities ranging from 75 to 90% of VO_2peak. Participants performed functional tests (sit-to-stand, timed-up-and-go, stair climbing); cardiopulmonary exercise testing (maximal cycling power output: W_max, peak oxygen uptake: VO_2peak, cycling economy), as well as body composition assessment (DXA) before, post 8 and post 16 weeks of training. The groups improved similarly (P < 0.05) with training in all functional capacity outcomes, W_max, cycling economy, VO_2peak and body composition (P < 0.05). These findings suggest that HIIT based CT programs involving TST vs. PT are equally effective in improving functionality, cardiorespiratory fitness and body composition in healthy older men.

Exercise rescues mitochondrial coupling in aged skeletal muscle: a comparison of different modalities in preventing sarcopenia

Skeletal muscle aging is associated with a decline in motor function and loss of muscle mass- a condition known as sarcopenia. The underlying mechanisms that drive this pathology are associated with a failure in energy generation in skeletal muscle, either from age-related decline in mitochondrial function, or from disuse. To an extent, lifelong exercise is efficacious in preserving the energetic properties of skeletal muscle and thus may delay the onset of sarcopenia. This review discusses the cellular and molecular changes in skeletal muscle mitochondria during the aging process and how different exercise modalities work to reverse these changes. A key factor that will be described is the efficiency of mitochondrial coupling—ATP production relative to O₂ uptake in myocytes and how that efficiency is a main driver for age-associated decline in skeletal muscle function. With that, we postulate the most effective exercise modality and protocol for reversing the molecular hallmarks of skeletal muscle aging and staving off sarcopenia. Two other concepts pertinent to mitochondrial efficiency in exercise-trained skeletal muscle will be integrated in this review, including- mitophagy, the removal of dysfunctional mitochondrial via autophagy, as well as the implications of muscle fiber type changes with sarcopenia on mitochondrial function.

2 + 2 (+ 2) = 4: A new approach for appendicular muscle mass assessment by ultrasound

OBJECTIVE

The aim of this study was to develop new appendicular lean mass (ALM) prediction models based on ultrasound and anthropometric measurements.

METHODS

This was a cross-sectional assessment of a subsample from a population-based study (COMO VAI?), conducted with community-dwelling individuals ≥60 y of age living in a southern Brazilian city. ALM was measured by dual-energy x-ray absorptiometry (DXA). Muscle thickness (MT) from supine participants was assessed by ultrasound on the anterior aspect of both upper and lower limbs. Such measures, along with anthropometric data, were used to develop prediction models (multivariable linear regression) through the backward stepwise method.

RESULTS

The study included 190 participants composed mainly of women, white, and middle-class individuals. The best ALM predictive performance was achieved by a model based on two "lengths" (height and arm length), two circumferences (dominant arm and thigh), and two ultrasound-measured MTs (dominant arm and thigh): R² = 0.90, limits of agreement: ±2.36 kg. Closely satisfactory results were also achieved by an "abbreviated" model composed by the two aforementioned "lengths" and MTs (R² = 0.89, limits of agreement: ±2.51 kg). ALM estimates from both equations were unbiased and similar to DXA measurements (P = 0.13 and 0.09, respectively). Bootstrap analysis favorably suggested the validity of the models.

CONCLUSIONS

Based on two ultrasound assessments and a few anthropometric measurements, the developed equations produced accurate and unbiased ALM estimates in the sample. Hence: 2 MTs + 2 lengths (+ 2 circumferences) = 4 limbs' muscle mass. Such models might represent promising alternatives for muscle assessment among older individuals.

Effect of a 6-week strength-training program on neuromuscular efficiency in type 2 diabetes mellitus patients

Background

The neuromuscular system generates human movement. The functional capacity of the neuromuscular system in patients with type 2 diabetes mellitus (T2DM) is decreased and this affects the generation of muscle force. Exercise is recommended as an effective treatment in such cases. Short-duration strength training causes neural adaptations in healthy participants, but the effects of strength training on T2DM are unclear. The present study aimed to evaluate the effect of strength training on neuromuscular efficiency of lower limb muscles in T2DM.

Methods

Surface electromyograms (SEMG) of the knee flexors and extensors were recorded during isometric contractions. The ratio of peak torque to SEMG amplitude was calculated as neuromuscular efficiency. Measurements were taken before the intervention after 6 weeks of non-training, and after 6 weeks of strength training.

Results

SEMG amplitudes did not differ among the subsequent measurement sessions. Flexor and extensor peak torque increased after the strength-training program. The neuromuscular efficiency of all muscles increased after the 6 weeks of strength training.

Conclusion

A 6-week strength-training program increased the neuromuscular efficiency and peak torque in patients with T2DM; however, the electrical properties of the muscles did not change. These results may be related to increased neural adaptations and motor learning in the early stages of strength training.

Effects of long-term concurrent training to failure or not in muscle power output, muscle quality and cardiometabolic risk factors in older men: A secondary analysis of a randomized clinical trial

This study investigated the effects of concurrent training performed either with repetitions to failure or not to failure in muscle power, muscle quality (MQ), peak oxygen uptake (VO_2peak), and visceral fat in older men. This is an ancillary analysis of a randomized controlled trial. 36 older men (mean age ± SD; 67.1 ± 5.1 years) were randomized into three groups: one performing repetitions to failure (RFG, n = 13), another performing repetitions not to failure and 50% of the repetitions of the RFG (NFG, n = 12), and third performing repetitions not to failure with equal training volume of the RFG (ENFG, n = 11). The training was performed twice a week for 20 weeks at intensities ranging from 65 to 80% of maximal strength. In each session, the individuals started with strengthening exercises and then performed aerobic exercise (i.e., walking) on a treadmill. The primary endpoint was change from baseline to post-20 wk of absolute and relative muscle power output during squat and countermovement jump, ultrasound measurements for MQ using quadriceps echo intensity, and visceral fat thickness, as well as their VO_2peak through a maximal incremental test on a treadmill. All training groups improved similarly and significantly jump height (ranging from 9 to 16%) and all their muscle power outcomes (mean change ranging from 2 to 7%) (P < .001). In addition, all groups significantly decreased visceral fat thickness (ranging from -11 to -21%) (P < .001), and significantly increased VO_2peak (ranging from 4 to 8%) (P < .01), with no differences between groups. No changes were observed in the MQ outcomes. Concurrent training performed using repetitions to failure or not to failure promoted similar gains in the muscle power output, aerobic capacity, and visceral fat in healthy older men.

Improved balance in middle-aged adults after 8 weeks of a modified version of Otago Exercise Program: A randomized controlled trial

Objective

The objective of this randomized controlled trial was to examine dynamic balance changes (reach distance) in middle-aged adults using the Y Balance Test (YBT) following 8 weeks of home-based exercise program adapted from the Otago Exercise Program (OEP).

Methods

Fifty-two healthy middle-aged adults with mean age of 54.4±5.4 years and body mass index of 27.7±5.7 kg/m² were randomly assigned into either the exercise group (a modification of the Otago Exercise Program, that consisted of home-based balance and strength exercises) or the non-exercise group (continuation of usual lifestyle) by having the participants select a paper from a sealed envelope. The YBT was used to measure participants’ dynamic balance in the right and left anterior (RA, LA), posteromedial (RPM, LPM), and posterolateral (RPL, LPL) directions.

Results

The outcome in this trial was reach distance (cm). There was a significant group by time interaction in terms of reach distance for all directions (p<0.05, η² ranged from 0.06 to 0.20). In the exercise group, results of the repeated measures analysis of variance (ANOVA) showed significant improvements in the reach distance in all the directions (p<0.001). In contrast, the non-exercise group had significant difference only in the left posterolateral direction (p = 0.009). Participants in the exercise group achieved significantly greater reach distance (cm) (95% confidence interval (CI)) for RA[(2.8, 0.4 to 5.2), p = 0.023]; LA[(3.2, 0.9 to 5.6), p = 0.008]; RPM[(4.0, 1.0 to 7.9), p = 0.046]; LPM[(5.8,1.3 to 10.3), p = 0.013]; RPL[(7.6, 2.6 to 12.6), p = 0.003]; and LPL[(4.2, 0.3 to 8.2), p = 0.035].

Conclusion

The modified version of OEP appears to be effective in improving parameters of dynamic balance in the middle-aged adult population. The improvements in YBT reach distance in the exercise group are indicative of the significance of performing balance and strength exercises regularly for this population.

Order of same-day concurrent training influences some indices of power development, but not strength, lean mass, or aerobic fitness in healthy, moderately-active men after 9 weeks of training

Background

The importance of concurrent exercise order for improving endurance and resistance adaptations remains unclear, particularly when sessions are performed a few hours apart. We investigated the effects of concurrent training (in alternate orders, separated by ~3 hours) on endurance and resistance training adaptations, compared to resistance-only training.

Materials and methods

Twenty-nine healthy, moderately-active men (mean ± SD; age 24.5 ± 4.7 y; body mass 74.9 ± 10.8 kg; height 179.7 ± 6.5 cm) performed either resistance-only training (RT, n = 9), or same-day concurrent training whereby high-intensity interval training was performed either 3 hours before (HIIT+RT, n = 10) or after resistance training (RT+HIIT, n = 10), for 3 d^.wk^-1 over 9 weeks. Training-induced changes in leg press 1-repetition maximal (1-RM) strength, countermovement jump (CMJ) performance, body composition, peak oxygen uptake (V˙O2peak), aerobic power (W˙peak), and lactate threshold (W˙LT) were assessed before, and after both 5 and 9 weeks of training.

Results

After 9 weeks, all training groups increased leg press 1-RM (~24–28%) and total lean mass (~3-4%), with no clear differences between groups. Both concurrent groups elicited similar small-to-moderate improvements in all markers of aerobic fitness (V˙O2peak ~8–9%; W˙LT ~16-20%; W˙peak ~14-15%). RT improved CMJ displacement (mean ± SD, 5.3 ± 6.3%), velocity (2.2 ± 2.7%), force (absolute: 10.1 ± 10.1%), and power (absolute: 9.8 ± 7.6%; relative: 6.0 ± 6.6%). HIIT+RT elicited comparable improvements in CMJ velocity only (2.2 ± 2.7%). Compared to RT, RT+HIIT attenuated CMJ displacement (mean difference ± 90%CI, -5.1 ± 4.3%), force (absolute: -8.2 ± 7.1%) and power (absolute: -6.0 ± 4.7%). Only RT+HIIT reduced absolute fat mass (mean ± SD, -11.0 ± 11.7%).

Conclusions

In moderately-active males, concurrent training, regardless of the exercise order, presents a viable strategy to improve lower-body maximal strength and total lean mass comparably to resistance-only training, whilst also improving indices of aerobic fitness. However, improvements in CMJ displacement, force, and power were attenuated when RT was performed before HIIT, and as such, exercise order may be an important consideration when designing training programs in which the goal is to improve lower-body power.

Photobiomodulation therapy increases functional capacity of patients with chronic kidney failure: randomized controlled trial

Photobiomodulation (PBM) has been used in different populations as a strategy to attenuate muscle fatigue and improve exercise performance. Recent findings demonstrated that a single session with specific PBM doses during hemodialysis (HD) increased the upper limb muscle strength of chronic kidney failure (CKF) patients. Now, the primary objective of this study was to evaluate the chronic effect of PBM on the functional capacity of this population. Secondarily, we aimed at investigating the effects of PBM on the patients' strength, muscle thickness and echogenicity, perception of pain, fatigue, and quality of life. A randomized controlled trial was conducted in which the intervention group (IG, n = 14) received 24 sessions of PBM (810 nm, 5 diodes × 200 mW, 30 J/application site) on lower limb during HD. The control group (CG, n = 14) did not receive any physical therapy intervention, it only underwent HD sessions. As a result, there was an increase in the functional capacity (assessed through the six-minute walk test) for the IG compared with the CG [50.7 m (CI95% 15.63; 85.72), p = 0.01, large effect size, d = 1.12], as well as an improvement on lower limb muscle strength (assessed through the sit-and-stand test) [- 7.4 s (CI95% - 4.54; - 10.37), p = 0.00, large effect size, d = 1.99]. For other outcomes evaluated, no significant difference between-group was observed. Finally, PBM applied as monotherapy for 8 weeks in the lower limb improves functional capacity and muscle strength of CKF patients.

Adaptations in mechanical muscle function, muscle morphology, and aerobic power to high-intensity endurance training combined with either traditional or power strength training in older adults: a randomized clinical trial

PURPOSE

There is a lack of information on the effects of power training (PT) as an alternative to traditional strength training (TST) during concurrent training (CT) in older individuals. This study aimed to verify the neuromuscular adaptations that occurred following 16-week interventions with two CT models in older men: high-intensity interval training (HIIT) combined with either TST or PT.

METHODS

Thirty-five older men (65.8 ± 3.9 years) were randomly assigned into one of two training groups CTS: TST + HIIT (n = 18) or CTP: PT + HIIT (n = 17). CTS performed resistance training at intensities ranging from 65 to 80% of 1 RM at slow controlled speed, whereas CTP trained at intensities ranging from 40 to 60% of 1 RM at maximal intentional speed. Lower body one-repetition maximum (1 RM), isometric rate of force development (RFD), countermovement jump (CMJ) muscle power output, quadriceps femoris muscles thickness (QF MT), and peak oxygen uptake (VO_2peak) were assessed before training and after 8 and 16 weeks of CT.

RESULTS

Groups improved similarly in all primary outcomes (P < 0.05), with mean increases ranging: 1 RM (from 39.4 to 75.8%); RFD (from 9.9 to 64.8%); and CMJ muscle power (from 1.8 to 5.2%). Significant increases (P < 0.05) were observed in all secondary outcomes (QF MT, specific tension and VO_2peak) with no differences between groups.

CONCLUSION

CT models were effective for improving maximal and explosive force (1 RM, RFD, and CMJ power), QF MT, and VO_2peak. Moreover, despite that using lower loading intensities, PT induced similar adaptations to those of TST.

The Effects of Concurrent Training Order on Satellite Cell-Related Markers, Body Composition, Muscular and Cardiorespiratory Fitness in Older Men with Sarcopenia

OBJECTIVES

Concurrent Training (CT) is described as a combination of resistance training (RT) and endurance training (ET) in a periodized program to maximize all aspects of physical performance. To date, effects of CT order on muscular and cardiorespiratory fitness adaptations are controversial. Owing to the age-related decrement in satellite cells (SC) which are critical for fiber repair, conservation, muscle hypertrophy as well as cardiorespiratory fitness, the present study examined the response of SC related markers to CT order in older sarcopenic men.

PARTICIPANTS

Thirty older men (age= 64.3 ± 3.5 years) were randomly assigned into one of 3 groups, ET followed by RT (E+R; n=10), RT followed by ET (R+E; n= 10) or a control (C; n=10).

INTERVENTION

The training protocol consisted of 3 exercise sessions per week for 8 weeks. Blood samples were obtained at baseline and 48 hours after the final training session.

RESULTS

Weight, skeletal muscle mass, lower and upper body power, maximal oxygen consumption (VO2max), Paired Box 7 (Pax7), and Myogenic factor 5 (Myf5) significantly increased, while were percent body fat significantly decreased following E+R and R+E compared to C. Importantly, the improvement in skeletal muscle mass, lower and upper body power, Myf5 and Pax7 in the E+R was significantly greater than the R+E group. Myogenin (Myog) and Paired Box 3 (Pax3) significantly increased (P < 0.01) in both training groups compared to no changes in C.

CONCLUSION

An 8-week CT intervention improves SC related markers, body composition and enhances power and VO2max in older sarcopenic participants, regardless of the order of RT and ET. However, performing ET before RT may be more effective at enhancing skeletal muscle mass, Myf5 and Pax7, in addition to both lower and upper body power. While both CT programs produced notable physiological and performance benefits, performing ET before RT during CT may provide the greatest therapeutic benefits for aging individuals.

The Influence of the Aerobic Training on Muscle Hypertrophy: Literature Review

AbstractThe literature presents some studies that show that aerobic exercise is responsible for mediating muscle catabolism. Thus, it is interpreted that continuous aerobic exercise produces little or no increase in muscle hypertrophy. The purpose of this review was to demonstrate the effects of aerobic training on muscle hypertrophy alone or in conjunction with resistance training. The present study is characterized by a review of the narrative literature, the databases of SciELO, Google academic and PubMed were consulted. Many studies show that aerobic training (AT) can promote hypertrophic responses in untrained individuals, however, these responses are related to exercise variables such as intensity, volume, frequency, and modality. Higher, continuous or interval intensities, at least 80% of the HRR, seem  to be capable of promoting hypertrophic responses when compared to low intensities. In addition, the training volume may also influence this response and different modalities may have a distinct response to muscle hypertrophy. While the combination of TA and resistance training (TR) corresponds to concurrent training (CT), the literature demonstrates that AT in CT can negatively affect acute and chronic hypertrophic responses depending on intensity, volume, mode and training schedule. Keywords: Exercise. Physical Education and Training. Metabolism. ResumoA literatura apresenta alguns estudos que mostram que exercício aeróbio é responsável por mediar o catabolismo muscular. Dessa maneira, interpreta-se que o exercício contínuo aeróbio produz pouco ou nenhum aumento na hipertrofia muscular. O objetivo desta revisão foi demonstrar os efeitos do treinamento aeróbio sobre a hipertrofia muscular de forma isolada ou em conjunto com o treinamento resistido. O presente estudo caracteriza-se um delineamento de revisão de literatura narrativa, foram consultadas as bases de dados do SciELO, Google acadêmico e PubMed. Muitos estudos mostram que o treinamento aeróbio (TA) pode promover respostas hipertróficas em indivíduos não treinados, entretanto, estas respostas estão relacionadas às variáveis do exercícios como intensidade, volume, frequência e modalidade. Intensidades mais altas, contínuas ou intervaladas, no mínimo 80% da FCR, parecem ser capazes de promover respostas hipertróficas quando comparado a baixas intensidades. Além disso, o volume do treinamento também pode influenciar esta resposta e diferentes modalidades podem ter resposta distinta sobre a hipertrofia muscular. Enquanto a combinação do TA com o treinamento resistido (TR) corresponde ao treinamento concorrente (TC), a literatura demonstra que o TA no TC pode interferir negativamente nas respostas hipertróficas de maneira aguda e crônica dependendo da intensidade, volume, modalidade e programação de treinamento.  Palavras-chave: Exercício. Educação Física e Treinamento. Metabolismo.

Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association

Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.

Adaptations to Concurrent Training in Combination with High Protein Availability: A Comparative Trial in Healthy, Recreationally Active Men

Background

We implemented a high-protein diet (2 g·kg⁻¹·d⁻¹) throughout 12 weeks of concurrent exercise training to determine whether interferences to adaptation in muscle hypertrophy, strength and power could be attenuated compared to resistance training alone.

Methods

Thirty-two recreationally active males (age: 25 ± 5 years, body mass index: 24 ± 3 kg·m⁻²; mean ± SD) performed 12 weeks of either isolated resistance (RES; n = 10) or endurance (END; n = 10) training (three sessions·w⁻¹), or concurrent resistance and endurance (CET; n = 12) training (six sessions·w⁻¹). Maximal strength (1RM), body composition and power were assessed pre- and post-intervention.

Results

Leg press 1RM increased ~ 24 ± 13% and ~ 33 ± 16% in CET and RES from PRE-to-POST (P < 0.001), with no difference between groups. Total lean mass increased ~ 4% in both CET and RES from PRE-to-POST (P < 0.001). Ultrasound estimated vastus lateralis volume increased ~ 15% in CET and ~ 11% in RES from PRE-to-POST (P < 0.001), with no difference between groups. Wingate peak power relative to body mass displayed a trend (P = 0.053) to be greater in RES (12.5 ± 1.6 W·kg BM⁻¹) than both CET (10.8 ± 1.7 W·kg BM⁻¹) and END (10.9 ± 1.8 W·kg BM⁻¹) at POST. Absolute VO_2peak increased 6.9% in CET and 12% in END from PRE-to-POST (P < 0.05), with no difference between groups.

Conclusion

Despite high protein availability, select measures of anaerobic power-based adaptations, but not muscle strength or hypertrophy, appear susceptible to ‘interference effects’ with CET and should be closely monitored throughout training macro-cycles.

Trials Registry: This trial was registered with the Australian-New Zealand Clinical Trials Registry (ACTRN12617001229369).

Electronic supplementary material

The online version of this article (10.1007/s40279-018-0999-9) contains supplementary material, which is available to authorized users.

Comparisons of low-intensity versus moderate-intensity combined aerobic and resistance training on body composition, muscle strength, and functional performance in older women

OBJECTIVE

This study aimed to examine the effects of exercise order of combined aerobic and low- or moderate-intensity resistance training into the same session on body composition, functional performance, and muscle strength in healthy older women. Furthermore, this study compared the effects of different (low- vs moderate-) intensity combined training.

METHODS

A total of 60 healthy older women (age 61-81 y) were randomly assigned to five groups that performed aerobic exercise before low-intensity resistance training (AR-L, n = 12) or after resistance training (RA-L, n = 12), performed aerobic exercise before moderate-intensity resistance training (AR-M, n = 12) or after resistance training (RA-M, n = 12), or nonintervention control conditions (CON, n = 12). Body composition, functional performance, and muscle strength were evaluated before and after the 10-week training.

RESULTS

No effects of exercise order of combined aerobic and low- or moderate-intensity resistance training (AR-L vs RA-L, AR-M vs RA-M) were observed in body composition, functional performance, or muscle strength, whereas the effects of training intensity of combined training (AR-L vs AR-M, RA-L vs RA-M) were observed on functional performance. All combined trainings significantly increased muscle strength and gait ability (P < 0.01, respectively). Functional reach test significantly increased in the AR-M and RA-M groups (P < 0.01, respectively), and there were significant group differences between AR-L and AR-M (P = 0.002), RA-L and RA-M (P = 0.014).

CONCLUSIONS

Preliminary findings suggest that combined aerobic and low- or moderate-intensity resistance training increases muscle strength and improves gait ability, regardless of the exercise order. Also, greater improvement in dynamic balance capacity, a risk factor associated with falling, is observed in moderate-intensity combined training.

Effect of Flywheel Resistance Training on Balance Performance in Older Adults. A Randomized Controlled Trial

This study aimed to assess the effects of flywheel resistance exercise training on postural stability and mobility in older adults and to investigate whether changes in power are related to improvements in balance. Thirty-six participants were randomly allocated to either a flywheel resistance exercise training group (ETG; n = 18) who underwent 6-weeks of training (2 to 3 days per week) or a control group (CON; n = 18). The average power and Mean Propulsive Velocity (MPV) were computed. Timed up-and-go test (TUG) and postural balance (anterior-posterior (AP) and medial-lateral (ML) center of pressure (COP) excursions) in different tasks were also assessed. Within-group analyses showed a significantly better performance in mobility (TUG, p < 0.01) and COP_AP with open eyes (p < 0.05) for ETG. Between-groups analyses showed significant improvements in TUG (-0.68 [-1.25 to -0.98]) and in COP_AP (-2.90 [-4.82 to -0.99]) in ETG compared with CON. Mean power also increased in ETG and the changes were related to those observed in stability (COP; r = -0.378, p < 0.05). In conclusion flywheel resistance exercise training improved balance and mobility in older adults as well as muscle power.

Combining a high DHA multi-nutrient supplement with aerobic exercise: Protocol for a randomised controlled study assessing mobility and cognitive function in older women

There is a complex interplay between cognition and gait in older people, with declines in gait speed coexisting with, or preceding cognitive decline. Omega-3 fatty acids, B vitamins, vitamin E, phosphatidylserine, and Ginkgo Biloba show promise in preserving mobility and cognitive function in older adults. Exercise benefits mobility and there is evidence suggesting positive interactions between exercise and omega-3 fatty acids on physical and cognitive function in older adults. Non-frail or pre-frail females aged ≥60 years are included in a randomized placebo controlled study. Intervention groups are: high DHA multi-nutrient supplement and exercise, placebo supplement and exercise, high DHA multi-nutrient supplement, and placebo supplement. Dietary supplementation is 24 weeks. The exercise intervention, two cycle ergometer classes per week, is for the final 12 weeks. The primary outcome is habitual walking speed, secondary outcomes include gait variables under single and dual task, five times sit to stand, verbal and spatial memory, executive function, interference control and health related quality of life. Blood fatty acids, serum homocysteine, dietary intake, physical activity, and verbal intelligence are measured to assess compliance and control for confounding factors. The study is registered at www.clinicaltrials.gov (NCT03228550).

Combined effects of very short "all out" efforts during sprint and resistance training on physical and physiological adaptations after 2 weeks of training

PURPOSE

The aim of this study was to compare the combined effects of resistance and sprint training, with very short efforts (5 s), on aerobic and anaerobic performances, and cardiometabolic health-related parameters in young healthy adults.

METHODS

Thirty young physically active individuals were randomly allocated into four groups: resistance training (RTG), sprint interval training (SITG), concurrent training (CTG), and control (CONG). Participants trained 3 days/week for 2 weeks in the high-intensity interventions that consisted of 6-12 "all out" efforts of 5 s separated by 24 s of recovery, totalizing ~ 13 min per session, with 48-72 h of recovery between sessions. Body composition, vertical jump, lower body strength, aerobic and anaerobic performances, heart rate variability (HRV), and redox status were evaluated before and after training. Total work (TW), rating of perceived exertion (CR-10 RPE) and mean HR (HR_mean) were monitored during sessions. Incidental physical activity (PA), dietary intake and perceived stress were also controlled.

RESULTS

Maximum oxygen consumption (VO_2max) significantly increased in SITG and CTG (P < 0.05). Lower body strength improved in RTG and CTG (P < 0.05), while countermovement jump (CMJ) was improved in RTG (P = 0.04) only. Redox status improved after all interventions (P < 0.05). No differences were found in TW, PA, dietary intake, and psychological stress between groups (P > 0.05).

CONCLUSIONS

RT and SIT protocols with very short "all out" efforts, either performed in isolation, or combined, demonstrated improvement in several physical fitness- and health-related parameters. However, CT was the most efficient exercise intervention with improvement observed in the majority of the parameters.

Does Aerobic Exercise Impair Neuromuscular Function During Water-Based Resistance Exercises?

PURPOSE

The purpose of this study was to investigate the acute effects of water-based aerobic exercises on the performance of water-based resistance exercises by assessing kinematic parameters during protocols and neuromuscular responses after them.

METHOD

Ten women performed 2 water-based protocols (i.e., resistance and concurrent water-based exercises) on separate days. We evaluated isometric force and electromyographic signal (sEMG) before and after protocols and analyzed kinematic parameters during a water-based resistance exercise.

RESULTS

There was no significant difference between knee extension force production and sEMG from the vastus lateralis during the maximal voluntary contraction performed before and after the protocols. However, sEMG from the rectus femoris presented a significant difference between pretest and posttest measurements in both water-based protocols with greater values in the measurement after the end of the protocol (p = .046). The peak angular velocity of knee extension and mean angular velocity of knee extension and flexion showed similar values among the sets, with no difference between protocols. The peak angular velocity of knee flexion presented greater values in the water-based resistance exercises compared with the water-based concurrent protocol in the last set (p < .001).

CONCLUSION

The main impairment induced by the water-based concurrent exercises was the lower peak angular velocity in the knee flexors compared with water-based resistance exercises alone.

A Brief Review on Concurrent Training: From Laboratory to the Field

The majority of sports rely on concurrent training (CT; e.g., the simultaneous training of strength and endurance). However, a phenomenon called “Concurrent training effect” (CTE), which is a compromise in adaptation resulting from concurrent training, appears to be mostly affected by the interference of the molecular pathways of the underlying adaptations from each type of training segments. Until now, it seems that the volume, intensity, type, frequency of endurance training, as well as the training history and background strongly affect the CTE. High volume, moderate, continuous and frequent endurance training, are thought to negatively affect the resistance training-induced adaptations, probably by inhibition of the Protein kinase B—mammalian target of rapamycin pathway activation, of the adenosine monophosphate-activated protein kinase (AMPK). In contrast, it seems that short bouts of high-intensity interval training (HIIT) or sprint interval training (SIT) minimize the negative effects of concurrent training. This is particularly the case when HIIT and SIT incorporated in cycling have even lower or even no negative effects, while they provide at least the same metabolic adaptations, probably through the peroxisome proliferator-activated receptor-γ coactivator (PGC-1a) pathway. However, significant questions about the molecular events underlying the CTE remain unanswered.