Longitudinal comparison of low- and high-velocity resistance training in relation to body composition and functional fitness of older adults

Effect of Resistance Training Programs With Equated Power on Older Adults' Functionality and Strength: A Randomized Controlled Trial

ABSTRACT

Fraga-Germade, E, Carballeira, E, and Iglesias-Soler, E. Effect of resistance training programs with equated power on older adults' functionality and strength: a randomized controlled trial. J Strength Cond Res 38(1): 153-163, 2024-This study aimed to compare the effect of 2 training programs of equated power but differing in load intensity on older adults' functionality, strength, performance, and body composition. Forty-four active (23 female) older adults (66.3 ± 4.5 years) were randomly assigned to low-load high-velocity (LL-HV), high-load low-velocity (HL-LV), and control (CON) groups. Low-load high-velocity and HL-LV performed, twice weekly for 5 weeks, a resistance training program at 95% of their individual peak power (PP) but with different load intensities for 3 exercises: chest press (CHP), leg press (LP), and seated row (SR). Before and after the intervention, body composition, functional performance, maximal voluntary isokinetic force (MVF), PP, and a relative load-power profile (L-PP) were evaluated for every exercise. PP similarly improved in the experimental groups for SR and LP (p < 0.05). Both groups increased their MVF for the 3 exercises (p < 0.05). Positive effects on L-PP were observed in LL-HV for SR (p = 0.009) and HL-LV for LP (p < 0.001). CON decreased its global power performance in SR (p = 0.009) and CHP (p = 0.031) compared with the baseline. Both experimental groups improved Timed Up and Go performance (p < 0.05), but only HL-LV increased 6-minute walking performance (pre: 514.3 ± 89.0 m, post: 552.6 ± 65.4 m; p < 0.05). In conclusion, adding short-term power training (i.e., 10 sessions throughout 5 weeks) with loads slightly above the optimal load to nonsupervised multicomponent training might improve active older adults' functional performance and cardiovascular endurance.

High-velocity power training has similar effects to traditional resistance training for functional performance in older adults: a systematic review

QUESTIONS

What is the effect of high-velocity power training (HVPT) compared with traditional resistance training (TRT) on functional performance in older adults? What is the quality of intervention reporting for the relevant literature?

DESIGN

Systematic review and meta-analysis of randomised controlled trials.

PARTICIPANTS

Older adults (aged > 60 years), regardless of health status, baseline functional capacity or residential status.

INTERVENTIONS

High-velocity power training with the intent to perform the concentric phase as quickly as possible compared with traditional moderate-velocity resistance training performed with a concentric phase of ≥ 2 seconds.

OUTCOME MEASURES

Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), five times sit-to-stand test (5-STS), 30-second sit-to-stand test (30-STS), gait speed tests, static or dynamic balance tests, stair climb tests and walking tests for distance. The quality of intervention reporting was assessed with the Consensus on Exercise Reporting Template (CERT) score.

RESULTS

Nineteen trials with 1,055 participants were included in the meta-analysis. Compared with TRT, HVPT had a weak-to-moderate effect on change from baseline scores for the SPPB (SMD 0.27, 95% CI 0.02 to 0.53; low-quality evidence) and TUG (SMD 0.35, 95% CI 0.06 to 0.63; low-quality evidence). The effect of HVPT relative to TRT for other outcomes remained very uncertain. The average CERT score across all trials was 53%, with two trials rated high quality and four rated moderate quality.

CONCLUSION

HVPT had similar effects to TRT for functional performance in older adults, but there is considerable uncertainty in most estimates. HVPT had better effects on the SPPB and TUG, but it is unclear whether the benefit is large enough to be clinically worthwhile.

Effects of maximal-versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults: a systematic review and meta-analysis

The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT's) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move 'as fast as possible' during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: - 1.74 [95% CI - 2.79, - 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: - 1.21, [95% CI - 2.17, - 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: - 0.84, [95% CI - 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: - 0.57, [95% CI - 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality ("low" PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible.

Comparison of Power Training vs Traditional Strength Training on Physical Function in Older Adults: A Systematic Review and Meta-analysis

IMPORTANCE

Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under control) and power training (PT) (lifting weights fast and lowering under control) are associated with improved physical function in older adults is not clear.

OBJECTIVE

To evaluate whether PT vs traditional strength training is associated with physical function improvement in older adults.

DATA SOURCES

Systematic searches of MEDLINE, Embase, Cochrane Central, CINAHL, PsycInfo, PEDro, and SPORTDiscus were conducted from database inception to October 20, 2021.

STUDY SELECTION

Randomized clinical trials (RCTs) that compared strength training with instructions to move the weight as fast as possible in the lifting phase with traditional strength training in healthy, community-living older adults (age ≥60 years).

DATA EXTRACTION AND SYNTHESIS

Two authors independently selected trials, extracted data, assessed the risk of bias using the Cochrane risk-of-bias tool 2, and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Summary effect size measures were calculated using a multilevel random-effects model with cluster robust variance estimation and are reported as standardized mean differences (SMDs). Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline.

MAIN OUTCOMES AND MEASURES

Primary outcomes included physical function and self-reported physical function. Secondary outcomes included power, strength, muscle mass, walk speed, balance, and adverse effects.

RESULTS

A total of 20 RCTs enrolling 566 community-living older adults (mean [SD] age, 70.1 [4.8] years; 368 [65%] women) were included. For the primary outcomes, PT was associated with an improvement in physical function with low-certainty evidence in 13 RCTs (n = 383) (SMD, 0.30; 95% CI, 0.05-0.54) and self-reported function with low-certainty evidence in 3 RCTs (n = 85) (SMD, 0.38; 95% CI, -0.62 to 1.37). The evidence was downgraded by 2 levels for high risk of bias and imprecision for physical function and very serious imprecision for self-reported physical function.

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, PT was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.

High-velocity resistance training as a tool to improve functional performance and muscle power in older adults

The aging process results in several physiological impairments that, in turn, may predispose older individuals to a series of restrictions on their functional capacity. These impairments are important to understand so that suitable conditions for healthier aging can be pursued. In this review, we first summarize the effects of aging on the neuromuscular system, as well as on the relation between the main age-associated physiological impairments and functional performance with an emphasis on muscle power output. We then proceed to discuss the effects of resistance training, specifically high-velocity resistance training (HVRT), on the aforementioned neuromuscular impairments, and on functional performance in healthy and mobility-limited older adults. Collectively, available evidence suggests that HVRT seems to be a safe and effective intervention for improving muscle power, functional performance, and mobility of older individuals. It also seems that mobility-limited older adults may improve power and functional performance to a greater extent than their healthy counterparts after HVRT, which is in line with the principle of diminishing returns. Considering that only a very limited number of investigations directly compared the effects of HVRT in more than one of the aforementioned groups, studies comparing the adaptations to HVRT of middle-aged adults and older adults with distinct functional capacities would be valuable to determine whether there are differences in neuromuscular adaptations, functional performance, and functional reserve among these groups.

Evaluation of impact-shock on gait after the implementation of two different training programs in older adults

BACKGROUND

Gait is negatively affected with increasing age. It is widely accepted that training produces physical-functional improvements in older adults, which can be assessed with numerous physical-functional tests. However, very few studies have been carried out using accelerometry to analyse the training effect on kinetic and kinematic variables in older adults, and there is no one that investigate the effects of two different training programs. Therefore, the aim of this study is to analyse the effects of an interval-walking program and a multicomponent program on the acceleration impacts, shock attenuation, step-length, stride frequency, and gait speed in older adults.

METHODS

23 participants were divided into multicomponent training group [n = 12, 7 female, 71.58 (4.56) years] and interval-walking group [n = 11, 6 female, 69.64 (3.56) years]. We evaluated the participants using three triaxial accelerometers, placing one on the distal end of each tibia and one on the forehead.

FINDINGS

After 14 weeks' of training, the maximum acceleration values both for the head accelerometer and for the non-dominant tibia, as well as the attenuation in the same leg, increased in the multicomponent training group. The maximum acceleration values for the head and the stride frequency also increased in the interval-walking group. Lower limb strength improved in both groups.

INTERPRETATION

Given the benefits we found for each of these programs, we encourage their consideration when planning older adults training programs and suggest that multicomponent programs should be introduced prior to the start of walking-based programs.

Do All Resistance Exercise Protocols Improve the Functional Parameters of the Elderly? A Review Study

Context: Aging has been associated with negative changes in the neuromuscular system, significantly impairing the performance of daily life activities. A number of studies have validated functional tests (e.g. timed-up-and-go, gait speed) for the assessment of daily activity performance in the elderly. Thus, it is critical to understand the role of exercise training in this context. The practice of resistance training (RT) has been found to promote muscle strength in the elderly; however, we cannot safely state that any of these resistance exercise protocols would lead to improved performance of functional parameters (e.g. timed-up-and-go, gait speed, getting out of a chair) of this population. To assess the effects of RT on functional parameters of the elderly and to undertake a detailed assessment of the exercise protocols surveyed. Methods: PubMed, Cochrane CENTRAL, and PEDro databases were used to search the literature. A total of 917 articles were initially selected, of which 10 peer-reviewed articles met the search criteria. Results: In the included studies, the positive effects of RT on the functional parameters of the elderly were observed. The training protocols presented the following characteristics: duration of 12 – 16 - 24 - 36 - 60 - 72 sec and 96 sessions; frequency of 1 - 3 sessions per week; training volume of 2 - 5 sets of 4 - 15 repetitions; 40 - 60 - 90 - 120 - 180 sec rest interval between sets; 40 - 60 - 90 - 120 - 180 sec rest interval between exercises; 24 - 48 - 72 hour rest interval between sessions; 40 - 85% intensity of one maximum repetition; isotonic contractions, contraction velocity (as fast as possible-1 - 2 - 3 seconds to concentric and 2 - 3 seconds to eccentric phases). Conclusions: Although the benefits of RT were observed, it was not possible to determine that any of these resistance exercise protocols would lead to improved performance of functional parameters (e.g. timed-up-and-go, gait speed, getting out of a chair) of this population, given the limitations we found in the research papers reviewed.

The influence of sex, training intensity, and frequency on muscular adaptations to 40 weeks of resistance exercise in older adults

The purpose of this investigation was to identify the influence that sex, training intensity, and frequency have on long-term resistance exercise (RE) outcomes in older adults.

METHODS

One-hundred eleven older adults (men: 41, women: 70) completed either: high-intensity RE 2d/week (HI-2D; n = 29), low-intensity RE 2d/week (LI-2D; n = 32), high-intensity RE 3d/week (HI-3D, n = 20), or low-intensity RE 3d/week (LI-3D, n = 30). HI protocols completed 3 sets of 8 repetitions with 80% one-repetition maximum (1-RM) while LI completed 3 sets of 16 repetitions with 40% 1-RM. Total and regional bone free lean body mass (BFLBM) were assessed via dual-energy x-ray absorptiometry and cross-sectional area (mCSA) of the rectus femoris.

RESULTS

mCSA was the only muscle quantity parameter to increase (p = 0.043). Significant trial effects for upper body, lower body, and specific strength were observed (all p < 0.001). Significant sex × time interactions (p < 0.001) were observed for upper and lower body strength, however, men and women displayed similar increases in lower body (45.7 ± 29.6 vs 46.4 ± 34.9%), upper body (33.1 ± 21.0 vs 33.4 ± 24.7%), and specific strength (36.5 ± 28.5 vs 40.1 ± 28.7%). A group × time interaction for lower body strength indicated that at 20-weeks HI-2D and LI-3D displayed greater lower body strength than LI-2D (both p < 0.009), and at 40-weeks HI-2D, HI-3D, and LI-3D displayed significantly greater lower body strength than LI-2D (all p < 0.038).

CONCLUSIONS

These observations indicate that older men and women display similar long-term RE outcomes. Additionally, regardless of frequency or intensity, the current prescriptions were effective for increasing strength, however these data suggest HI-2D > LI-2D and LI-3D > LI-2D but similar outcomes among HI-2D, HI-3D, and LI-3D. The variety of effective RE approaches provides flexibility among older adults for selecting a lifestyle intervention that would be most sustainable.

Trajectories of Body Composition during Advanced Aging in Consideration of Diet and Physical Activity: A 20-Year Longitudinal Study

This prospective study investigates age-dependent changes in anthropometric data and body composition over a period of two decades in consideration of physical activity and diet in community-dwelling subjects ≥60 years. Overall, 401 subjects with median follow-up time of 12 years were examined. Fat-free mass (FFM) and fat mass (FM) were analyzed using bioelectrical impedance analysis. Physical activity was assessed via a self-administered questionnaire. Dietary intake was examined by 3-day dietary records. Linear mixed-effects models were used to analyze the influence of age, sex, physical activity and energy/protein intake on anthropometric data and body composition by considering year of entry, use of diuretics and diagnosis of selected diseases. At baseline, median values for daily energy and protein intakes were 8.5 megajoule and 81 g and physical activity index was 1.7. After adjusting for covariates, advancing age was associated with parabolic changes indicating overall changes from age 60 to 90 years in women and men in body mass: −4.7 kg, −5.0 kg; body mass index: +0.04 kg/m², −0.33 kg/m²; absolute FFM: −2.8 kg, −3.5 kg; absolute FM: −1.8 kg, −1.2 kg and waist circumference: +16 cm, +12 cm, respectively. No age-dependent changes were found for upper arm circumference and relative (%) FFM. Dietary and lifestyle factors were not associated with changes in anthropometric or body composition parameters. In summary, the results indicate non-linear age-dependent changes in anthropometric data and body composition, which are largely unaffected by the degree of habitual physical activity and dietary protein intake in well-nourished community-dwelling subjects.

Is power training effective to produce muscle hypertrophy in older adults? A systematic review and meta-analysis

Power training has been suggested to be effective in improving strength, power, and functional capacity in older adults. However, there is still a lack of systematic investigations reporting its effectiveness for muscle hypertrophy. Thus, this study investigated the effect of power training on muscle hypertrophy and compared its magnitude with traditional moderate-velocity resistance training in older adults. A systematic search was conducted to identify clinical trials investigating the effect of power training on muscle hypertrophy (power training vs. control) and/or comparing the effect of power training versus moderate-velocity resistance training for a meta-analytical approach. Ten studies comparing power training to control conditions and 9 studies comparing power training to moderate-velocity resistance training were selected. Three studies were classified as high quality and 2 were preregistered. The meta-analysis showed that power training was superior for muscle hypertrophy compared with control condition (n = 8 studies; standardised mean difference (SMD) = 0.31; 95% confidence interval (CI) = 0.04, 0.58; p = 0.029), and resulted in similar hypertrophy compared with moderate-velocity resistance training (n = 7 studies; SMD = 0.07; 95% CI = –0.18, 0.32; p = 0.50). No significant heterogeneity was observed (p = 0.46 and 0.54, and I2 = 0% and 0%, respectively). Our data suggest that power training is effective for muscle hypertrophy in older adults, with similar effectiveness as moderate-velocity resistance training. (PROSPERO registration no.: CRD42019128951.)

Novelty It is known that power training might be superior to moderate-velocity resistance training for function improvements in older adults, but there was no meta-analysis investigating its effect on muscle hypertrophy. Power training is effective to induce muscle hypertrophy in older adults to a similar extent as moderate-velocity resistance training.

Effects of resistance training concentric velocity on older adults' functional capacity: A systematic review and meta-analysis of randomised trials

Reduced levels of functional capacity in older adults are related to lower quality of life, frailty, and sarcopenia, and can increase risk of falling, fractures and hospitalisation. Resistance training is an effective method to attenuate age-related functional declines. Based on the findings that muscle power and explosive strength are strongly associated with functional performance in older adults, it has been suggested that fast-intended-velocity resistance training may elicit greater improvements in functional capacity when compared to moderate-velocity resistance training. However, currently, there is no high-quality systematic review and meta-analysis supporting this assertion. The present study compared the magnitude of functional capacity improvements following resistance training performed with fast-intentional velocity versus moderate velocity. Pubmed, Scopus, and Web of Science databases were searched from inception to January 2019. The following eligibility criteria for selecting studies was adopted: Participants aged ≥60 years; resistance training based intervention for lower limbs performed solely with slow to moderate concentric velocity (≥2 s for each concentric phase) or solely with the intention of maximising velocity (i.e., as fast as possible); and at least one functional test for lower limbs, with pre- and post-intervention measurements. When studies employed multiple functional tests, a single (pooled) standardised mean difference was calculated and presented as combined functional capacity. In addition, functional tests were grouped accordingly to their specificity for the sub-groups meta-analyses. Fifteen studies were selected (high quality, n = 3; and pre-registered, n = 2). The results presented heterogeneity and small-studies publication bias, leading to a biased advantage for fast-intended-velocity resistance training (95%CI = 0.18, 0.65; I² = 45%). Short physical performance battery indicated an advantage for fast-intended-velocity resistance training (95%CI = 0.10, 0.94; I² = 0%). There was no difference for timed up and go (95%CI = -0.07, 0.94; I² = 48%), 30-s chair stand (95%CI = -0.24, 1.39; I² = 71%), 5-times chair stand (95%CI = -1.63, 1.27; I² = 57%) stair climb (95%CI = -1.89, 2.81; I² = 0%), short walk (95%CI = -0.99, 0.96; I² = 21%) and long walk (95%CI = -0.59, 1.00; I² = 0%). These results suggest that there is inconclusive evidence to support the superiority of fast-intended-velocity resistance training to improve functional capacity when compared to moderate-velocity resistance training. These results may have been influenced by the lack of high-quality and pre-registered studies, high heterogeneity, and small-studies publication bias. PROSPERO REGISTRATION NUMBER: CRD42019122251.

Muscle adaptation in response to a high-intensity interval training in obese older adults: effect of daily protein intake distribution

BACKGROUND

Aging is associated with declines in muscle mass, strength and quality, leading to physical impairments. An even protein distribution in daily meals has recently been proposed along with adequate total protein intake as important modulators of muscle mass. In addition, due to its short duration, high-intensity interval training (HIIT) has been highlighted as a promising intervention to prevent physical deterioration. However, the interaction between daily protein intake distribution and HIIT intervention in elderlies remain unknown.

OBJECTIVE

To investigate muscle adaptation following HIIT in older adults according to daily protein intake distribution.

METHODS

Thirty sedentary obese subjects who completed a 12-week elliptical HIIT program were matched [criteria: age (± 2 years), sex, BMI (± 2 kg/m²)] and divided a posteriori into 2 groups according to the amount of protein ingested at each meal: < 20 g in at least one meal (P20-, n = 15, 66.8 ± 3.7 years) and ≥ 20 g in each meal (P20+, n = 15, 68.1 ± 4.1 years). Body composition, functional capacity, muscle strength, muscle power, physical activity level, and nutritional intakes were measured pre- and post-intervention. A two way repeated ANOVA was used to determine the effect of the intervention (HIIT) and protein distribution (P20- vs P20+, p < 0.05).

RESULTS

No difference was observed at baseline between groups. Following the HIIT intervention, we observed a significant decrease in waist and hip circumferences and improvements in functional capacities in both P20- and P20 + group (p < 0.05). However, no protein distribution effect was observed.

CONCLUSION

A 12-week HIIT program is achievable and efficient to improve functional capacities as well as body composition in obese older adults. However, consuming at least 20 g of proteins in every meal does not further enhance muscle performance in response to a 12-week HIIT intervention.