Effects of combined endurance and strength training on muscle strength, power and hypertrophy in 40-67-year-old men

Effects of Exercise Type on Muscle Strength and Body Composition in Men and Women: A Systematic Review and Meta-Analysis

Background and Objectives: There are typical differences in body composition and distribution of muscle fiber types between women and men. However, research investigating the effects of exercise based on sex differences is limited, and studies examining sex differences in physiological adaptations according to exercise type are scarce. We aimed to compare the effects of exercise types on muscle strength and body composition in men and women through a meta-analysis. Materials and Methods: A systematic literature search was conducted using the PubMed/Medline, Web of Science, CINAHL, and EBSCO databases. Keywords included "endurance training", "resistance training", "concurrent training", "muscle strength", "body composition", "sex characteristics", and "men and women". The standardized mean difference (SMD) was presented separately for men and women based on the pre- and post-intervention values for each exercise type. Results: Concurrent training showed the greatest effect on the increase in leg press muscle strength in men, and resistance training showed the greatest effect in women. Concurrent training showed the greatest effect size in both men and women in increasing bench press muscle strength. Resistance training and concurrent training showed a small effect size on lean mass reduction in both men and women. Endurance training and concurrent training significantly reduced fat mass in men. However, no significant changes in fat mass were observed in any exercise type among women. Conclusions: Concurrent training is the most efficient type of exercise for men, as it is effective in increasing upper- and lower-body muscle strength, increasing lean mass, and reducing fat mass. Resistance training is most effective in increasing muscle strength in females, whereas endurance training is most effective in reducing fat mass. However, it is difficult to corroborate these results because of the lack of study samples included in the analysis and the differences in exercise methods, participant age, and exercise duration.

Comparing the Impacts of Testosterone and Exercise on Lean Body Mass, Strength and Aerobic Fitness in Aging Men

BACKGROUND

Based on the largely untested premise that it is a restorative hormone that may reverse the detrimental impacts of aging, prescription of testosterone (T) has increased in recent decades despite no new clinical indications. It is apparent that middle-aged and older men with low-normal serum T levels are considering T supplementation as an anti-aging strategy. At the same time, there is evidence that physical activity (PA) is at historical lows in the Western world. In this review, we compare the impacts of T treatment aimed at achieving physiological T concentrations in middle-aged and older men, alongside the impacts of ecologically relevant forms of exercise training. The independent, and possible combined, effects of T and exercise therapy on physiological outcomes such as aerobic fitness, body composition and muscular strength are addressed.

MAIN BODY

Our findings suggest that both T treatment and exercise improve lean body mass in healthy older men. If improvement in lean body mass is the primary aim, then T treatment could be considered, and the combination of T and exercise may be more beneficial than either in isolation. In terms of muscle strength in older age, an exercise program is likely to be more beneficial than T treatment (where the dose is aimed at achieving physiological concentrations), and the addition of such T treatment does not provide further benefit beyond that of exercise alone. For aerobic fitness, T at doses aimed at achieving physiological concentrations has relatively modest impacts, particularly in comparison to exercise training, and there is limited evidence as to additive effects. Whilst higher doses of T, particularly by intramuscular injection, may have larger impacts on lean body mass and strength, this must be balanced against potential risks.

CONCLUSION

Knowing the impacts of T treatment and exercise on variables such as body composition, strength and aerobic fitness extends our understanding of the relative benefits of physiological and pharmacological interventions in aging men. Our review suggests that T has impacts on strength, body composition and aerobic fitness outcomes that are dependent upon dose, route of administration, and formulation. T treatment aimed at achieving physiological T concentrations in middle-aged and older men can improve lean body mass, whilst exercise training enhances lean body mass, aerobic fitness and strength. Men who are physically able to exercise safely should be encouraged to do so, not only in terms of building lean body mass, strength and aerobic fitness, but for the myriad health benefits that exercise training confers.

Exercise Training Differentially Affects Skeletal Muscle Mitochondria in Rats with Inherited High or Low Exercise Capacity

Exercise capacity has been related to morbidity and mortality. It consists of an inherited and an acquired part and is dependent on mitochondrial function. We assessed skeletal muscle mitochondrial function in rats with divergent inherited exercise capacity and analyzed the effect of exercise training. Female high (HCR)- and low (LCR)-capacity runners were trained with individually adapted high-intensity intervals or kept sedentary. Interfibrillar (IFM) and subsarcolemmal (SSM) mitochondria from gastrocnemius muscle were isolated and functionally assessed (age: 15 weeks). Sedentary HCR presented with higher exercise capacity than LCR paralleled by higher citrate synthase activity and IFM respiratory capacity in skeletal muscle of HCR. Exercise training increased exercise capacity in both HCR and LCR, but this was more pronounced in LCR. In addition, exercise increased skeletal muscle mitochondrial mass more in LCR. Instead, maximal respiratory capacity was increased following exercise in HCRs' IFM only. The results suggest that differences in skeletal muscle mitochondrial subpopulations are mainly inherited. Exercise training resulted in different mitochondrial adaptations and in higher trainability of LCR. HCR primarily increased skeletal muscle mitochondrial quality while LCR increased mitochondrial quantity in response to exercise training, suggesting that inherited aerobic exercise capacity differentially affects the mitochondrial response to exercise training.

The Effects of Combining Aerobic and Heavy Resistance Training on Body Composition, Muscle Hypertrophy, and Exercise Satisfaction in Physically Active Adults

This study investigated the effects of combined aerobic and heavy resistance training on the variables of body composition, muscle hypertrophy, and exercise satisfaction in physically active adults in comparison with heavy resistance training only (predominantly designed for hypertrophy). Twenty-two healthy male adults between the ages of 18 and 35, who had limited previous experience with muscle resistance training, participated in the intervention program while maintaining their physical activity level. The participants were randomly allocated into two groups: the resistance training group (control group) and the combined training group (experimental group), which involved both resistance training and aerobic training. Aerobic training consisted of 30 min aerobic interval training sessions three times a week with a total of 8 min work bouts in each at 60-70% of heart rate reserve (HRR). The intervention training program lasted for eight weeks. Resistance training consisted of a 3-day muscle group split (2-3 exercises per muscle group, 8 sets per muscle group, 6-12 repetition maximum (RM). Upon completion, body composition, muscle hypertrophy, and exercise satisfaction were analyzed using the mixed-design ANOVA. Variables selected for this study as markers of body composition responded differently to the different interventions and time; however, some trends were not statistically significant. Overall, it is not possible to state unequivocally that one training modality was superior to another in the body composition cluster, for significant improvements were observed within the groups from pre- to post-interventions, but no significant differences were observed between the resistance training and combined training groups, while, both interventions showed improvement with time in some variables of muscle hypertrophy. Compared to baseline, the exercise satisfaction post-intervention improved within the groups. From pre- to post-testing, both resistance and combined training groups improved exercise satisfaction (p < 0.05 in both groups). However, there was no significant difference in exercise satisfaction observed between the resistance training and combined training groups after the training intervention (p > 0.05).

Influence of exercise type and duration on cardiorespiratory fitness and muscular strength in post-menopausal women: a systematic review and meta-analysis

Background and aim

Both cardiorespiratory fitness (CRF) and muscular strength are reported to decrease with age and menopause, which considered to be risk for cardiovascular diseases (CVDs). Previous relevant meta-analyses are inconclusive on the beneficial effects of exercise, particularly in post-menopausal women. In this systematic review and meta-analysis, we investigated the effects of exercise modalities on CRF and muscular strength in post-menopausal women, and identified the effective exercise type and duration.

Methods

A comprehensive search was conducted on PubMed, Web of Science, CINAHL, and Medline to identify the randomized controlled trials, which evaluated exercise effect on CRF, lower- and upper-body muscular strength, and/or handgrip strength in post-menopausal women and compared the results with control. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random effects models.

Results

A total of 129 studies comprising 7,141 post-menopausal women with mean age and BMI ranging from ∼53 to 90 years and 22 to 35 kg/m², respectively, were included in the meta-analysis. Overall, exercise training effectively increased CRF (SMD: 1.15; 95% CI: 0.87, 1.42; p = 0.001), lower-body muscular strength (SMD: 1.06; 95% CI: 0.90, 1.22; p = 0.001), upper-body muscular strength (SMD: 1.11; 95% CI: 0.91, 1.31; p = 0.001), and handgrip strength (WMD: 1.78 kg; 95% CI: 1.24, 2.32; p = 0.001) in post-menopausal women. These increments were found to be irrespective of ages and intervention durations. Regarding exercise type, aerobic, resistance, and combined training significantly increased CRF and lower-body muscular strength, while resistance and combined training effectively increased handgrip strength. However, only resistance training increased the upper-body muscular strength in women.

Conclusion

Our findings suggest that exercise training is effective in increasing CRF and muscular strength in post-menopausal women, which might be cardioprotective. Both aerobic and resistance training alone or in combination increased CRF and lower-body muscular strength, but only resistance training increased upper-body strength in women.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283425, identifier: CRD42021283425.

Human and African ape myosin heavy chain content and the evolution of hominin skeletal muscle

Humans are unique among terrestrial mammals in our manner of walking and running, reflecting 7 to 8 Ma of musculoskeletal evolution since diverging with the genus Pan. One component of this is a shift in our skeletal muscle biology towards a predominance of myosin heavy chain (MyHC) I isoforms (i.e. slow fibers) across our pelvis and lower limbs, which distinguishes us from chimpanzees. Here, new MyHC data from 35 pelvis and hind limb muscles of a Western gorilla (Gorilla gorilla) are presented. These data are combined with a similar chimpanzee dataset to assess the MyHC I content of humans in comparison to African apes (chimpanzees and gorillas) and other terrestrial mammals. The responsiveness of human skeletal muscle to behavioral interventions is also compared to the human-African ape differential. Humans are distinct from African apes and among a small group of terrestrial mammals whose pelvis and hind/lower limb muscle is slow fiber dominant, on average. Behavioral interventions, including immobilization, bed rest, spaceflight and exercise, can induce modest decreases and increases in human MyHC I content (i.e. -9.3% to 2.3%, n = 2033 subjects), but these shifts are much smaller than the mean human-African ape differential (i.e. 31%). Taken together, these results indicate muscle fiber content is likely an evolvable trait under selection in the hominin lineage. As such, we highlight potential targets of selection in the genome (e.g. regions that regulate MyHC content) that may play an important role in hominin skeletal muscle evolution.

Effects of Concurrent Resistance and Endurance Training Using Continuous or Intermittent Protocols on Muscle Hypertrophy: Systematic Review With Meta-Analysis

ABSTRACT

Monserdà-Vilaró, A, Balsalobre-Fernández, C, Hoffman, JR, Alix-Fages, C, and Jiménez, SL. Effects of concurrent resistance and endurance training using continuous or intermittent protocols on muscle hypertrophy: Systematic review with meta-analysis. J Strength Cond Res 37(3): 688-709, 2023-The purpose of this systematic review with meta-analysis was to explore the effects of concurrent resistance and endurance training (CT) incorporating continuous or intermittent endurance training (ET) on whole-muscle and type I and II muscle fiber hypertrophy compared with resistance training (RT) alone. Randomized and nonrandomized studies reporting changes in cross-sectional area at muscle fiber and whole-muscle levels after RT compared with CT were included. Searches for such studies were performed in Web of Science, PubMed, Scopus, SPORTDiscus, and CINAHL electronic databases. The data reported in the included studies were pooled in a random-effects meta-analysis of standardized mean differences (SMDs). Twenty-five studies were included. At the whole-muscle level, there were no significant differences for any comparison (SMD < 0.03). By contrast, RT induced greater type I and type II muscle fiber hypertrophy than CT when high-intensity interval training (HIIT) was incorporated alone (SMD > 0.33) or combined with continuous ET (SMD > 0.27), but not compared with CT incorporating only continuous ET (SMD < 0.16). The subgroup analyses of this systematic review and meta-analysis showed that RT induces greater muscle fiber hypertrophy than CT when HIIT is included. However, no CT affected whole-muscle hypertrophy compared with RT.

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

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

Hybrid Exercise Program Enhances Physical Fitness and Reverses Frailty in Older Adults: Insights and Predictions from Machine Learning

PURPOSE

The declining physical condition of the older adults is a pressing issue. Wu Qin Xi exercise, despite being low-intensity, is highly effective among older adults. Inspired by its characteristics, we designed a new exercise program for frail older adults, combining strength, endurance, and Wu Qin Xi. Furthermore, we employed machine learning to predict whether frailty can be reversed in older adults after the intervention.

METHODS

A total of 181 community-dwelling frail older adults aged 65 years or older participated in this single-center, randomized controlled study, with 54.7% (n=99) being female. The study assessed the effectiveness of several exercise modalities in reversing frailty. The Fried's frailty criterion was used to assess the degree of frailty of the subjects. Participants were assigned a three-digit code 001-163 and randomly assigned (1:1:1) by computer to three different groups based on the study participant number: the Wu Qin Xi group (WQX), the strength exercise mixed with endurance exercise training group (SE), and the WQXSE hybrid exercise group incorporated the above two. Body composition and frailty-related physical fitness factors were measured before and after a 24-week intervention. The measurements included Body height, Body mass, Timed Up and Go Test (TUGT), grip strength assessment (GS), 6min walk test (6 min WT), and 10 m maximum walk speed (10 m MWS). Data were analyzed using repeated measures ANOVA to determine group and time interaction effects and machine learning models were used to predict program effectiveness.

RESULTS

A total of 163 participants completed the study, with 53.9% (n=88) of them being female. The two items, 10 m maximum walking speed (10 m MWS) and grip strength, were significantly affected by the interaction of group and time. Compared to the other two groups, the WQXSE group showed the most improvement in the item 10 m MWS. In addition, following 24 weeks of training, 68 (41.7%) of the initially frail older adults had reversed their frailty status. Among them, 19 (36.5%) were in the WQX group, 24 (44.4%) were in the WQXSE group, and 25 (43.9%) were in the SE group. The stacking model exhibited superior performance when compared to other algorithms.

CONCLUSION

A hybrid exercise regimen comprising the Wu Qin Xi routine and exercises focused on both strength and endurance holds the potential to yield greater improvements in the physical fitness of older adults, as well as reducing frailty. Leveraging a stacking model, it is possible to forecast the likelihood of older adults successfully reversing their frailty status following participation in a prevention exercise program.

Effects of Concurrent Strength and Endurance Training on Measures of Physical Fitness in Healthy Middle-Aged and Older Adults: A Systematic Review with Meta-Analysis

BACKGROUND

There is evidence that in older adults the combination of strength training (ST) and endurance training (ET) (i.e., concurrent training [CT]) has similar effects on measures of muscle strength and cardiorespiratory endurance (CRE) compared with single-mode ST or ET, respectively. Therefore, CT seems to be an effective method to target broad aspects of physical fitness in older adults.

OBJECTIVES

The aim was to examine the effects of CT on measures of physical fitness (i.e., muscle strength, power, balance and CRE) in healthy middle-aged and older adults aged between 50 and 73 years. We also aimed to identify key moderating variables to guide training prescription.

STUDY DESIGN

We conducted a systematic review with meta-analysis of randomized controlled trials.

DATA SOURCES

The electronic databases PubMed, Web of Science Core Collection, MEDLINE and Google Scholar were systematically searched until February 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included randomized controlled trials that examined the effects of CT versus passive controls on measures of physical fitness in healthy middle-aged and older adults aged between 50 and 73 years.

RESULTS

Fifteen studies were eligible, including a total of 566 participants. CT induced moderate positive effects on muscle strength (standardized mean difference [SMD] = 0.74) and power (SMD = 0.50), with a small effect on CRE (SMD = 0.48). However, no significant effects were detected for balance (p > 0.05). Older adults > 65 years (SMD = 1.04) and females (SMD = 1.05) displayed larger improvements in muscle strength compared with adults ≤ 65 years old (SMD = 0.60) and males (SMD = 0.38), respectively. For CRE, moderate positive effects (SMD = 0.52) were reported in those ≤ 65 years old only, with relatively larger gains in females (SMD = 0.55) compared with males (SMD = 0.45). However, no significant differences between all subgroups were detected. Independent single training factor analysis indicated larger positive effects of 12 weeks (SMD = 0.87 and 0.88) compared with 21 weeks (SMD = 0.47 and 0.29) of CT on muscle strength and power, respectively, while for CRE, 21 weeks of CT resulted in larger gains (SMD = 0.62) than 12 weeks (SMD = 0.40). For CT frequency, three sessions per week produced larger beneficial effects (SMD = 0.91) on muscle strength compared with four sessions (SMD = 0.55), whereas for CRE, moderate positive effects were only noted after four sessions per week (SMD = 0.58). A session duration of > 30-60 min generated larger improvements in muscle strength (SMD = 0.99) and power (SMD = 0.88) compared with > 60-90 min (SMD = 0.40 and 0.29, respectively). However, for CRE, longer session durations (i.e., > 60-90 min) seem to be more effective (SMD = 0.61) than shorter ones (i.e., > 30-60 min) (SMD = 0.34). ET at moderate-to-near maximal intensities produced moderate (SMD = 0.64) and small positive effects (SMD = 0.49) on muscle strength and CRE, respectively, with no effects at low intensity ET (p > 0.05). Finally, intra-session ST before ET produced larger gains in muscle strength (SMD = 1.00) compared with separate sessions (SMD = 0.55), whereas ET and ST carried out separately induced larger improvements in CRE (SMD = 0.58) compared with intra-session ET before ST (SMD = 0.49).

CONCLUSIONS

CT is an effective method to improve measures of physical fitness (i.e., muscle strength, power, and CRE) in healthy middle-aged and older adults aged between 50 and 73 years, regardless of sex. Results of independent single training factor analysis indicated that the largest effects on muscle strength were observed after 12 weeks of training, > 30-60 min per session, three sessions per week, higher ET intensities and when ST preceded ET within the same session. For CRE, the largest effects were noted after 21 weeks of training, four sessions per week, > 60-90 min per session, higher ET intensities and when ET and ST sessions were performed separately. Regarding muscle power, the largest effects were observed after 12 weeks of training and > 30-60 min per session.

The Effects of Concurrent Aerobic and Strength Training on Muscle Fiber Hypertrophy: A Systematic Review and Meta-Analysis

Background

Whole muscle hypertrophy does not appear to be negatively affected by concurrent aerobic and strength training compared to strength training alone. However, there are contradictions in the literature regarding the effects of concurrent training on hypertrophy at the myofiber level.

Objective

The current study aimed to systematically examine the extent to which concurrent aerobic and strength training, compared with strength training alone, influences type I and type II muscle fiber size adaptations. We also conducted subgroup analyses to examine the effects of the type of aerobic training, training modality, exercise order, training frequency, age, and training status.

Design

A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [PROSPERO: CRD42020203777]. The registered protocol was modified to include only muscle fiber hypertrophy as an outcome.

Data Sources

PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched on 12 August, 2020, and updated on 15 March, 2021.

Eligibility Criteria

Population: healthy adults of any sex and age; intervention: supervised, concurrent aerobic and strength training of at least 4 weeks; comparison: identical strength training prescription, with no aerobic training; and outcome: muscle fiber hypertrophy.

Results

A total of 15 studies were included. The estimated standardized mean difference based on the random-effects model was − 0.23 (95% confidence interval [CI] − 0.46 to − 0.00, p = 0.050) for overall muscle fiber hypertrophy. The standardized mean differences were − 0.34 (95% CI − 0.72 to 0.04, p = 0.078) and − 0.13 (95% CI − 0.39 to 0.12, p = 0.315) for type I and type II fiber hypertrophy, respectively. A negative effect of concurrent training was observed for type I fibers when aerobic training was performed by running but not cycling (standardized mean difference − 0.81, 95% CI − 1.26 to − 0.36). None of the other subgroup analyses (i.e., based on concurrent training frequency, training status, training modality, and training order of same-session training) revealed any differences between groups.

Conclusions

In contrast to previous findings on whole muscle hypertrophy, the present results suggest that concurrent aerobic and strength training may have a small negative effect on fiber hypertrophy compared with strength training alone. Preliminary evidence suggests that this interference effect may be more pronounced when aerobic training is performed by running compared with cycling, at least for type I fibers.

The Effectiveness of a Hybrid Exercise Program on the Physical Fitness of Frail Elderly

BACKGROUND

Frailty is a serious physical disorder affecting the elderly all over the world. However, the frail elderly have low physical fitness, which limits the effectiveness of current exercise programs. Inspired by this, we attempted to integrate Baduanjin and strength and endurance exercises into an exercise program to improve the physical fitness and alleviate frailty among the elderly. Additionally, to achieve the goals of personalized medicine, machine learning simulations were performed to predict post-intervention frailty.

METHODS

A total of 171 frail elderly individuals completed the experiment, including a Baduanjin group (BDJ), a strength and endurance training group (SE), and a combination of Baduanjin and strength and endurance training group (BDJSE), which lasted for 24 weeks. Physical fitness was evaluated by 10-meter maximum walk speed (10 m MWS), grip strength, the timed up-and-go test (TUGT), and the 6 min walk test (6 min WT). A one-way analysis of variance (ANOVA), chi-square test, and two-way repeated-measures ANOVA were carried out to analyze the experimental data. In addition, nine machine learning models were utilized to predict the frailty status after the intervention.

RESULTS

In 10 m MWS and TUGT, there was a significant interactive influence between group and time. When comparing the BDJ group and the SE group, participants in the BDJSE group demonstrated the maximum gains in 10 m MWS and TUGT after 24 weeks of intervention. The stacking model surpassed other algorithms in performance. The accuracy and precision rates were 75.5% and 77.1%, respectively.

CONCLUSION

The hybrid exercise program that combined Baduanjin with strength and endurance training proved more effective at improving fitness and reversing frailty in elderly individuals. Based on the stacking model, it is possible to predict whether an elderly person will exhibit reversed frailty following an exercise program.

Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance

Background: Due to the low physical fitness of the frail elderly, current exercise program strategies have a limited impact. Eight-form Tai Chi has a low intensity, but high effectiveness in the elderly. Inspired by it, we designed an exercise program that incorporates eight-form Tai Chi, strength, and endurance exercises, to improve physical fitness and reverse frailty in the elderly. Additionally, for the ease of use in clinical practice, machine learning simulations were used to predict the frailty status after the intervention. Methods: For 24 weeks, 150 frail elderly people completed the experiment, which comprised the eight-form Tai Chi group (TC), the strength and endurance training group (SE), and a comprehensive intervention combining both TC and SE (TCSE). The comparison of the demographic variables used one-way ANOVA for continuous data and the chi-squared test for categorical data. Two-way repeated measures analysis of variance (ANOVA) was performed to determine significant main effects and interaction effects. Eleven machine learning models were used to predict the frailty status of the elderly following the intervention. Results: Two-way repeated measures ANOVA results before the intervention, group effects of ten-meter maximum walking speed (10 m MWS), grip strength (GS), timed up and go test (TUGT), and the six-minute walk test (6 min WT) were not significant. There was a significant interaction effect of group × time in ten-meter maximum walking speed, grip strength, and the six-minute walk test. Post hoc tests showed that after 24 weeks of intervention, subjects in the TCSE group showed the greatest significant improvements in ten-meter maximum walking speed (p < 0.05) and the six-minute walk test (p < 0.05) compared to the TC group and SE group. The improvement in grip strength in the TCSE group (4.29 kg) was slightly less than that in the SE group (5.16 kg). There was neither a significant main effect nor a significant interaction effect for TUGT in subjects. The stacking model outperformed other algorithms. Accuracy and the F1-score were 67.8% and 71.3%, respectively. Conclusion: A hybrid exercise program consisting of eight-form Tai Chi and strength and endurance exercises can more effectively improve physical fitness and reduce frailty among the elderly. It is possible to predict whether an elderly person will reverse frailty following an exercise program based on the stacking model.

The Effects of Concurrent Aerobic and Strength Training on Muscle Fiber Hypertrophy: A Systematic Review and Meta-Analysis

Background

Whole muscle hypertrophy does not appear to be negatively affected by concurrent aerobic and strength training compared to strength training alone. However, there are contradictions in the literature regarding the effects of concurrent training on hypertrophy at the myofiber level.

Objective

The current study aimed to systematically examine the extent to which concurrent aerobic and strength training, compared with strength training alone, influences type I and type II muscle fiber size adaptations. We also conducted subgroup analyses to examine the effects of the type of aerobic training, training modality, exercise order, training frequency, age, and training status.

Design

A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [PROSPERO: CRD42020203777]. The registered protocol was modified to include only muscle fiber hypertrophy as an outcome.

Data Sources

PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched on 12 August, 2020, and updated on 15 March, 2021.

Eligibility Criteria

Population: healthy adults of any sex and age; intervention: supervised, concurrent aerobic and strength training of at least 4 weeks; comparison: identical strength training prescription, with no aerobic training; and outcome: muscle fiber hypertrophy.

Results

A total of 15 studies were included. The estimated standardized mean difference based on the random-effects model was − 0.23 (95% confidence interval [CI] − 0.46 to − 0.00, p = 0.050) for overall muscle fiber hypertrophy. The standardized mean differences were − 0.34 (95% CI − 0.72 to 0.04, p = 0.078) and − 0.13 (95% CI − 0.39 to 0.12, p = 0.315) for type I and type II fiber hypertrophy, respectively. A negative effect of concurrent training was observed for type I fibers when aerobic training was performed by running but not cycling (standardized mean difference − 0.81, 95% CI − 1.26 to − 0.36). None of the other subgroup analyses (i.e., based on concurrent training frequency, training status, training modality, and training order of same-session training) revealed any differences between groups.

Conclusions

In contrast to previous findings on whole muscle hypertrophy, the present results suggest that concurrent aerobic and strength training may have a small negative effect on fiber hypertrophy compared with strength training alone. Preliminary evidence suggests that this interference effect may be more pronounced when aerobic training is performed by running compared with cycling, at least for type I fibers.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01688-x.

Compatibility of Concurrent Aerobic and Strength Training for Skeletal Muscle Size and Function: An Updated Systematic Review and Meta-Analysis

BACKGROUND

Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two distinct training modes remains unclear.

OBJECTIVE

This systematic review assessed the compatibility of concurrent aerobic and strength training compared with strength training alone, in terms of adaptations in muscle function (maximal and explosive strength) and muscle mass. Subgroup analyses were conducted to examine the influence of training modality, training type, exercise order, training frequency, age, and training status.

METHODS

A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched (12 August 2020, updated on 15 March 2021). Eligibility criteria were as follows.

POPULATION

healthy adults of any sex and age; Intervention: supervised concurrent aerobic and strength training for at least 4 weeks; Comparison: identical strength training prescription, with no aerobic training; Outcome: maximal strength, explosive strength, and muscle hypertrophy.

RESULTS

A total of 43 studies were included. The estimated standardised mean differences (SMD) based on the random-effects model were - 0.06 (95% confidence interval [CI] - 0.20 to 0.09; p = 0.446), - 0.28 (95% CI - 0.48 to - 0.08; p = 0.007), and - 0.01 (95% CI - 0.16 to 0.18; p = 0.919) for maximal strength, explosive strength, and muscle hypertrophy, respectively. Attenuation of explosive strength was more pronounced when concurrent training was performed within the same session (p = 0.043) than when sessions were separated by at least 3 h (p > 0.05). No significant effects were found for the other moderators, i.e. type of aerobic training (cycling vs. running), frequency of concurrent training (> 5 vs. < 5 weekly sessions), training status (untrained vs. active), and mean age (< 40 vs. > 40 years).

CONCLUSION

Concurrent aerobic and strength training does not compromise muscle hypertrophy and maximal strength development. However, explosive strength gains may be attenuated, especially when aerobic and strength training are performed in the same session. These results appeared to be independent of the type of aerobic training, frequency of concurrent training, training status, and age.

PROSPERO

CRD42020203777.

Acute Effects of Aerobic Exercise on Muscle Strength and Power in Trained Male Individuals: A Systematic Review with Meta-analysis

BACKGROUND

Concurrent training can be an effective and time-efficient method to improve both muscle strength and aerobic capacity. A major challenge with concurrent training is how to adequately combine and sequence strength exercise and aerobic exercise to avoid interference effects. This is particularly relevant for athletes.

OBJECTIVE

We aimed to examine the acute effects of aerobic exercise on subsequent measures of muscle strength and power in trained male individuals.

DESIGN

We performed a systematic review with meta-analysis.

DATA SOURCES

Systematic literature searches in the electronic databases PubMed, Web of Science, and Google Scholar were conducted up to July 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included that applied a within-group repeated-measures design and examined the acute effects of aerobic exercise (i.e., running, cycling exercise) on subsequent measures of lower limb muscle strength (e.g., maximal isometric force of the knee extensors) and/or proxies of lower limb muscle power (e.g., countermovement jump height) in trained individuals.

RESULTS

Fifteen studies met the inclusion criteria. Aerobic exercise resulted in moderate declines in muscle strength (standardized mean difference [SMD] = 0.79; p = 0.003). Low-intensity aerobic exercise did not moderate effects on muscle strength (SMD = 0.65; p = 0.157) while moderate-to-high intensity aerobic exercise resulted in moderate declines in muscle strength (SMD = 0.65; p = 0.020). However, the difference between subgroups was not statistically significant (p = 0.979). Regarding aerobic exercise duration, large declines in muscle strength were found after > 30 min (SMD = 1.02; p = 0.049) while ≤ 30 min of aerobic exercise induced moderate declines in muscle strength (SMD = 0.59; p = 0.013). The subgroup difference was not statistically significant (p = 0.204). Cycling exercise resulted in significantly larger decrements in muscle strength (SMD = 0.79; p = 0.002) compared with running (SMD = 0.28; p = 0.035). The difference between subgroups was statistically significant (p < 0.0001). For muscle power, aerobic exercise did not result in any statistically significant changes (SMD = 0.04; p = 0.846).

CONCLUSIONS

Aerobic exercise induced moderate declines in measures of muscle strength with no statistically significant effects on proxies of muscle power in trained male individuals. It appears that higher compared with lower intensity as well as longer compared with shorter aerobic exercise duration exacerbate acute declines in muscle strength. Our results provide evidence for acute interference effects when aerobic exercies is performed before strength exercises. These findings may help practitioners to better prescribe single training sessions, particularly if environmental and/or infrastructural reasons (e.g., availability of training facilities) do not allow the application of strength training before aerobic exercise.

Endurance training-induced increase in muscle oxidative capacity without loss of muscle mass in younger and older resistance-trained men

While concurrent training is regularly used in older populations, the inverse relationship between fibre size and oxidative capacity suggests that endurance training in resistance-trained individuals may result in some loss of resistance training-induced gains in muscle mass, which may be more pronounced in older people. We investigated the impact of superimposed endurance training in younger (28.5 ± 4.8 years; n = 8) and older (67.5 ± 5.5 years; n = 7) highly resistance-trained men. Participants underwent a 10-week endurance cycling training programme consisting of five 6-min intervals at 75% max heart rate (HRmax) separated by 4-min intervals at 90% HRmax. The anatomical cross-sectional area (ACSA) of the thigh muscles, as determined with MRI, was 24% smaller in older compared to younger participants (p < 0.001). Although maximal oxygen consumption (VO₂max) was also lower in the older group (p < 0.001), VO₂max per kg body mass did not differ significantly between younger and older participants. Histological analyses of biopsies of the m. vastus lateralis showed that endurance training induced an increase in succinate dehydrogenase activity in both younger and older participants (p ≤ 0.043), and an increase in the number of capillaries around type I fibres (p = 0.017). The superimposed endurance training did not induce a significant decrease in thigh ACSA, fibre cross-sectional area, or knee extensor maximum voluntary isometric force. These observations indicate that adding endurance training to resistance training can lead to positive endurance-related adaptations without negative consequences for muscle size and strength in older and younger resistance-trained people.

The influence of resistance training on neuromuscular function in middle-aged and older adults: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Deterioration of neuromuscular function is a major mechanism of age-related strength loss. Resistance training (RT) improves muscle strength and mass. However, the effects of RT on neuromuscular adaptations in middle-aged and older adults are unclear.

METHODS

Randomised controlled RT interventions (≥2 weeks) involving adults aged ≥50 years were identified. Primary outcome measures were voluntary activation (VA), electromyographic (EMG) activity during maximal voluntary contraction (MVC), and antagonist coactivation. Data were pooled using a weighted random-effect model. Sub-analyses were conducted by muscle or muscle group and health status of participants. Sensitivity analysis was based on study quality. P < 0.05 indicated statistical significance.

RESULTS

Twenty-seven studies were included. An effect was found for VA (standardised mean difference [SMD] 0.54, 0.01 to 1.07, P = 0.04), This result remained significant following sensitivity analysis involving only studies that were low risk of bias. Subgroup analyses showed an effect for plantar flexor VA (SMD 1.13, 0.20 to 2.06, P = 0.02) and VA in healthy participants (SMD 1.04, 0.32 to 1.76, P = 0.004). There was no effect for EMG activity or antagonist coactivation of any muscle group (P > 0.05).

DISCUSSION

Resistance training did not alter EMG activity or antagonist coactivation in older adults. Sensitivity analysis resulted in the effect for VA remaining significant, indicating that this finding was not dependent on study quality. Studies predominantly involved healthy older adults (78%), limiting the generalisability of these findings to clinical cohorts. Future research should determine the effects of RT on neuromuscular function in people with sarcopenia and age-related syndromes.

The Genetic Effect on Muscular Changes in an Older Population: A Follow-Up Study after One-Year Cessation of Structured Training

Older adults lose muscle mass and strength at different speeds after the cessation of physical exercise, which might be genotype related. This study aimed to explore the genetic association with changes in muscle mass and strength one year after the cessation of structured training in an older population. Participants (n = 113, aged between 61 and 81 years) who performed one-year of combined fitness (n = 44) or whole-body vibration (n = 69) training were assessed one year after the cessation of the training. Whole-body skeletal muscle mass and knee strength were measured. Data-driven genetic predisposition scores (GPSs) were calculated and analysed in a general linear model with sex, age, body mass index and post-training values of skeletal muscle mass or muscle strength as covariates. Forty-six single nucleotide polymorphisms (SNPs) from an initial 170 muscle-related SNPs were identified as being significantly linked to muscular changes after cessation. Data-driven GPSs and over time muscular changes were significantly related (p < 0.01). Participants with higher GPSs had less muscular declines during the cessation period while data-driven GPSs accounted for 26–37% of the phenotypic variances. Our findings indicate that the loss of training benefits in older adults is partially genotype related.

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

Background

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

Materials and methods

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

Results

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

Conclusions

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

Adaptations to strength training differ between endurance-trained and untrained women

PURPOSE

The purpose of this study was to investigate if endurance athletes, sustaining their normal endurance training, experience attenuated adaptations to strength training compared to untrained individuals.

METHODS

Eleven non-strength-trained female endurance athletes (E + S) added 11 weeks of strength training to their normal endurance training (5.1 ± 1.1 h per week), and 10 untrained women (S) performed the same strength training without any endurance training. The strength training consisted of four leg exercises [3 × 4 - 10 repetition maximum (RM)], performed twice a week for 11 weeks.

RESULTS

E + S and S displayed similar increases in 1RM one-legged leg press (E + S 39 ± 19%, S 42 ± 17%, p < 0.05), maximal isometric torque in knee extension (E + S 12 ± 11%, S 8 ± 10%, p < 0.05) and lean mass in the legs (E + S 3 ± 4%, S 3 ± 3%, p < 0.05). However, S displayed superior increases in peak torque in knee extension at an angular velocity of 240° sec^-1 (E + S 8 ± 5%, S 15 ± 7%, p < 0.05) and maximal squat jump height (E + S 8 ± 6%, S 14 ± 7%, p < 0.05).

CONCLUSIONS

In this study, concurrent training did not impair the adaptations in the ability to develop force at low contraction velocities or muscle hypertrophy. However, concurrent training attenuated strength training-associated changes in the ability to develop force at higher muscular contraction velocities.

An Overview of the Beneficial Effects of Exercise on Health and Performance

Life expectancy is steadily increasing in modern societies, and so are noncommunicable diseases such as cardiovascular diseases, diabetes, obesity, and cancer, accounting for more than 70% of all deaths globally. The costs associated with these diseases are enormous, but it has been estimated that the majority of these noncommunicable diseases are preventable. In addition to an unhealthy diet, tobacco use, and harmful use of alcohol, physical inactivity is a key risk factor. Consequently, physical activity is a logical remedy, and in this chapter an overview of the numerous beneficial effects of physical activity on health and performance is given.The chapter is divided into three parts: First, the basics of physical activity and exercise are discussed, for instance exercise classification, exercise intensity operationalization, energy supply, and the acute effects of exercise such as blood flow redistribution and increased cardiac output. In the second part, the effects of exercise on physical performance are summarized. Specifically, it is discussed how endurance, strength, power, and balance can be improved. This discussion includes recommendations regarding the type, intensity, and duration of the exercise leading to improvements in one of these aspects of physical performance, as well as the mechanisms causing these adaptations. In the third part, the beneficial effects of physical activity on physical and mental health are outlined, with particular attention to cardiovascular diseases, the metabolic syndrome, musculoskeletal diseases, mood, anxiety, depression, and dementia.It can be concluded that with adequate programming, regular physical activity is an effective way to improve physical performance, improve physical and mental health, and reduce the risk factors for many noncommunicable diseases such as cardiovascular diseases, metabolic syndrome, sarcopenia, osteoporosis, and depression. In contrast to medication, physical exercise has no negative side effects, costs very little, and targets many health issues at once. If the multitude of beneficial effects of regular exercise were to be combined in a single low-cost drug, it would be prescribed for almost all types of physical and mental health issues.

CARDIOVASCULAR AND STRENGTH ADAPTATIONS IN CONCURRENT TRAINING IN HYPERTENSIVE WOMEN

ABSTRACT Introduction Physical exercise has been recommended as a non-pharmacological strategy for preventing and controlling hypertension. Objective To verify chronic cardiovascular and muscle strength adaptations in hypertensive women who underwent 12 weeks of concurrent training (CT) in different orders. Methods Twenty hypertensive women were randomly assigned into 2 groups: resistance exercise-endurance group (REE; 56.00 ± 5.20 years; 78.95 ± 8.28 kg; 155.10 ± 5.30 cm; 33.00 ± 5.30 kg.m-2) and endurance-resistance exercise group (ERE; 57.10 ± 13.38 years; 76.56 ± 18.87 kg; 155.50 ± 8.18 cm; 31.41 ± 5.84 kg.m-2). The endurance exercise was composed of 3 sets of 4 exercises, with 8-RM loads with a 90-second break between sets and exercises. The resistance exercise lasted for 25 minutes and was of progressive intensity. Muscle strength (8-RM), systolic and diastolic blood pressure, heart rate, and double product were assessed pre- and post-exercise. Results The ANOVA showed significant increases in strength for all exercises (p <0.0001) regardless of the order of the concurrent training (bench press, p = 0.680; leg press, p = 0.244; seated row, p = 0.668; and leg extension, p = 0.257). No significant differences in systolic (p = 0.074) and diastolic blood pressures (p = 0.064) were observed for different CT conditions. However, significant reductions in systolic (p = 0.0001) and diastolic blood pressures (p = 0.006) and double product (p = 0.006) only occurred in the REE group. Conclusion Endurance training and resistance exercise promote significant muscle strength gains after 12 weeks of training regardless of CT order in hypertensive women. Beneficial cardiovascular responses (SBP, DBP, and RPP) were also observed when endurance training was initiated. Level of evidence I; Therapeutic Studies - Investigating Treatment Outcomes.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

A comparative study: tongue muscle performance in weightlifters and runners

Exercise mode (i.e., resistance training, endurance training) is known to yield mode-specific effects on strength and endurance of muscles that are directly targeted during the exercise. Such mode-specific effects can also be observed in indirectly involved (i.e., nontargeted) muscles. Mode-specific muscle performance changes of nontargeted muscles, however, have only been investigated within the skeletal system. Therefore, as a first step, this study aimed to determine if bulbar muscle performance (tongue strength [TS], tongue endurance [TE]) differs between weightlifters and runners and if group differences are tongue region-specific. The Iowa Oral Performance Instrument (IOPI) was used to measure TS and TE of the anterior and posterior tongue regions in 21 weightlifters and 23 runners. In weightlifters anterior TS was significantly greater than posterior TS (P = 0.008), whereas in runners anterior and posterior TS were comparable. Furthermore, weightlifters produced significantly greater anterior TS than runners (P = 0.001). Finally, TE was overall significantly greater in runners than in weightlifters (P = 0.001). Findings suggest that exercise mode may differentially impact performance patterns of nontargeted bulbar muscles. More research is warranted to better understand the mechanisms underlying tongue muscle performance differences between weightlifters and runners.

Role of exercise in age-related sarcopenia

Sarcopenia is an age-associated decline of skeletal muscle mass and function and is known to lead to frailty, cachexia, osteoporosis, metabolic syndromes, and death. Notwithstanding the increasing incidence of sarcopenia, the molecular and cellular mechanisms driving age-related sarcopenia are not completely understood. This article reviews current definitions of sarcopenia, its potential mechanisms, and effects of exercise on sarcopenia. The pathogenesis of age-related sarcopenia is multifactorial and includes myostatin, inflammatory cytokines, and mitochondria-derived problems. Especially, age-induced mitochondrial dysfunction triggers the production of reactive oxygen species (ROS) by mitochondria, impedes mitochondrial dynamics, interrupts mitophagy, and leads to mitochondria-mediated apoptosis. Aerobic exercise provides at least a partial solution to sarcopenia as it ameliorates mitochondria-derived problems, and resistance exercise strengthens muscle mass and function. Furthermore, combinations of these exercise types provide the benefits of both. Collectively, this review summarizes potential mechanisms of age-related sarcopenia and emphasizes the use of exercise as a therapeutic strategy, suggesting that combined exercise provides the most beneficial means of combating age-related sarcopenia.

Cardiorespiratory Adaptations in Elderly Men Following Different Concurrent Training Regimes

BACKGROUND

This study aimed to investigate the effects of different intra-session exercise orders during concurrent training (CT) on endurance performance in elderly men, as well as to verify its influence on individual responses in endurance performance.

DESIGN

Twenty-five healthy elderly men (64.7 ± 4.1 years) were placed into two groups: strength training prior to endurance training (SE, n=13), and one in the reverse order (ES, n=12). CT was performed three times a week during 12 weeks. Before and after training, peak oxygen uptake (VO2peak), maximal workload (Wmax), absolute and relative cycling economy at 25, 50, 75 and 100 W (i.e., average VO2 at different stages) were assessed.

RESULTS

Similar increases in VO2peak were observed in the SE and ES groups (SE: 8.1 ± 9.9%; ES: 9.3 ± 9.8%; P<0.001), as well as in Wmax (SE: 19.9 ± 19.3%; ES: 24.1 ± 24.0%; P<0.001). Moreover, significant reductions were observed in the absolute VO2 at 100 W (P<0.05) in the SE and ES groups. No difference between groups was observed. In the ES group, one subject did not respond positively in terms of both VO2max and Wmax, whereas 4 subjects did not respond positively in terms of both VO2max and Wmax in SE group.

CONCLUSIONS

CT improved maximal and submaximal endurance performance in elderly men, independent of intra-session exercise order. However, it seems that the ES order elicited more individual responsiveness in terms of maximal endurance performance than SE order.

Tongue strength and endurance: Comparison in active and non-active young and older adults

PURPOSE

Tongue strength and endurance are important for swallowing and upper airway patency. Physical activity positively affects targeted and non-targeted skeletal muscles; however, little is known about the indirect effect of physical activity on tongue muscles. This study sought to determine if tongue muscle performance differs between highly active and non-active individuals and if such an effect varies with age.

METHOD

Forty-eight healthy adults were divided into two age groups (24 young, 20.96 ± 3.22 years; 24 older, 65 ± 3.72 years) and further divided into highly active and non-active based on The General Practice Physical Activity Questionnaire. Tongue strength (TS) and tongue endurance (TE) were obtained using the Iowa Oral Performance Instrument.

RESULT

A significant main effect of activity level on TS and TE was found. Although the main effect of age on TS and TE and age × activity level interactions were not significant, the effect of activity level on TS and TE was more pronounced in older adults than younger adults.

CONCLUSION

Findings suggest physical activity may affect TS and TE, particularly in older adults. Future research is warranted to understand the underlying mechanisms contributing to these group differences. Clinical implications of these findings are discussed.

Original Research: Effect of sprint and strength training on glucoregulatory hormones: Effect of advanced age

The aim of this study was to examine the effect of high-intensity sprint and strength training (HISST) on glucoregulatory hormones in young (20 years) and middle-aged (40 years) men. Thirty-six moderately trained men participated as volunteers in this study. After medical examination, eligible subjects were randomly assigned to one of four groups according to their age: a young training group (21.3 ± 1.3 yrs, YT, n = 9), a young control group (21.4 ± 1.7 yrs, YC, n = 9), a middle-aged training group (40.7 ± 1.8 yrs, AT, n = 9), and a middle-aged control group (40.5 ± 1.8 yrs, AC, n = 9). YT and AT participated in HISST for 13 weeks. Before and after HISST, all participants performed the Wingate Anaerobic Test (WAnT). Blood samples were collected at rest, after warm-up (50% VO_2max), immediately post-WAnT, and 10 min post-WAnT. Before HISST, we observed significantly higher (P < 0.05) glucose concentrations in AT (5.86 ± 0.32 mmol.L^-1) compared to YT (4.24 ± 0.79 mmol.L^-1) at rest, and in response to WAnT (6.56 ± 0.63 mmol.L^-1 vs. 5.33 ± 0.81 mmol.L^-1). Cortisol levels were significantly higher (P < 0.05) in AT than in YT in response to WAnT (468 ± 99.50 ng.mL^-1 vs. 382 ± 64.34 ng.mL^-1). Catecholamine levels measured at rest and in response to WAnT rose in a similar fashion. After HISST, this "age effect" disappeared at rest and in response to exercise in the trained groups (YT and AT). Changes in hormone concentrations with intense training are due to adaptive changes in various tissues, especially in the skeletal muscle and liver in trained subjects. HISST may, at least in part, counteract the negative "age effect" on glucose metabolism.

Heterogeneity in resistance training-induced muscle strength and mass responses in men and women of different ages

Physical activity recommendations for public health include typically muscle-strengthening activities for a minimum of 2 days a week. The range of inter-individual variation in responses to resistance training (RT) aiming to improve health and well-being requires to be investigated. The purpose of this study was to quantify high and low responders for RT-induced changes in muscle size and strength and to examine possible effects of age and sex on these responses. Previously collected data of untrained healthy men and women (age 19 to 78 years, n = 287 with 72 controls) were pooled for the present study. Muscle size and strength changed during RT are 4.8 ± 6.1 % (range from -11 to 30 %) and 21.1 ± 11.5 % (range from -8 to 60 %) compared to pre-RT, respectively. Age and sex did not affect to the RT responses. Fourteen percent and 12 % of the subjects were defined as high responders (>1 standard deviation (SD) from the group mean) for the RT-induced changes in muscle size and strength, respectively. When taking into account the results of non-training controls (upper 95 % CI), 29 and 7 % of the subjects were defined as low responders for the RT-induced changes in muscle size and strength, respectively. The muscle size and strength responses varied extensively between the subjects regardless of subject's age and sex. Whether these changes are associated with, e.g., functional capacity and metabolic health improvements due to RT requires further studies.

Similar increases in strength after short-term resistance training due to different neuromuscular adaptations in young and older men

This study investigated whether differences in neuromuscular performance and muscle hypertrophy occur between young and older men. Twenty-three young (29 ± 9 years) and 26 older men (64 ± 8 years) completed 10 weeks of high-volume, medium load "hypertrophic" resistance training with low frequency (twice per week) with 10 young (34 ± 11 years) and 11 older men (65 ± 3 years) acting as nontraining control subjects. Training consisted of 2-5 sets of 8-14 repetitions (1- to 2-minute rest). Lower-limb dynamic (leg press) and isometric maximum leg extension force, as well as lower-limb lean mass and vastus lateralis cross-sectional area were assessed before and after the training period. Training led to significant increases in 1 repetition maximum (1RM) leg press performance in both training groups (young: 13 ± 7%, p < 0.001; older: 14 ± 9%, p < 0.001). Performance improvements were accompanied by increased muscle activation, assessed by voluntary activation level (29 ± 51%, p ≤ 0.05) and electromyography amplitude (35 ± 51%, p < 0.01) in older men only. Conversely, only young men showed significantly increased lower-limb lean mass (2.4 ± 2.5%, p < 0.01). Furthermore, increases in 1RM performance and lower-limb lean mass were significantly related in young men only (r = 0.524, p = 0.01, n = 23). In conclusion, although high-volume, medium load "hypertrophic" resistance training may induce similar improvements in strength between young and older men, it appears that different mechanisms underpin these improvements.

Effect of endurance and/or strength training on muscle fiber size, oxidative capacity, and capillarity in hemodialysis patients

We previously reported reduced limb muscle fiber succinate dehydrogenase (SDH) activity and capillarity density and increased cross-sectional areas (CSAs) of all fiber types in maintenance hemodialysis (MHD) patients compared with matched controls that may contribute to their effort intolerance and muscle weakness. This study evaluated whether endurance training (ET), strength training (ST), or their combination (EST) alters these metabolic and morphometric aberrations as a mechanism for functional improvement. Five groups were evaluated: 1) controls; 2) MHD/no training; 3) MHD/ET; 4) MHD/ST; and 5) MHD/EST. Training duration was 21.5 ± 0.7 wk. Vastus lateralis muscle biopsies were obtained after HD at baseline and at study end. Muscle fibers were classified immunohistochemically, and fiber CSAs were computed. Individual fiber SDH activity was determined by a microdensitometric assay. Capillaries were identified using antibodies against endothelial cells. Type I and IIA fiber CSAs decreased significantly (10%) with EST. In the ET group, SDH activity increased 16.3% in type IIA and 19.6% in type IIX fibers. Capillary density increased significantly by 28% in the EST group and 14.3% with ET. The number of capillaries surrounding individual fiber type increased significantly in EST and ET groups. Capillary-to-fiber ratio increased significantly by 11 and 9.6% in EST and ET groups, respectively. We conclude that increments in capillarity and possibly SDH activity in part underlie improvements in endurance of MHD patients posttraining. We speculate that improved specific force and/or neural adaptations to exercise underlie improvements in limb muscle strength of MHD patients.

Strength and endurance training prescription in healthy and frail elderly

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

Strength and endurance training prescription in healthy and frail elderly

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

Nutrition and protein energy homeostasis in elderly

Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly.

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

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

Are skeletal muscle FNDC5 gene expression and irisin release regulated by exercise and related to health?

Recently, contradictory findings have been reported concerning the function of irisin and its precursor gene, skeletal muscle FNDC5, in energy homeostasis, and the associated regulatory role of exercise and PGC-1α. We therefore evaluated whether muscle FNDC5 mRNA and serum irisin are exercise responsive and whether PGC-1α expression is associated with FNDC5 expression. The male subjects in the study performed single exercises: (1) 1 h low-intensity aerobic exercise (AE) (middle-aged, n = 17), (2) a heavy-intensity resistance exercise (RE) bout (young n = 10, older n = 11) (27 vs. 62 years), (3) long-term 21 weeks endurance exercise (EE) training alone (twice a week, middle-aged, n = 9), or (4) combined EE and RE training (both twice a week, middle-aged, n = 9). Skeletal muscle mRNA expression was analysed by quantitative PCR and serum irisin by ELISA. No significant changes were observed in skeletal muscle PGC-1α, FNDC5 and serum irisin after AE, EE training or combined EE + RE training. However, a single RE bout increased PGC-1α by 4-fold in young and by 2-fold in older men, while FNDC5 mRNA only increased in young men post-RE, by 1.4-fold. Changes in PGC-1α or serum irisin were not consistently accompanied by changes in FNDC5. In conclusion, for the most part, neither longer-term nor single exercise markedly increases skeletal muscle FNDC5 expression or serum irisin. Therefore their changes in response to exercise are probably random and not consistent excluding the confirmation of any definitive link between exercise and FNDC5 expression and irisin release in humans. Moreover, irisin and FNDC5 were not associated with glucose tolerance and being overweight, or with metabolic disturbances, respectively. Finally, factor(s) other than PGC-1α and transcription may regulate FNDC5 expression.

Efficiency of twice weekly concurrent training in trained elderly men

This study compared the effects of different weekly training frequencies on the cardiovascular and neuromuscular adaptations induced by concurrent training in previously trained elderly. After 20weeks of combined strength and endurance training, twenty-four healthy elderly men (65±4 years) were randomly placed into two frequency training groups: strength and endurance training performed twice a week (SE2, n=12); or, strength and endurance training performed three times per week (SE3, n=12). The interventions lasted 10 weeks and each group performed identical exercise intensity and volume per session. Before and after the exercise training, one maximum repetition test (1RM), isometric peak torque (PT), maximal surface electromyographic activity (EMG), as well as muscle thickness (MT) were examined. Additionally, peak oxygen uptake (VO(2peak)), maximum aerobic workload (W(max)), first and second ventilatory thresholds (VT1 and VT2) were evaluated. There were significant increases in upper and lower-body 1RM, MT, VO(2peak), VT1 and VT2, with no differences between groups. There were no changes after training in maximal EMG and isometric peak torque. W(max) was improved only in SE3. After 10 weeks of training, twice weekly combined strength and endurance training leads to similar neuromuscular and cardiovascular adaptations as three times per week, demonstrating the efficiency of lower frequency of concurrent training in previously trained elderly men.