Resistance training improves capacity to delay neuromuscular fatigue in older adults

Network meta-analysis of the intervention effects of different exercise measures on Sarcopenia in cancer patients

PURPOSE

This study aims to investigate the impact of four exercise modes (aerobic exercise, resistance exercise, aerobic combined with resistance multimodal exercise, and stretching) on the physical performance of cancer patients.

METHODS

Randomized controlled trials (RCTs) were exclusively collected from PubMed, EMBASE, Web of Science, and The Cochrane Library, with a search deadline of April 30, 2023. Different exercise interventions on the physical performance of cancer patients were studied, and the Cochrane risk of bias assessment tool was employed to evaluate the quality of the included literature. Data analysis was conducted using STATA 15.1 software.

RESULTS

This study included ten randomized controlled trials with a combined sample size of 503 participants. Network meta-analysis results revealed that aerobic combined with resistance multimodal exercise could reduce fat mass in cancer patients (SUCRA: 92.3%). Resistance exercise could improve lean mass in cancer patients (SUCRA: 95.7%). Furthermore, resistance exercise could enhance leg extension functionality in cancer patients with sarcopenia (SUCRA: 83.0%).

CONCLUSION

This study suggests that resistance exercise may be more beneficial for cancer-related sarcopenia.In clinical practice, exercise interventions should be tailored to the individual patients' circumstances.

REGISTRATION NUMBER

This review was registered on INPLASY2023110025; DOI number is https://doi.org/10.37766/inplasy2023.11.0025 .

Does High-Velocity Resistance Exercise Elicit Greater Physical Function Benefits Than Traditional Resistance Exercise in Older Adults? A Systematic Review and Network Meta-Analysis of 79 Trials

BACKGROUND

A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults.

METHODS

CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions.

RESULTS

Eighty articles describing 79 trials (n = 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] -0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD -0.76, 95% CI: -1.05 to -0.47), and 5-times sit-to-stand (SMD -0.74, 95% CI: -1.20 to -0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03).

CONCLUSION

Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants.

Resistance training and Down Syndrome: A narrative review on considerations for exercise prescription and safety

The current manuscript reviews the literature on the health effects of resistance training (RT) for individuals with Down syndrome (DS), focusing on this training modality’s methodology, application, and safety. The literature has mentioned that early aging in this population is associated with loss of muscle strength, lower lean and bone mass, and increased obesity. It is necessary to propose non-pharmacological measures for prevention and health promotion. Thus, this review suggests a current research-based RT guide for individuals with DS. This review is divided into three sections: Section 2 briefly reviews DS and the effects on structural and functional decline and how exercise and physical activity can influence health aspects in this population; Section 3 summarizes the evidence for RT prescription; Section 4 briefly reviews the health and potential benefits of RT in individuals with DS. The findings from this review suggest that most individuals with DS should engage in moderate-intensity RT at least 2 days a week and perform RT on the major muscle groups and include balance training. The RT program should be modified and adapted according to individuals’ characteristics and limitations. RT promotes positive, health-related benefits such as increasing strength, improving body composition, improving functional capacity and balance, reducing inflammatory status and oxidative stress, and improving the immune system. The RT protocols summarized in this current review provide guidance, critical conclusions, and novel research settings, which could be useful to coaches, clinicians, and researchers to effectively design RT program for individuals with DS.

Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis

PURPOSE

To analyze the effectiveness of resistance training programs (RTP) on strength, functional capacity, balance, general health perception, and fatigue for people with Multiple Sclerosis (MS) and to determine the most effective dose of RTP in this population.

METHODS

Studies examining the effect of RTP on strength, functional capacity, balance, general health perception, and fatigue in MS patients were included. 44 studies were included. The meta-analysis, subgroup analysis and meta-regression methods were used to calculate the mean difference and standardized mean difference.

RESULTS

Significant group differences were observed in knee extensor (p = 0.01) and flexor (p < 0.001), but not in 1-repetition maximum. Regarding functional capacity and balance, differences between groups, in favour of the RTP group, were found in the Timed Up and Go Test (p = 0.001), walking endurance, (p = 0.02) gait speed (p = 0.02) and balance (p = 0.02). No significant differences between groups were observed in fatigue or general health perception. The results regarding the optimal dose are inconsistent.

CONCLUSIONS

RTP improves strength, functional capacity, balance, and fatigue in people with MS. Registration: (PROSPERO): CRD42020182781Implications for rehabilitationResistance training is a valid strategy to improve isometric strength and functional capacity in MS patients.RTP using long durations (more than 6 weeks), high intensity (more than 80% 1-RM) and two-day weekly training frequency may be a correct stimulus to improve strength, functional capacity, balance, and fatigue in people with MS.Trainers and rehabilitators should consider these indicators in order to maximize muscular and functional adaptations in this population.

Muscle Activation in Older Females after a Community-Based Resistance Training Program: A Pilot Study

Many randomized controlled trials utilizing resistance training have shown improvements in muscle activation in older adults. However, these programs lack applicability to community-dwelling older adults due to several challenges. Therefore, the purpose of this study was to test the effects of an eight-week community-based resistance training program on muscle activation in older adults. Eight females (age: 61 ± 4 years, body mass index (BMI): 31.7 ± 5.7 kg/m2) were enrolled in the study. The surface electromyography (sEMG) activity was evaluated before and after training for three muscles (biceps brachii, upper trapezius, and rectus femoris). Additional weight load tests were performed to measure muscle activation in response to the added resistance. After eight weeks of training, no changes were observed in muscle activation for biceps brachii and upper trapezius but was decreased for rectus femoris (p = 0.04). Furthermore, in response to weight loads, biceps brachii and upper trapezius improved muscle activation after training. In summary, eight weeks of community-based resistance training program non-significantly improved the activation of upper-body muscles in older adults.

Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis

INTRODUCTION

Fatigue is a common complaint among older adults. Evidence grows that fatigue is linked to several negative health outcomes. A general overview of fatigue and its relationship with negative health outcomes still lacks in the existing literature. This brings complications for healthcare professionals and researchers to identify fatigue-related health risks. Therefore, this study gives an overview of the prospective predictive value of the main negative health outcomes for fatigue in community-dwelling older adults.

METHODS

PubMed, Web of Knowledge and PsycINFO were systematically screened for prospective studies regarding the relationship between fatigue and negative health outcomes resulting in 4595 articles (last search 5th March 2020). Meta-analyses were conducted in RevMan using Odds ratios (ORs), Hazard ratios (HRs) and relative risk ratios (RR) that were extracted from the included studies. Subgroup-analyses were performed based on (1) gender (male/female), (2) length of follow-up and (3) fatigue level (low, medium and high).

RESULTS

In total, thirty articles were included for this systematic review and meta-analysis encompassing 152 711 participants (age range 40-98 years), providing information on the relationship between fatigue and health outcomes. The results showed that fatigue is related to an increased risk for the occurrence of all studied health outcomes (range OR 1.299-3.094; HR/RR 1.038-1.471); for example, mortality OR 2.14 [1.74-2.63]; HR/RR 1.44 [1.28-1.62]), the development of disabilities in basic activities of daily living (OR 3.22 [2.05-5.38]), or the occurrence of physical decline (OR 1.42 [1.29-1.57]).

CONCLUSION

Overall fatigue increases the risk for developing negative health outcomes. The analyses presented in this study show that fatigue related physical decline occurs earlier than hospitalization, diseases and mortality, suggesting the importance of early interventions.

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.

Better Outcomes for Older people with Spinal Trouble (BOOST) Trial: a randomised controlled trial of a combined physical and psychological intervention for older adults with neurogenic claudication, a protocol

INTRODUCTION

Neurogenic claudication due to spinal stenosis is common in older adults. The effectiveness of conservative interventions is not known. The aim of the study is to estimate the clinical and cost-effectiveness of a physiotherapist-delivered, combined physical and psychological intervention.

METHODS AND ANALYSIS

This is a pragmatic, multicentred, randomised controlled trial. Participants are randomised to a combined physical and psychological intervention (Better Outcomes for Older people with Spinal Trouble (BOOST) programme) or best practice advice (control). Community-dwelling adults, 65 years and over, with neurogenic claudication are identified from community and secondary care services. Recruitment is supplemented using a primary care-based cohort. Participants are registered prospectively and randomised in a 2:1 ratio (intervention:control) using a web-based service to ensure allocation concealment. The target sample size is a minimum of 402. The BOOST programme consists of an individual assessment and twelve 90 min classes, including education and discussion underpinned by cognitive behavioural techniques, exercises and walking circuit. During and after the classes, participants undertake home exercises and there are two support telephone calls to promote adherence with the exercises. Best practice advice is delivered in one to three individual sessions with a physiotherapist. The primary outcome is the Oswestry Disability Index at 12 months. Secondary outcomes include the 6 Minute Walk Test, Short Physical Performance Battery, Fear Avoidance Beliefs Questionnaire and Gait Self-Efficacy Scale. Outcomes are measured at 6 and 12 months by researchers who are masked to treatment allocation. The primary statistical analysis will be by 'intention to treat'. There is a parallel health economic evaluation and qualitative study.

ETHICS AND DISSEMINATION

Ethical approval was given on 3 March 2016 (National Research Ethics Committee number: 16/LO/0349). This protocol adheres to the Standard Protocol Items: Recommendations for Interventional Trials checklist. The results will be reported at conferences and in peer-reviewed publications using the Consolidated Standards of Reporting Trials guidelines. A plain English summary will be published on the BOOST website.

TRIAL REGISTRATION NUMBER

ISRCTN12698674; Pre-results.

The effects of exercise on muscle strength, body composition, physical functioning and the inflammatory profile of older adults: a systematic review

PURPOSE OF REVIEW

This systematic review reports the most recent literature regarding the effects of physical exercise on muscle strength, body composition, physical functioning and inflammation in older adults. All articles were assessed for methodological quality and where possible effect size was calculated.

RECENT FINDINGS

Thirty-four articles were included - four involving frail, 24 healthy and five older adults with a specific disease. One reported on both frail and nonfrail patients. Several types of exercise were used: resistance training, aerobic training, combined resistance training and aerobic training and others. In frail older persons, moderate-to-large beneficial exercise effects were noted on inflammation, muscle strength and physical functioning. In healthy older persons, effects of resistance training (most frequently investigated) on inflammation or muscle strength can be influenced by the exercise modalities (intensity and rest interval between sets). Muscle strength seemed the most frequently used outcome measure, with moderate-to-large effects obtained regardless the exercise intervention studied. Similar effects were found in patients with specific diseases.

SUMMARY

Exercise has moderate-to-large effects on muscle strength, body composition, physical functioning and inflammation in older adults. Future studies should focus on the influence of specific exercise modalities and target the frail population more.

Wet, volatile, and dry biomarkers of exercise-induced muscle fatigue

Background

The physiological background of exercise-induced muscle fatigue(EIMUF) is only poorly understood. Thus, monitoring of EIMUF by a single or multiple biomarkers(BMs) is under debate.

After a systematic literature review 91 papers were included.

Results

EIMUF is mainly due to depletion of substrates, increased oxidative stress, muscle membrane depolarisation following potassium depletion, muscle hyperthermia, muscle damage, impaired oxygen supply to the muscle, activation of an inflammatory response, or impaired calcium-handling. Dehydration, hyperammonemia, mitochondrial biogenesis, and genetic responses are also discussed. Since EIMUF is dependent on age, sex, degree of fatigue, type, intensity, and duration of exercise, energy supply during exercise, climate, training status (physical fitness), and health status, BMs currently available for monitoring EIMUF have limited reliability. Generally, wet, volatile, and dry BMs are differentiated. Among dry BMs of EIMUF the most promising include power output measures, electrophysiological measures, cardiologic measures, and questionnaires. Among wet BMs of EIMUF those most applicable include markers of ATP-metabolism, of oxidative stress, muscle damage, and inflammation. VO₂-kinetics are used as a volatile BM.

Conclusions

Though the physiology of EIMUF remains to be fully elucidated, some promising BMs have been recently introduced, which together with other BMs, could be useful in monitoring EIMUF. The combination of biomarkers seems to be more efficient than a single biomarker to monitor EIMUF. However, it is essential that efficacy, reliability, and applicability of each BM candidate is validated in appropriate studies.