The Consequences of Resistance Training for Movement Control in Older Adults

Hypertrophy Training Following A Total Hip Replacement: A Literature Review

Hip OA is becoming more common, with a greater number of younger individuals undergoing total hip arthroplasty (THA). These individuals have the desire to return to considerable loading and in some instances return to sport. The purpose of this review was to investigate the current guidelines and/or protocols for hypertrophy or strengthening in individuals who have undergone total hip arthroplasty. A total of 16 papers were identified, some of which also addressed total knee arthroplasty. There is no consensus for the best practice for a hypertrophy program following THA especially regarding when a direct anterior approach was used during hip arthroplasty. Further research is needed as this is a growing area in rehabilitation. This review aims to bridge the gap by offering a comprehensive synthesis of the available literature on postoperative rehabilitation after THA, with a specific emphasis on identifying the most effective muscular strengthening and hypertrophy training programs for patients undergoing anterior approach hip surgery.

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.

Prescription analgesic overuse in older adults: Can we mitigate this growing problem?

With older adults already on numerous prescription medications to manage their chronic conditions, the addition of pain medications could impose an even greater burden due to dependency issues. We need to understand the use of chronic pain medication, especially opioids, discuss current strategies and gaps, and offer potential solutions to mitigate overuse among older adults.

Deficits in rate of force production during multifinger tasks are associated with cognitive status

OBJECTIVES

The multifinger force deficit (MFFD) is the decline in force generated by an individual finger as the number of fingers contributing to the action is increased. It has been proposed that as a measure of neural sufficiency rather than muscle status, it provides a means of detecting individuals at risk of cognitive decline. Age-related deficits in central neural drive exert a disproportionate impact on the rate at which force can be generated. We examined whether a MFFD derived from the maximum rate at which force is generated, is more sensitive to individual differences in cognitive status, than one calculated using the maximum level of force.

METHODS

Monotonic associations between each of two variants of the MFFD, and cognition (measured with the Montreal Cognitive Assessment), were estimated cross sectionally using generalized partial rank correlations, in which age, level of education and degree of handedness were included as covariates. The participants (n=26) were community dwelling adults aged 66-87.

RESULTS

The MFFD derived using the maximum rate of force development was negatively associated with cognitive status. The association for the MFFD based on the maximum level of force, was not statistically reliable. The associations with cognitive status obtained for both variants of the MFFD were of greater magnitude than those reported previously for standard grip strength dynamometry.

CONCLUSION

The sensitivity with which the MFFD detects risk of cognitive decline may be enhanced by using the maximum rate of force developed by each finger, rather than the maximum force generated by each finger.

Role of exercise in estrogen deficiency-induced sarcopenia

A decline in estrogen levels during menopause is associated with the loss of muscle mass and function, and it can accelerate sarcopenia. However, with the growing number of postmenopausal women due to the increase in life expectancy, the effects of estrogen on skeletal muscle are not completely understood. This article reviews the relationship between estrogen deficiency and skeletal muscle, its potential mechanisms, including those involving mitochondria, and the effects of exercise on estrogen deficiency-induced skeletal muscle impairment. In particular, mitochondrial dysfunction induced by estrogen deficiency accelerates sarcopenia via mitochondrial dynamics, mitophagy, and mitochondrial-mediated apoptosis. It is well known that exercise training is essential for health, including for the improvement of sarcopenia. This review highlights the importance of exercise training (aerobic and resistance exercise) as a therapeutic intervention against estrogen deficiency-induced sarcopenia.

Neural mechanisms mediating cross education: With additional considerations for the ageing brain

CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons.

Characteristics of the Passive Muscle Stiffness of the Vastus Lateralis: A Feasibility Study to Assess Muscle Fibrosis

Skeletal muscle fibrosis occurs with aging and has been suggested to impair muscle performance, thereby decreasing quality of life. Recently, muscle stiffness, a surrogate measure of muscle fibrosis, was noninvasively quantified as the shear modulus using ultrasound shear wave elastography (SWE) in humans. We aimed to investigate thigh muscle stiffness in females and males, respectively, across a broad range of ages by using SWE. Eighty-six community-dwelling Japanese people who were aged 30 to 79 years and did not regularly exercise participated in this study. The vastus lateralis (VL) shear modulus was measured at three different knee joint angles: full extension, 90° of flexion, and full flexion. There were no significant main effects of sex or age on the VL shear modulus in full extension or 90° of flexion of the knee. However, the VL shear modulus in knee full flexion was significantly smaller in females than in males and increased with age from 47.9 years. The results suggest that the accelerated increase in VL stiffness that occurs after an individual passes their late 40s may be an important therapeutic target for developing effective treatments and programs that preserve and improve quality of life.

Can Resistance Training Improve Upper Limb Postural Tremor, Force Steadiness and Dexterity in Older Adults? A Systematic Review

BACKGROUND

The ageing process and several health conditions may increase tremor and reduce force steadiness and dexterity, which can severely impact on function and quality of life. Resistance training can evoke a range of neuromuscular adaptions that may significantly reduce tremor and/or increase force steadiness and/or dexterity in older adults, irrespective of their health condition.

OBJECTIVES

The objective of this study was to systematically review the literature to determine if a minimum of 4 weeks' resistance training can reduce postural tremor and improve force steadiness and/or dexterity in older adults, defined as aged 65 years and over.

METHODS

An electronic search using Ovid, CINAHL, SPORTDiscus and EMBASE was performed. Risk of bias was assessed using the Cochrane Risk of Bias Tool.

RESULTS

Fourteen studies met the eligibility criteria, including six randomised controlled trials and two quasi-randomised controlled trials. All eight studies that recruited healthy older adults reported significant reductions in postural tremor and/or improvements in force steadiness and dexterity. Five out of seven studies that examined older adults with a particular health condition reported some improvements in force steadiness and/or dexterity. Specifically, significant benefits were observed for older adults with chronic obstructive pulmonary disease and essential tremor; however, small or no changes were observed for individuals with osteoarthritis or stroke.

CONCLUSIONS

Resistance training is a non-pharmacological treatment that can reduce tremor and improve force steadiness and dexterity in a variety of older adult populations. Future research should employ randomised controlled trials with larger sample sizes, better describe training programme methods, and align exercise prescription to current recommendations for older adults.

Chronic Pain Management in the Elderly

Chronic pain is extremely prevalent in older adults and is associated with significant morbidity, including limited mobility, social isolation, and depressed mood. Pain is defined by a biopsychosocial model highlighting the importance of a multidisciplinary approach to treatment, including multimodal medications, selected interventions, physical therapy and rehabilitation, and psychological treatments. In this narrative review, the authors highlight the use of these approaches in older adults with specific attention paid to considerations unique to aging, including alterations in drug metabolism, avoidance of polypharmacy, and physiologic changes predisposing to painful conditions.

Exercise training in older adults, what effects on muscle force control? A systematic review of randomized clinical trials

AIM

To determine the magnitude of the effects of different exercise training (ET) modalities on variables of muscle force control in older adults.

METHODS

Relevant articles were searched in PubMed, Web of Science, Science Direct and Scopus, using the keywords: Aged AND "Exercise Movement Techniques" AND ("Complexity of torque" OR "Complexity of force" OR "Variability of torque" OR "Variability of force" OR "Force Steadiness" OR "Force fluctuations"). To be included in the full analysis, the studies had to be randomized controlled trials in which older adults were submitted to ET programs and muscle force control assessment.

RESULTS

The searches resulted in 702 articles from which 6 met all the inclusion criteria. The trials involved 171 healthy and functionally limited older adults (71.64 ± 1.53 years). Studies included resistance, steadiness and functional training programs. Training sessions were 2-3 time per week, lasted 6-16 months with intensities determined as percentage of the one repetition maximum loads. There is a heterogeneity regarding experimental set-up and data analysis parameters between studies. The findings show an improved muscle force control in older adults after ET. Such response is better evidenced by the assessment of the coefficient of variation (CV) of the force signals. There is moderate evidence that resistance training programs are effective to decrease CV of knee extensor force signals at lower force targets.

CONCLUSIONS

The findings from this review suggest that ET programs are effective to improve muscle force control in older adults.

Age related changes of the motor excitabilities and central and peripheral muscle strength

INTRODUCTION

The purpose was to investigate the age effects on central versus peripheral sources of strength, fatigue, and central neural excitabilities.

METHODS

42 healthy subjects were recruited as young group (23.73 ± 2.15 years; n = 26) and middle-aged group (57.25 ± 4.57 years; n = 16). Maximum voluntary contraction force (MVC), voluntary activation level (VA), and twitch force of quadriceps were evaluated to represent general, central, and peripheral strengths. Central and peripheral fatigue indexes were evaluated using femoral nerve electrical stimulation. Cortical excitabilities were evaluated using transcranial magnetic stimulation (TMS).

RESULTS

The middle-aged group had lower MVC and twitch force of quadriceps, but not VA, than young group. No between group differences were found in fatigue indexes. The cortical excitability in middle-aged group was different from young group in paired TMS with inter-stimulus interval of 7 ms.

CONCLUSION

The age-related strength loss at early stage was primarily caused by peripheral muscular strength. The deviation of central neural excitability can be detected but the activation level was not impaired in middle-age adults.

Get a grip: individual variations in grip strength are a marker of brain health

Demonstrations that grip strength has predictive power in relation to a range of health conditions-even when these are assessed decades later-has motivated claims that hand-grip dynamometry has the potential to serve as a "vital sign" for middle-aged and older adults. Central to this belief has been the assumption that grip strength is a simple measure of physical performance that provides a marker of muscle status in general, and sarcopenia in particular. It is now evident that while differences in grip strength between individuals are influenced by musculoskeletal factors, "lifespan" changes in grip strength within individuals are exquisitely sensitive to integrity of neural systems that mediate the control of coordinated movement. The close and pervasive relationships between age-related declines in maximum grip strength and expressions of cognitive dysfunction can therefore be understood in terms of the convergent functional and structural mediation of cognitive and motor processes by the human brain. In the context of aging, maximum grip strength is a discriminating measure of neurological function and brain health.

Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis

Osteoporosis affects many aspects of daily life. The aim of this systematic review was to assess the effects of exercise interventions on functional outcomes in persons with osteoporosis, in comparison with controls.

METHODS

Four databases were searched and yielded 1587 citations. Two reviewers independently determined study eligibility, rated risk of bias, appraised methodological quality of studies, and resolved discordance by consensus.

RESULTS

A total of 28 studies examining 2113 participants met inclusion criteria; 25 studies were suitable for meta-analyses. Four categories of exercise were identified using the ProFaNE taxonomy. After removing studies with high risk of bias and sorting them into intervention sub-types, we were able to sufficiently reduce the heterogeneity. The standardized mean difference (SMD) favored multicomponent exercise for mobility (- 0.56, 95% CI [- 0.81, - 0.32], p = 0.06, I² = 51%); balance (0.50, 95% CI [0.27, 0.74], p = 0.28, I² = 21%); and self-reported measures of functioning (- 0.69, 95% CI [- 1.04, - 0.34], p = 0.02, I² = 61%). Trials were judged at low or unclear risk of selection bias, indicating inadequate reporting and at high risk of performance bias due to lack of participant blinding. The mean methodological quality rating of the studies was 63.5% indicating moderate quality.

CONCLUSIONS

A multicomponent exercise program of high-speed training combined with simulated functional tasks is promising to enhance functional outcomes. Due to substantial clinical heterogeneity of the target groups and specific demands of exercise modes, it is unclear which exercise program is optimal.

Effects of acute isometric resistance exercise on cervicomedullary motor evoked potentials

Cervicomedullary motor evoked potentials (CMEPs) in relaxed biceps brachii have been reported to facilitate after acute isometric exercise of the elbow flexors. This facilitation, which reflects either enhanced corticospinal transmission or increased motoneurone excitability, has only been documented in the limb posture used during exercise. In Experiment 1, we tested if these spinal changes "transfer" to a second posture. Fourteen individuals completed 12 sets of high-force isometric contractions of the elbow flexors with the forearm pronated. Before and after exercise, biceps CMEPs were acquired with the forearm either pronated or supinated. CMEPs in pronation and supination were facilitated after exercise, indicating transfer (57.5 ± 55.5% and 53.9 ± 54.9%, respectively; mean ± SD). In Experiment 2, we examined if exercise posture influences the effect that exercise has on CMEPs. A different sample of 14 individuals performed isometric exercise in 2 sessions. In one, exercise was performed in supination. In the other, exercise was performed in pronation. Exercise intensity and volume were the same as in Experiment 1, as were participant characteristics. CMEPs were unchanged after exercise in supination (13.6 ± 31.2%) and pronation (7.7 ± 41.5%). The absence of an effect differs from the finding of Experiment 1. Thus, effects of acute isometric resistance exercise on corticospinal transmission and/or motoneurone excitability are not as consistent as previously thought. When exercise induces this spinal change, the effect is not specific to the posture used for exercise. However, the change does not always occur, and the reasons for this remain unknown.

The Effectiveness of Hollowing and Bracing Strategies With Lumbar Stabilization Exercise in Older Adult Women With Nonspecific Low Back Pain: A Quasi-Experimental Study on a Community-based Rehabilitation

OBJECTIVE

The purpose of this study was to explore the therapeutic effectiveness of hollowing lumbar stabilization exercise (HLSE) and bracing lumbar stabilization exercise (BLSE) for older adult women with nonspecific low back pain (NSLBP) in community welfare centers.

METHOD

A total of 38 older adult women with NSLBP were allocated to either the HLSE group (n = 17, 70.4 ± 1.7 years) or the BLSE group (n = 21, 66.8 ± 4.4 years). Both groups performed intervention for 12 consecutive weeks, 3 times per week. Each group performed 5 lumbar stabilization exercises, including side plank exercise, bridge exercise, 4-kneeling exercise, prone plank exercise, and prone back extension exercise with hollowing and bracing strategy, respectively. The baseline and post-test values of trunk strength, low back disability (Korean Oswestry Disability Index [K-ODI] and Korean Roland Morris Disability Questionnaire [K-RMDQ]), and static balance (1-leg standing test) were compared by using per-protocol analysis.

RESULTS

In trunk strength, the trunk flexor had significant difference (F = 11.10, P = .001) between groups and within groups of BLSE (t = -5.56, P = .001) and HLSE (t = -2.50, P = .024). Trunk back extensor of HLSE (t = -6.00, P = .001) and BLSE (t = -9.19, P = .001) only had significant within-group difference. However, in trunk side flexor, HLSE and BLSE had only significant difference between groups. In low back disability, K-ODI for HLSE (t = 4.50, P = .001) and BLSE (t = 4.60, P = .001) had significant within-group difference but no significant difference between groups (F = 0.28, P = .202). In K-RMDQ, HLSE only had significant within-group difference (t = 3.97, P = .001). In trunk muscle strength, the effect size of HLSE and BLSE groups for trunk flexor was HLSE -0.53 (medium) and BLSE -1.21 (large); trunk side flexor: HLSE 0.27 (small) and BLSE -0.24 (small); and trunk back extensor: HLSE 1.1 (large) and BLSE 2.00 (large), respectively. In low back disability, the effect size of both groups for K-ODI was HLSE 0.88 (large) and BLSE 1.05 (large), and K-RMDQ, HLSE 0.19 (small) and BLSE 0.40 (small), respectively.

CONCLUSION

Our findings suggest that HLSE and BLSE could be recommended for community settings to improve trunk strength and low back disability in older adult women with NSLBP. Especially, HLSE and BLSE could be recommended for elderly women with NSLBP who have lower back disability and weak trunk muscle strength, respectively.

Older Korean adults have lower physical function despite longer exercise times compared to their Japanese counterparts: A Japan-Korea comparative study

AIM

We aimed to compare the level of physical function (PF) and habitual exercise between older Japanese and Korean adults.

METHODS

A comparative study was carried out on 1069 community-dwelling older Japanese and Korean adults (mean age 73.9 ± 5.2 years). The participants were asked to complete a self-reported questionnaire regarding habitual exercise and covariates. PF age, a composite measure of PF, was derived from the 12 items, using principal component analysis. PF age and habitual exercise were compared between the Japanese and Korean adults, using analysis of covariance (ancova) and multivariable logistic regression analysis adjusted for all covariates using propensity scores.

RESULTS

ancova showed that PF age in older Japanese adults was significantly younger than in their Korean counterparts. Older Japanese adults exercised significantly less frequently than their Korean counterparts. Furthermore, older Japanese adults practiced significantly less walking, mountain climbing and bicycling, but more calisthenics, resistance training, ball games and dances than their Korean counterparts.

CONCLUSIONS

We found that older Korean adults had lower PF (3.7 years older in PF age) than their Japanese counterparts. Although the overall frequency and amount of habitual exercise in older Korean adults were higher than those in their Japanese counterparts, particular types of exercise might have contributed to the higher PF levels among older Japanese adults. Thus, older Korean adults might need to engage more in habitual exercises that are specifically effective in maintaining PF. Geriatr Gerontol Int 2018; 18: 576-583.

Vitamin D and muscle function

Muscle weakness is a hallmark of severe vitamin D deficiency, but the effect of milder vitamin D deficiency or insufficiency on muscle mass and performance and risk of falling is uncertain. In this presentation, I review the evidence that vitamin D influences muscle mass and performance, balance, and risk of falling in older adults. Special consideration is given to the impact of both the starting 25-hydroxyvitamin D [25(OH)D] level and the dose administered on the clinical response to supplemental vitamin D in older men and women. Based on available evidence, older adults with serum 25(OH)D levels <40nmol/L appear most likely to improve their muscle performance with supplementation. The vitamin D dose range of 800-1000 IU per day has been effective in many studies; lower doses have generally been ineffective and several doses above this range have increased the risk of falls. In conclusion, older adults with serum 25(OH)D levels <40nmol/L are likely to have fewer falls if supplemented with 800-1000 IU per day of vitamin D.

Wrist Resistance Training Improves Motor Control and Strength

Chu, E, Kim, Y-S, Hill, G, Kim, YH, Kim, CK, and Shim, JK. Wrist resistance training improves motor control and strength. J Strength Cond Res 32(4): 962-969, 2018-The aim of this study was to investigate the effects of a 6-week direction-specific resistance training program on isometric torque control and isokinetic torque strength of the wrist joint. Nineteen subjects were randomly assigned to either the wrist training group (n = 9) or the control group (n = 10). The training group performed wrist exercises in 6 directions (flexion, extension, pronation, supination, radial deviation, and ulnar deviation), whereas the control group did not. Data were collected on the isometric torque control, 1-repetition maximum (1RM) strength, and isokinetic maximum torque (angular velocity of 60° per second wrist movements) before and after 6 weeks of resistance training and at 2-week intervals during training. The training group showed significant decreases in isometric torque control error in all 6 directions after 2 weeks of resistance training, whereas the control group did not show significant increase or decrease. After 4 weeks of training, the training group showed significant increases in maximum strength in all 6 directions as assessed by 1RM strength and isokinetic strength tests, whereas the control group did not show any statistically significant changes. This study shows that motor control significantly improves within the first 2 weeks of resistance training, whereas the wrist strength significantly improves within the first 4 weeks of resistance training. Based on the findings of this study, coaches and trainers should consider wrist resistance training to improve athletes' muscular strength and control of the wrist muscles.

Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

Background

Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone.

Methods

A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50–60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.

Results

At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =−0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01).

Conclusion

Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.

Transfer effects of step training on stepping performance in untrained directions in older adults: A randomized controlled trial

BACKGROUND

Although step training improves the ability of quick stepping, some home-based step training systems train limited stepping directions and may cause harm by reducing stepping performance in untrained directions. This study examines the possible transfer effects of step training on stepping performance in untrained directions in older people.

METHODS

Fifty four older adults were randomized into: forward step training (FT); lateral plus forward step training (FLT); or no training (NT) groups. FT and FLT participants undertook a 15-min training session involving 200 step repetitions. Prior to and post training, choice stepping reaction time and stepping kinematics in untrained, diagonal and lateral directions were assessed.

RESULTS

Significant interactions of group and time (pre/post-assessment) were evident for the first step after training indicating negative (delayed response time) and positive (faster peak stepping speed) transfer effects in the diagonal direction in the FT group. However, when the second to the fifth steps after training were included in the analysis, there were no significant interactions of group and time for measures in the diagonal stepping direction.

CONCLUSIONS

Step training only in the forward direction improved stepping speed but may acutely slow response times in the untrained diagonal direction. However, this acute effect appears to dissipate after a few repeated step trials. Step training in both forward and lateral directions appears to induce no negative transfer effects in diagonal stepping. These findings suggest home-based step training systems present low risk of harm through negative transfer effects in untrained stepping directions.

TRIAL REGISTRATION

ANZCTR 369066.

Improved muscle function and quality after diet intervention with leucine-enriched whey and antioxidants in antioxidant deficient aged mice

Antioxidant (AOX) deficiencies are commonly observed in older adults and oxidative stress has been suggested to contribute to sarcopenia. Here we investigate if 1) low levels of dietary antioxidants had a negative impact on parameters of muscle mass, function and quality, and 2) to study if nutritional interventions with AOX and/or leucine-enriched whey protein could improve these muscle parameters in aged mice. 18-months-old mice were fed a casein-based antioxidant-deficient (lowox) diet or a casein-based control-diet (CTRL) for 7 months. During the last 3 months, lowox-mice were subjected to either: a) continued lowox, b) supplementation with vitamin A/E, Selenium and Zinc (AOX), c) substitution of casein with leucine-enriched whey protein (PROT) or d) a combination of both AOX and PROT (TOTAL). After 7 months lowox-mice displayed lower muscle strength and more muscle fatigue compared to CTRL. Compared to lowox-mice, PROT-mice showed improved muscle power, grip strength and less muscle fatigue. AOX-mice showed improved oxidative status, less muscle fatigue, improved grip strength and mitochondrial dynamics compared to lowox-mice. The TOTAL-mice showed the combined effects of both interventions compared to lowox-mice. In conclusion, nutritional intervention with AOX and/or leucine-enriched whey protein can play a role in improving muscle health in a AOX-deficient mouse model.

Resistance Training Alters the Proportion of Skeletal Muscle Fibers but Not Brain Neurotrophic Factors in Young Adult Rats

Antonio-Santos, J, Ferreira, DJS, Gomes Costa, GL, Matos, RJB, Toscano, AE, Manhães-de-Castro, R, and Leandro, CG. Resistance training alters the proportion of skeletal muscle fibers but not brain neurotrophic factors in young adult rats. J Strength Cond Res 30(12): 3531–3538, 2016—Resistance training (RT) is related to improved muscular strength and power output. Different programs of RT for rats have been developed, but peripheral and central response has not been evaluated directly in the same animal. To test the hypothesis that RT induces central and peripheral adaptations, this study evaluated the effects of a RT on the performance of a weekly maximum overload test, fiber-type typology, and brain neurotrophic factors in young adult rats. Thirty-one male Wistar rats (65 ± 5 days) were divided in 2 groups: nontrained (NT, n = 13) and trained (T, n = 18). Trained group was submitted to a program of RT ladder climbing, gradually added mass, 5 days per week during 8 weeks at 80% of individual maximum overload. This test was weekly performed to adjust the individual load throughout the weeks for both groups. After 48 hours from the last session of exercise, soleus and extensor digital longus (EDL) muscles were removed for myofibrillar ATPase staining analysis. Spinal cord, motor cortex, and cerebellum were removed for RT-PCR analysis of BDNF and insulin-like growth factor-1 (IGF-1) gene expression. In EDL muscle, T animals showed an increase in the proportion of type IIb fibers and a reduction of type IIa fibers. Insulin-like growth factor-1 gene expression was reduced in the cerebellum of T animals (NT: 1.025 ± 0.12; T: 0.57 ± 0.11). Our data showed that 8 weeks of RT were enough to increase maximum overload capacity and the proportion of glycolytic muscle fibers, but there were no associations with the expression of growth neurotrophic factors.

Acute Effects of a Single Bout of Resistance Exercise on Postural Control in Elderly Persons

Many elderly persons are engaging in resistance exercise to counter muscle atrophy due to aging. Here, the acute effects of resistance exercise on postural control mechanisms were examined. Postural control was quantified by mean square center-of-pressure displacements were calculated utilizing force vectors in accordance with previously developed equations. Stabilogram-diffusion plots utilized the displacements as data points after curve-fitting techniques were applied. Two regions, representing the open-loop and closed-loop postural control mechanisms, are shown by the plots and separated at the critical point, which represents the shift in control mechanisms. 21 older adults (age M = 71.2, SD = 3.84, range 66–81 years) performed three sets of 10–12 repetitions for six resistance exercises for the lower extremity until fatigue. Immediately after exercise, postural stability was reduced. This was represented by a shift of the critical point to the right, indicating an increase in open-loop control. Since resistance training has an acute negative effect on postural control, it is advised to assist elderly clients carefully and immediately after resistance training.

Effects of aquatic exercise on muscle strength and functional performance of individuals with osteoarthritis: a systematic review

Water-based exercises are recommended for people with osteoarthritis (OA), due to the beneficial effects on physical function, quality of life and symptom reduction. However, the effects on muscle strength are still controversial. The aim of this review was to assess and compare the effects of aquatic exercise programs on muscle strength and physical function in people with OA. A systematic search was performed at Pubmed, Scopus and Web of Science databases. Clinical trials with interventions involving aquatic exercises for individuals with OA were included. The methodological quality of the studies was evaluated using the PEDro scale. 296 studies were found and twelve were selected: six studies comparing water-based exercises with land-based exercise, and six comparing water-based exercise groups with the control group. Exercise programs included muscle strengthening, aerobic, balance, flexibility and stretching exercises. Duration of the program, weekly frequency, intensity and progression varied between studies. Beneficial effects of aquatic exercise were found on physical function. However, only two of five studies that assessed muscle strength observed positive effect of aquatic exercise. Although it is difficult to compare studies and establish guidelines for the standardized protocol formulation, it was observed that water-based exercises can be effective on improving physical function and increasing muscle strength, since they are well-structured, with exercise intensity and overload controlled.

The muscle quality index and mortality among males and females

PURPOSE

The muscle quality index (MQI) was proposed as a measure to quantify age-related alterations in muscle function. It is unknown if the MQI predicts mortality.

METHODS

This was a population-based cohort study from the Third National Health and Nutrition Survey (NHANES III; 1988-1994). The MQI was quantified using a timed sit-to-stand test, body mass, and leg length. Vital status was obtained through the National Center for Health Statistics. We fit multivariable-adjusted regression models to estimate the hazard ratio (HR) and 95% confidence interval (CI) between the MQI and mortality.

RESULTS

During 14.6 years of follow-up, 3299 (73.1%) of 4510 study participants died. Lower MQI was associated with a higher risk of mortality (Ptrend <.001). The multivariable-adjusted HR for mortality was 1.50 (95% CI, 1.15-1.96) for those in the lowest quintile of MQI compared to the highest quintile. The association between MQI and mortality was stronger among males (highest vs. lowest quintile of MQI, HR = 1.37 [95% CI, 1.00-1.87]; Ptrend = .001) compared to females (highest vs. lowest quintile of MQI, HR = 1.27 (95% CI, 0.89-1.83); Ptrend = .044; Pinteraction = .005].

CONCLUSIONS

The MQI predicts mortality and may differ between males and females. Additional research examining the MQI is warranted.

Handgrip strength, quadriceps muscle power, and optimal shortening velocity roles in maintaining functional abilities in older adults living in a long-term care home: a 1-year follow-up study

Purpose

To assess the relative role of handgrip strength (HGS), quadriceps muscle power (P_max), and optimal shortening velocity (υ_opt) in maintaining functional abilities (FAs) in older adults living in a long-term care home over a 1-year follow-up.

Subjects and methods

Forty-one inactive older institutionalized adults aged 69.8±9.0 years participated in this study. HGS, P_max, υ_opt, cognitive function using the Mini-Mental State Examination, depressive symptoms using the Geriatric Depression Scale, nutritional status using the Mini Nutritional Assessment (MNA), and physical activity (PA) using the Seven-Day Physical Activity Recall Questionnaire were assessed at baseline and at 1-year follow-up. FAs were assessed with activities of daily living (ADL), instrumental ADL, and Timed Up & Go test.

Results

Both at baseline and at follow-up, FAs were related to age, HGS, P_max/kg, υ_opt, MNA, and PA. These associations were generally similar in both sexes. As revealed in multiple regression analysis, υ_opt was the strongest predictor of FA, followed by P_max/kg, PA, and MNA. FA deteriorated after 1 year as measured by ADL and Timed Up & Go test. P_max and υ_opt, but not HGS, also decreased significantly after 1 year. Nevertheless, 1-year changes in FAs were not related to changes in HGS, P_max, υ_opt, or PA.

Conclusion

The 1-year period of physical inactivity among older institutionalized adults was found to have a negative effect on their FAs, P_max, and υ_opt. The present study demonstrates that P_max and, especially, υ_opt correlated with FAs of older adults more than HGS, both at baseline and at follow-up. Despite this, 1-year natural fluctuations of PA, P_max, and υ_opt are not significant enough to influence FAs in inactive institutionalized older adults.

Strength and Power Training Effects on Lower Limb Force, Functional Capacity, and Static and Dynamic Balance in Older Female Adults

It has been proposed that muscle power is more effective to prevent falls than muscle force production capacity, as rapid reactions are required to allow the postural control. This study aimed to compare the effects of strength and power training on lower limb force, functional capacity, and static and dynamic balance in older female adults. Thirty-seven volunteered healthy women had been allocated into the strength-training group (n = 14; 69 ± 7.3 years, 155 ± 5.6 cm, 72 ± 9.7 kg), the power-training group (n = 12; 67 ± 7.4 years, 153 ± 5.5 cm, 67.2 ± 7 kg), and control group (n = 11; 65 ± 3.1 years, 154 ± 5.6 cm, 70.9 ± 3 kg). After 12 weeks of training, the strength-training and power-training groups increased significantly maximum dynamic strength (29% and 27%), isometric strength (26% and 37%), and step total time (13% and 14%, dynamic balance), respectively. However, only the power-training group increased the rate of torque development (55%) and the functional capacity in 30-second chair stand (22%) and in time up and go tests (-10%). Empirically, power training may reduce the risk of injuries due to lower loads compared to strength training, and consequently, the physical effort demand during the training session is lower. Therefore, power training should be recommended as attractive training stimuli to improve lower limb force, functional capacity, and postural control of older female adults.

Total and Lower Extremity Lean Mass Percentage Positively Correlates With Jump Performance

Strength and power have been identified as valuable components in both athletic performance and daily function. A major component of strength and power is the muscle mass, which can be assessed with dual-energy x-ray absorptiometry (DXA). The primary purpose of this study was to quantify the relationship between total body lean mass percentage (TBLM%) and lower extremity lean mass percentage (LELM%) and lower extremity force/power production during a countermovement jump (CMJ) in a general population. Researchers performed a DXA analysis on 40 younger participants aged 18-35 years, 28 middle-aged participants aged 36-55 years, and 34 older participants aged 56-75 years. Participants performed 3 CMJ on force platforms. Correlations revealed significant and strong relationships between TBLM% and LELM% compared with CMJ normalized peak vertical ground reaction force (p < 0.001, r = 0.59), normalized peak vertical power (p < 0.001, r = 0.73), and jump height (p < 0.001, r = 0.74) for the combined age groups. Most relationships were also strong within each age group, with some relationships being relatively weaker in the middle-aged and older groups. Minimal difference was found between correlation coefficients of TBLM% and LELM%. Coefficients of determination were all below 0.6 for the combined group, indicating that between-participant variability in CMJ measures cannot be completely explained by lean mass percentages. The findings have implications in including DXA-assessed lean mass percentage as a component for evaluating lower extremity strength and power. A paired DXA analysis and CMJ jump test may be useful for identifying neuromuscular deficits that limit performance.

Effect of age on changes in motor units functional connectivity

With age, there is a change in functional connectivity of motor units in muscle. This leads to reduced muscle strength. This study has investigated the effect of age on the changes in the motor unit recruitment by measuring the mutual information between multiple channels of surface electromyogram (sEMG) of biceps brachii muscle. It is hypothesised that with ageing, there is a reduction in number of motor units, which can lead to an increase in the dependency of remaining motor units. This increase can be observed in the mutual information between the multiple channels of the muscle activity. Two channels of sEMG were recorded during the maximum level of isometric contraction. 28 healthy subjects (Young: age range 20-35years and Old: age range - 60-70years) participated in the experiments. The normalized mutual information (NMI), a measure of dependency factor, was computed for the sEMG recordings. Statistical analysis was performed to test the effect of age on NMI. The results show that the NMI among the older cohort was significantly higher when compared with the young adults.

Prevalent fragility fractures as risk factor for skeletal muscle function deficit and dysmobility syndrome in post-menopausal women

BACKGROUND

Fragility fractures are a major burden for health and social care in elderly people. In order to identify earlier the "frail elders", new concepts of "dysmobility syndrome" and skeletal muscle function deficit (SMFD), including sarcopenia, osteoporosis, obesity, and mobility limitation, leading to a higher risk of fractures, have been recently introduced. There are very few studies investigating the association between fragility fractures and both the dysmobility syndrome and the SMFD.

AIMS

The objective of our study is to investigate the role of previous fragility fractures as a risk factor in determining the dysmobility syndrome and/or the SMFD in post-menopausal women.

METHODS

In this case-control study, we retrospectively examined data from the medical records of post-menopausal women aged 50 or older. We divided the study population in two groups. The first group includes women with a previous fragility fracture (cases) and the other group includes women without any previous osteoporotic fracture (controls). We identified the subjects with "dysmobility syndrome", "dynapenic SMFD", "sarcopenic SMFD", and "mixed SMFD" in both groups. Data collected refer to a 6-month period.

RESULTS

We retrieved data of 121 post-menopausal women, 77 (63.64%) had already sustained a fragility fracture at any site (cases). The risk for dysmobility syndrome was significantly higher (adjusted OR for age and serum 25-OH vitamin D3 of 2.46) in the cases compared with the controls.

DISCUSSION AND CONCLUSIONS

An early diagnosis of conditions limiting mobility, including dysmobility syndrome, might be useful to identify, among patients with osteoporotic fractures, those who might have a higher risk of a new fragility fracture.

Treinamento resistido reduz riscos cardiovasculares em idosas

INTRODUÇÃO: O envelhecimento humano aliado ao estilo de vida sedentário é marcado por alterações metabólicas com modificação na composição corporal, que repercutem diretamente na proteína C-reativa (PCR), sendo este um importante marcador de risco de doenças cardiovasculares (DCV). O treinamento resistido (TR) é um método muito utilizado na prevenção de doenças associadas ao envelhecimento. Objetivo: Avaliar os efeitos de oito semanas de TR sobre a composição corporal, força muscular e PCR em um grupo de idosas.MÉTODO: Foi realizado um estudo experimental com 10 idosas (63 ± 2 anos de idade). Para o ensaio de PCR, análises bioquímicas de hemograma e lipidograma completos foram coletadas amostras de sangue venoso periférico antes do exercício e 24 horas depois. Para medidas antropométricas calcularam-se índice de massa corporal (IMC), relação cintura/quadril (RCQ) e composição corporal. O TR foi realizado por Série Combinada - Bi-Set. Para a análise estatística, primeiramente foi realizado o teste de normalidade de Shapiro-Wilk (p > 0,05) para testes paramétricos. As variáveis do grupo foram apresentadas como média e desvio padrão. Para variáveis de PCR, antropométricas, composição corporal e perfil lipídico foram realizados o teste t de Student,tanto anterior quanto posteriormente às oito semanas de treinamento. Para as amostras da evolução das cargas e médias do consumo alimentar foi realizado o teste One Way ANOVA e, quando necessário, o teste post hoc de Tukey. O nível de significância adotado foi de p ≤ 0,05.RESULTADOS: Houve redução estatisticamente significativa (p = 0,02) para as concentrações séricas de PCR, o que significa uma redução de 70,96%, além de diminuir a massa gorda e aumentar a massa magra e a carga de treino após oito semanas.CONCLUSÃO: Oito semanas de TR reduziram as concentrações séricas de proteína C-reativa, assim como diminuíram a massa gorda e aumentaram o volume muscular, demonstrando ser uma estratégia eficiente para a diminuição dos fatores de riscos de doenças cardiovasculares.

Endothelial nitric oxide synthase Glu298Asp gene polymorphism influences body composition and biochemical parameters but not the nitric oxide response to eccentric resistance exercise in elderly obese women

Both endothelial nitric oxide synthase (eNOS) gene polymorphism and nitric oxide (NO) are involved in important cardiovascular, muscular and inflammatory physiological mechanisms during ageing and response to exercise. The aim of this study was to investigate the NO kinetic response following an acute eccentric resistance exercise (ERE) session and the possible effect of the Glu298Asp eNOS gene polymorphism in elderly obese women. Eighty-seven women (age 69·4 ± 6·1 years, body weight 74·9 ± 12·7 kg, height 151·9 ± 6·0 cm and BMI 32·5 ± 5·7 kg m^-2 ) completed seven sets of ten eccentric repetitions at 110% of the ten repetitions maximum (10RM). NO concentrations remained elevated up to 48 h following the acute ERE session as compared with baseline, for GG and GT/TT groups (P<0·05), with no differences between genotypes. The GG genotype group had higher body weight, prevalence of obesity (BMI classification - 81% versus 56%), BMI and higher relative muscle strength, while they had significantly lower triglycerides, VLDL and urea concentrations as compared with TT/TG group. In conclusion, NO remains elevated for up to 48 h after an acute ERE session, without genotype interaction. The TT/TG genotype had a negative impact on triglycerides, VLDL and urea concentrations. Thus, T carriers should increase their attention to cardiovascular risk factor and metabolic disorders.

Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females

Background:

Older females have less dynamic postural control and muscle strength than do middle-aged females. Aging-related strength losses may limit balancing performance.

Objective:

The purpose of this study was to investigate the ability of the Y Balance Test (YBT) and lower limb strength to discriminate between females in 2 age groups, the relationship between YBT distance and the Berg Balance Scale (BBS), and the degree to which performance on YBT distance is related to lower limb strength in middle-aged and older females.

Method:

The 40 healthy, independently active females were divided into 2 groups: older and middle-aged. The participants underwent measurements of YBT distance using the YBT, maximal muscular strength of the lower limbs using a handheld dynamometer, and the BBS.

Results:

The YBT distance in 3 directions and lower limb muscle strength for both lower limbs were significantly lower in the older adults than in the middle-aged group. A moderate correlation but insignificant correlation was found between the YBT composite distance and the BBS score. In the older females, YBT distance was significantly positively correlated with strength of the knee flexor and hip abductor. In the middle-aged group, YBT distance was significantly positively correlated with strength of the knee flexor and hip extensor.

Conclusions:

Performance on the YBT was influenced by the strength of lower limb. We suggested that YBT can be used to alternative as a measurement of dynamic balance. Proper training programs for older people could include not only strengthening exercises but also YBT performance to improve balance.

Altered phalanx force direction during power grip following stroke

Many stroke survivors with severe impairment can grasp only with a power grip. Yet, little knowledge is available on altered power grip after stroke, other than reduced power grip strength. This study characterized stroke survivors' static power grip during 100 and 50 % maximum grip. Each phalanx force angular deviation from the normal direction and its contribution to total normal force was compared for 11 stroke survivors and 11 age-matched controls. Muscle activities and skin coefficient of friction were additionally compared for another 20 stroke and 13 age-matched control subjects. The main finding was that stroke survivors gripped with a 34 % greater phalanx force angular deviation of 19° ± 2° compared to controls of 14° ± 1° (p < .05). Stroke survivors' phalanx force angular deviation was closer to the 23° threshold of slippage between the phalanx and grip surface, which may explain increased likelihood of object dropping in stroke survivors. In addition, this altered phalanx force direction decreases normal grip force by tilting the force vector, indicating a partial role of phalanx force angular deviation in reduced grip strength post-stroke. Greater phalanx force angular deviation may biomechanically result from more severe underactivation of stroke survivors' first dorsal interosseous and extensor digitorum communis muscles compared to their flexor digitorum superficialis or somatosensory deficit. While stroke survivors' maximum power grip strength was approximately half of the controls, the distribution of their remaining strength over the fingers and phalanges did not differ, indicating evenly distributed grip force reduction over the entire hand.

Different ankle muscle coordination patterns and co-activation during quiet stance between young adults and seniors do not change after a bout of high intensity training

Background

Available evidence suggests that young adults and seniors use different strategies to adjust for increasing body sway during quiet standing. Altered antagonist muscle co-activation and different ankle muscle coordination patterns may account for this finding. Consequently, we aimed at addressing whether aging leads to changes in neuromuscular coordination patterns as well as co-activation during quiet stance. We additionally investigated whether a bout of high intensity interval training additionally alters these patterns.

Methods

Twenty healthy seniors (age: 70 ± 4 y) and twenty young adults (age: 27 ± 3 y) were enrolled in the present study. In between the testing procedures, four consecutive high-intensity intervals of 4 min duration at a target exercise intensity of 90 to 95% HR_max were completed on a treadmill. The total center of pressure (COP) path length displacement served as standing balance performance outcome. In order to assess ankle muscle coordination patterns, amplitude ratios (AR) were calculated for each muscle (e.g. tibialis anterior (TA) [%] = (TA × 100)/(gastrocnemius medialis (GM) + soleus (SOL) + peroneus longus (PL) + TA). The co-activation was calculated for the SOL and TA muscles computing the co-activation index (CAI = 2 × TA/TA + SOL).

Results

Seniors showed an inverted ankle muscle coordination pattern during single limb stance with eyes open (SLEO), compared to young adults (rest: GM, S: 15 ± 8% vs Y: 24 ± 9%; p = 0.03; SOL, S: 27 ± 14% vs Y: 37 ± 18%; p = 0.009; TA, S: 31 ± 13% vs Y: 13 ± 7%; p = 0.003). These patterns did not change after a high-intensity training session. A moderate correlation between amplitude ratios of the TA-contribution and postural sway was observed for seniors during SLEO (r = 0.61). Ankle co-activation was twofold elevated in seniors compared to young adults during SLEO (p < 0.001). These findings were also not affected by high intensity training.

Conclusion

Increased ankle co-activation in the anterior-posterior plane and inverted ankle muscle coordination pattern merely occurred during single-leg stance. Seniors with decreased postural control showed higher TA contributions during SLEO. These neuromuscular changes are not affected by acute intermittent high intensity aerobic exercise.

Training in the functional movement circle to promote strength and mobility-related activities in older adults: a randomized controlled trial

Movements of everyday life (e.g., climbing stairs, rising from a chair, walking) are essential for older adults to stay functional and independent. Due to the aging process, muscle mass decreases and balance abilities are reduced. One major criticism of former interventions is that implemented resistance and balance exercises were not associated with movements needed in older adults' everyday life. The Functional Movement Circle for older adults (FuMoC) includes the combination of three aspects: resistance, balance, and movements of everyday life. The aim of this study was to compare the effects of training in the FuMoC with those of other training programs. A randomized controlled trial (RCT) with three intervention groups (IG1: FuMoC; IG2: resistance and balance training; IG3: coordination training) with a training period of 6 months and one inactive control group (CG) was conducted. At baseline (T1), after three (T2) and six (T3) months, parameters of strength (isometric strength measurement and One-Repetition Maximum test in leg and chest press) and mobility-related activities (gait analysis, Multisurface Obstacle Test for Older Adults (MSOT), Chair Rise Test (CRT), Timed Up & Go Test (TUG), Maximum Step Length Test (MSLT)) were assessed as primary outcomes. Data of 78 (43 males, 35 females) older adults were analyzed (mean age: 68.4 years). Significant (p < 0.05) interactions between time and group were observed in most of the primary outcomes. IG1 showed the highest improvement rates in MSOT (+16 %), CRT (+28 %), TUG (+14 %), and MSLT (+15 %); demonstrating advantages of training in the FuMoC compared to other training programs.

Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly

[Purpose] The purpose of this study was to investigate the effects of an 8-week balance exercise and elastic-resistance exercise program on muscle strength and balance of the old-old elderly (over the age of 75). [Subjects and Methods] Fifty-five elderly persons were recruited from the community and assigned to three groups for convenience: balance exercise (intervention group 1; INT 1), resistance exercise (intervention group 2; INT 2), and control (CON) groups. The intervention was performed twice a week at a senior center and three times a week at home for 8 weeks. Muscle strength and balance were evaluated before and at the end of the trial, using a PowertrackIIand Tetrax. [Results] There were significant improvements in the strength of all seven muscle groups and balance in the INT 2 group. In the INT 1 group, there were significant improvements in the strength of all muscle groups except for the knee flexor and ankle plantar flexor muscle groups. [Conclusion] This study demonstrated that an intervention using balance exercises or elastic-resistance exercises is effective at improving the muscle strength and balance of the old-old elderly. These type of exercises should be appropriate for the physical characteristics of the subjects.

The functional movement circle for older adults: feasibility and effects on physical performance

BACKGROUND

To facilitate the transfer of exercise effects to older adults' everyday life, essential daily life movements (stair climbing and walking on different surfaces) were embedded into the functional movement circle for older adults (FuMoC) -- a systematic balance and resistance training programme supplemented by functional movements.

AIMS

This study's aim was to consider the feasibility of the FuMoC and to evaluate the effects of this new training programme in a randomised controlled pilot study.

METHODS

Twenty-one adults aged 60 years and older were randomised into one of two groups. The intervention group (IG; n = 11) trained for 12 weeks in the FuMoC, while the control group (CG; n = 10) maintained their usual activities. The evaluation of feasibility comprised training attendance, realised intensity of load, and perceived exertion. Outcome variables included measures of strength and performance-based tests of mobility-related activities.

RESULTS

Training attendance was 86 % and the prescribed intensity of load was realised by the participants in the IG. Physical performance showed significant improvements in the IG in comparison to the CG: an increase of 24 % in the One-Repetition Maximum test in the chest press (p < 0.05), of 9-13 % in the modified Timed Up and Go test (p < 0.05), and of 10 % in the Maximal Step Length test (p < 0.05) was identified.

DISCUSSION AND CONCLUSION

In conclusion, the FuMoC study was feasible in terms of compliance (training attendance) and the planned exercise regimen (suitable exercises, intensity, and exertion) and showed positive effects on physical performance.