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Balachandran AT, Evans W, Cawthon P, Wang Y, Shankaran M, Hellerstein M, Qiu P, Manini T. Comparing D3-Creatine Dilution and Dual-Energy X-ray Absorptiometry Muscle Mass Responses to Strength Training in Low-Functioning Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:1591-1596. [PMID: 36752568 PMCID: PMC10848235 DOI: 10.1093/gerona/glad047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND In contrast to dual-energy x-ray absorptiometry (DXA), the D3-creatine (D3Cr) dilution method provides a direct measure of skeletal muscle mass and in a cohort of older men has been strongly associated with health-related outcomes. However, sensitivity to detect changes in D3Cr-derived muscle mass due to an intervention is limited. METHODS Twenty-one older adults (≥70 years) with low-to-moderate physical function were randomized to a 15-week high-intensity strength training (ST) or a health education (HE) group. Full-body progressive intensity ST was performed 3 days per week. RESULTS The mean age was 82.1 years, with 64% females. After 15 weeks, both D3Cr muscle mass (MM; 2.29 kg; 95% CI: 0.22, 4.36) and DXA appendicular lean mass (ALM; 1.04 kg; 95% CI: 0.31, 1.77) were greater in ST group compared to HE. Baseline correlations between D3Cr MM and DXA ALM (r = 0.79; 95% CI: 0.53, 0.92) or total lean body mass (LBM; r = 0.79; 95% CI: 0.52, 0.91) were high. However, longitudinal changes in D3Cr MM were weakly correlated with changes in DXA ALM (r = 0.19; 95% CI: -0.35, 0.64) and LBM (r = 0.40; 95% CI: -0.13, 0.76). More participants showed positive response rates, defined as a >5% increase from baseline, with D3Cr MM (80%) than DXA measures (14%-43%). CONCLUSIONS A progressive ST intervention in low-functioning older adults increased D3Cr MM and DXA ALM. These data suggest that the D3Cr dilution is potentially sensitive to detect changes in muscle mass in response to resistance exercise training. These results are preliminary and could be used for planning larger trials to replicate these results.
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Affiliation(s)
- Anoop T Balachandran
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, New York, USA
| | - William J Evans
- Department of Nutrition Sciences and Toxicology, University of California, Berkeley, California, USA
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Yipeng Wang
- Department of Biostatistics, University of Florida, Gainesville, Florida,USA
| | - Mahalakshmi Shankaran
- Department of Nutrition Sciences and Toxicology, University of California, Berkeley, California, USA
| | - Marc K Hellerstein
- Department of Nutrition Sciences and Toxicology, University of California, Berkeley, California, USA
| | - Peihua Qiu
- Department of Biostatistics, University of Florida, Gainesville, Florida,USA
| | - Todd Manini
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida, USA
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T Balachandran A, Wang Y, Szabo F, Watts-Battey C, Schoenfeld BJ, Zenko Z, Quiles N. Comparison of traditional vs. lighter load strength training on fat-free mass, strength, power and affective responses in middle and older-aged adults: A pilot randomized trial. Exp Gerontol 2023; 178:112219. [PMID: 37236327 DOI: 10.1016/j.exger.2023.112219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Strength training is widely recommended to improve strength, muscle mass and power. However, the feasibility and potential efficacy of strength training using lighter loads near failure on these outcomes in middle and older-aged adults remains unclear. METHODS 23 community-living adults were randomized into two groups: Traditional strength training (ST) (8-12 repetitions) or a lighter load, higher repetitions (LLHR) (20-24 repetitions) group. Participants performed a full-body workout (twice a week) with 8 exercises at a perceived exertion of 7-8 (0-10 scale) for 10 weeks. Post-testing was performed by an assessor blinded to group assignments. An analysis of covariance (ANCOVA) was used to examine between group differences using baseline values as a covariate. RESULTS The study involved individuals with a mean age of 59 years, of which 61 % were women. The LLHR group demonstrated a high attendance rate of 92 % (9.5 %) and reported leg press exercise RPE of 7.1 (0.53), along with a session feeling scale of 2.0 (1.7). There was a trivial difference in fat free mass (FFM) favoring LLHR vs ST [0.27 kg 95 % CI (-0.87, 1.42)]. The ST group exhibited superior increases in leg press 1 repetition maximum (1RM) strength [-14 kg (-23, -5)], while the LLHR group showed greater strength endurance increases (65 % 1RM) [8 repetitions (2, 14)]. Leg press power [41 W (-42, 124)] and exercise efficacy [-3.8 (-21.2, 13.5)] demonstrated trivial between-group differences. CONCLUSION A pragmatic, full-body strength training program with lighter loads taken close to failure appears to be a viable option for promoting muscular adaptations in middle- and older-aged adults. These results are exploratory and require a larger trial for confirmation.
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Affiliation(s)
- Anoop T Balachandran
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA.
| | - Yipeng Wang
- Department of Biostatistics, University of Florida, Gainesville, USA
| | - Frank Szabo
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA
| | - Catharyn Watts-Battey
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA
| | - Brad J Schoenfeld
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY, USA
| | - Zachary Zenko
- California State University Bakersfield, Department of Kinesiology, Bakersfield, CA, USA
| | - Norberto Quiles
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA
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Balachandran AT, Steele J, Angielczyk D, Belio M, Quiles N, Schoenfeld B. Power Training Vs. Traditional Strength Training On Physical Function In Older Adults: A Systematic Review And Meta-analysis. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876212.47001.7e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Balachandran AT, Steele J, Angielczyk D, Belio M, Schoenfeld BJ, Quiles N, Askin N, Abou-Setta AM. Comparison of Power Training vs Traditional Strength Training on Physical Function in Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2211623. [PMID: 35544136 PMCID: PMC9096601 DOI: 10.1001/jamanetworkopen.2022.11623] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
IMPORTANCE Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under control) and power training (PT) (lifting weights fast and lowering under control) are associated with improved physical function in older adults is not clear. OBJECTIVE To evaluate whether PT vs traditional strength training is associated with physical function improvement in older adults. DATA SOURCES Systematic searches of MEDLINE, Embase, Cochrane Central, CINAHL, PsycInfo, PEDro, and SPORTDiscus were conducted from database inception to October 20, 2021. STUDY SELECTION Randomized clinical trials (RCTs) that compared strength training with instructions to move the weight as fast as possible in the lifting phase with traditional strength training in healthy, community-living older adults (age ≥60 years). DATA EXTRACTION AND SYNTHESIS Two authors independently selected trials, extracted data, assessed the risk of bias using the Cochrane risk-of-bias tool 2, and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Summary effect size measures were calculated using a multilevel random-effects model with cluster robust variance estimation and are reported as standardized mean differences (SMDs). Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. MAIN OUTCOMES AND MEASURES Primary outcomes included physical function and self-reported physical function. Secondary outcomes included power, strength, muscle mass, walk speed, balance, and adverse effects. RESULTS A total of 20 RCTs enrolling 566 community-living older adults (mean [SD] age, 70.1 [4.8] years; 368 [65%] women) were included. For the primary outcomes, PT was associated with an improvement in physical function with low-certainty evidence in 13 RCTs (n = 383) (SMD, 0.30; 95% CI, 0.05-0.54) and self-reported function with low-certainty evidence in 3 RCTs (n = 85) (SMD, 0.38; 95% CI, -0.62 to 1.37). The evidence was downgraded by 2 levels for high risk of bias and imprecision for physical function and very serious imprecision for self-reported physical function. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, PT was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
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Affiliation(s)
- Anoop T. Balachandran
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, New York
| | - James Steele
- School of Sport, Health, and Social Sciences, Solent University, Southampton, United Kingdom
| | - Daniel Angielczyk
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, New York
| | - Mark Belio
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, New York
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brad J. Schoenfeld
- Health Sciences Department, The City University of New York Lehman College, Bronx, New York
| | - Norberto Quiles
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, New York
| | - Nicole Askin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M. Abou-Setta
- George and Fay Yee Center for Healthcare Innovation, Winnipeg Regional Health Authority, University of Manitoba, Winnipeg, Manitoba, Canada
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Rosa A, Vazquez G, Grgic J, Balachandran AT, Orazem J, Schoenfeld BJ. Hypertrophic Effects of Single- Versus Multi-Joint Exercise of the Limb Muscles: A Systematic Review and Meta-analysis. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Quiles N, Balachandran AT, Ortiz A. Longitudinal association between cardiometabolic comorbidities and physical activity in middle aged and older adults living with HIV. Exp Gerontol 2022; 163:111797. [DOI: 10.1016/j.exger.2022.111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/10/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
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Miguel LAS, Balachandran AT. Physical Activity-based Interventions For Obsessive-Compulsive Disorder: A Systematic Review. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762676.09244.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Balachandran AT, Vigotsky AD, Quiles N, Angielczyk D, Belio M. Power Vs. Strength: Sit-to-stand Power Shows Greater Associations Than Grip Strength With Performance Outcomes In Older Adults. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000759180.46635.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Balachandran AT, Vigotsky AD, Quiles N, Mokkink LB, Belio MA, Glenn JM. Validity, reliability, and measurement error of a sit-to-stand power test in older adults: A pre-registered study. Exp Gerontol 2020; 145:111202. [PMID: 33347922 DOI: 10.1016/j.exger.2020.111202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lower body power declines with age and is associated with decreased physical function in older adults. However, the majority of the tools available to measure power are expensive and require considerable space and expertise to operate. The purpose of this study was to assess the validity, reliability, and measurement error of a sit-to-stand power test (STSp) to assess lower body power. METHODS 51 community-dwelling adults, 65 years or older, completed a power test using a pneumatic leg press (LP), the Short Physical Performance Battery (SPPB) that includes a test of balance, usual walking speed, and chair stand tests; Timed Up and Go (TUG) test at both usual and fast paces, and Patient-Reported Outcome Measures (PROMs). A two-week test-retest assessed the reliability in 36 participants. The study hypotheses and analysis were pre-registered prior to data collection and statistical analyses were blinded. RESULTS The mean age was 71.3 years, with 63% females, and an average SPPB score of 10.6 (median = 12). STSp peak power was strongly correlated with LP (r = 0.90, 95% CI (0.82, 0.94). As hypothesized, the STSp peak power showed similar or higher correlations with physical function tests relative to LP peak power: SPPB (0.41 vs. 0.29), chair stand test (-0.44 vs. -0.35), TUG test at usual pace (-0.37 vs. -0.29) and fast pace (-0.41 vs. -0.34) and balance (0.33 vs. 0.22), but not for mobility (0.34 vs. 0.38) and function (0.41 vs. 0.48) questionnaire. For discriminant validity, as hypothesized, males showed higher STSp peak power compared to females (Δ = 492 W, p < .001, Cohen's d = 2.0). Test-retest assessment yielded an intraclass correlation coefficient of 0.96 and a standard error of measurement of 70.4 W. No adverse events were reported or observed for both tests. CONCLUSION The STSp showed adequate validity and reliability in measuring lower body power in community-dwelling older adults. The test is quick, relatively inexpensive, safe, and portable and thus should be considered for use in aging research.
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Affiliation(s)
- Anoop T Balachandran
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America.
| | - Andrew D Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, IL, United States of America
| | - Norberto Quiles
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America
| | - Lidwine B Mokkink
- Amsterdam University Medical Centers, location VUmc, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Mark A Belio
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America
| | - Jordan McKenzie Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, United States of America; Neurotrack Technologies, 399 Bradford St., Redwood City, CA, United States of America
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Balachandran AT, Belio M, Angielczyk D, Quiles N. Validity And Reliability Of A Lower Body Power Test In Older Adults. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686656.54956.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Handing EP, Chen H, Rejeski WJ, Rosso AL, Balachandran AT, King AC, Kritchevsky SB. Cognitive Function as a Predictor of Major Mobility Disability in Older Adults: Results From the LIFE Study. Innov Aging 2019; 3:igz010. [PMID: 31065597 PMCID: PMC6499408 DOI: 10.1093/geroni/igz010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Indexed: 12/22/2022] Open
Abstract
Background and Objectives Many cross-sectional studies have confirmed a link between gait speed and cognitive function. However, it is unknown whether cognitive function plays a role in the onset of major mobility disability (MMD) and if the effects are independent of physical function. This study examined cognitive and physical function as predictors of MMD across an average of 2.6 years of follow-up in community-dwelling older adults with compromised mobility. Research Design and Method Data were collected from 1,635 participants in the Lifestyle Interventions and Independence for Elders (LIFE) study ages 70–89 years free of MMD at baseline. MMD was assessed every 6 months and defined as the inability to walk 400 m in ≤15 min without assistance or sitting. Cognitive function was assessed at baseline, 18 months, and 24 months using a cognitive battery categorized into four domains: global cognitive function, processing speed, verbal memory, and executive function. Results Across the study duration of 2.6 years, 536 participants (32.8%) developed MMD. Cox Proportional Hazard models indicated a protective relationship for higher baseline processing speed (Hazard Ratio [HR] per standard deviation: 0.86, p = .006), executive function (HR: 0.86, p = .002), and global cognition (HR: 0.85, p = .001) on incidence of MMD adjusted for demographics, intervention, and comorbidities. Results were not significant after adjustment for gait speed. In adjusted longitudinal models, a positive change in processing speed was significantly associated with reduced risk of MMD (HR: 0.52, p < .001) while other domains were not. Discussion and Implications In the LIFE study, processing speed at baseline and follow-up was a significant predictor of subsequent MMD although the observed association may be explained by physical function as reflected in gait speed. More studies are needed to understand how cognitive function, alone and in combination with physical function, influences risk of MMD.
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Affiliation(s)
- Elizabeth P Handing
- Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention
| | - Haiying Chen
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston - Salem, North Carolina
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest School of Medicine, Winston - Salem, North Carolina
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Anoop T Balachandran
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville.,Department of Family, Nutrition, and Exercise Science, Queens College of the City University of New York, Flushing
| | - Abby C King
- Division of Epidemiology, Department of Health Research and Policy, and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, California
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention
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Balachandran AT, Gandia K, Jacobs KA, Streiner DL, Eltoukhy M, Signorile JF. Power training using pneumatic machines vs. plate-loaded machines to improve muscle power in older adults. Exp Gerontol 2017; 98:134-142. [DOI: 10.1016/j.exger.2017.08.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/21/2017] [Accepted: 08/06/2017] [Indexed: 11/28/2022]
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Rendos NK, Harriell K, Dowen KL, Balachandran AT, Jun HP, Signorile JF. Comparison of Laboratory and Field Balance Tests in Healthy Adults. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000495558.10424.d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Balachandran AT, Krawczyk SK, Potiaumpai M, Siegel J, Gandia K, Adeyemo AO, De Faveri FG, Dalal S, Pacheco M, Signorile JF. A Novel Progression Method for Power Training Based on Power Plateaus. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000493354.75770.2a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Potiaumpai M, Balachandran AT, Krawczyk SN, Gandia K, Signorile JF. Optimal Loads for Power vary by Pneumatic Exercise Movement. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000496193.61530.d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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