ArticleLiterature Review

Reversing sarcopenia: How weight training can build strength and vitality

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Abstract

Sarcopenia, the loss of skeletal muscle mass with advancing age, results in lower basal metabolic rate, weakness, reduced activity levels, decreased bone density, and low calorie needs. The related increase in body fatness is linked to hypertension and abnormal glucose tolerance. Many consequences of sarcopenia are preventable or even reversible. Progressive resistance exercises can produce substantial increases in strength and muscle size, even in the oldest old. For many older patients, exercise represents the safest, least expensive means to lose body fat, decrease blood pressure, improving glucose tolerance, and maintain long-term independence.

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... La vejez está asociada con un aumento en la incidencia de diversas enfermedades crónicas, como coronariopatias, Diabetes mellitus tipo 2, osteoporo-sis, hipertensión 3 , y la sarcopenia puede contribuir a incrementar el riesgo de las mismas 7 . La sarcopenia está estrechamente relacionada con el aumento en el contenido de grasa corporal 1 , el cual se asocia con la hipertensión arterial 8 y con una tolerancia anormal a la glucosa 4,8 . La disminución del músculo-esquelético también puede contribuir a cambios en la sensibilidad a la insulina 2 y a la disminución de la densidad ósea 2,8 . ...
... La sarcopenia está estrechamente relacionada con el aumento en el contenido de grasa corporal 1 , el cual se asocia con la hipertensión arterial 8 y con una tolerancia anormal a la glucosa 4,8 . La disminución del músculo-esquelético también puede contribuir a cambios en la sensibilidad a la insulina 2 y a la disminución de la densidad ósea 2,8 . La pérdida de músculo también daña las funciones vitales, como por ejemplo la respiración 9 . ...
... El gasto energético diario disminuye progresivamente a lo largo de la vida del adulto. En las personas sedentarias el principal determinante del gasto energético es la masa magra, la cual disminuye aproximadamente un 15% entre la tercera y octava década de la vida 2,4,10 , contribuyendo a una menor velocidad del metabolismo basal 2,4,8,10 . Por lo tanto, la sarcopenia puede contribuir en la disminución de los requerimientos energéticos en los ancianos 4,8 . ...
Article
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El envejecimiento se relaciona con cambios en la compo- sición corporal, y uno de estos cambios es la sarcopenia, definida como la pérdida de masa muscular relacionada con la edad. La etiología de este proceso actualmente aún no es bien conocida, pero se puede considerar como un síndrome multifactorial. Las repercusiones clínicas y funcionales que conlleva afectan negativamente a la ca- lidad de vida de la población anciana. Ante esta situa- ción, el principal foco de investigación hoy en día es identificar cuales son las modalidades de actividad físi- ca y nutrición apropiadas para obtener efectos positivos en la fisiología muscular de los ancianos. Con esta fina- lidad se han realizado diversos estudios de intervención combinando dieta y ejercicio. La información obtenida a partir de la revisión bibliográfica nos permite sugerir la siguiente hipótesis: la suplementación energética, el ejer- cicio físico resistencia o la combinación de ambas inter- venciones son herramientas de interés en la prevención de la sarcopenia. Futuros estudios nos proporcionarán la respuesta.
... Thus, we stress that despite declines in muscle mass with aging, even senescent muscle can respond to resistance exercise and nutrition, likely in a manner much closer to, rather than different from, younger muscle. In general, humans entering the fifth decade of life begin to experience declines in overall muscle mass, albeit at a slow rate (for review, see [19,20]). This so-called sarcopenia of aging is associated with increased risk for falls [21], an associated morbidity due to hip fractures and complications arising from this, and reduced mobility [21,22]. ...
... Regardless of the mechanism, what is known is that aged muscle responds similarly to acute exercise and feeding in a qualitative, if not quantitative, fashion as young muscle [29,3839404142. Numerous studies have shown that elderly subjects retain the capacity to increase their muscle mass in response to resistance exercise (for reviews, see [19,43]). Thus, as a target of intervention in elderly persons, resistance exercise to increase muscle mass and strength has been widely studied [16,17,19,44,45]. ...
... Numerous studies have shown that elderly subjects retain the capacity to increase their muscle mass in response to resistance exercise (for reviews, see [19,43]). Thus, as a target of intervention in elderly persons, resistance exercise to increase muscle mass and strength has been widely studied [16,17,19,44,45]. Of relevance to this review, it appears that protein requirements for elderly persons may be elevated [46,47]; as such, many recent studies have focused on which proteins or amino acid mixtures might be able to support an enhanced rate of MPS, which, in our opinion, is the main variable affecting muscle protein balance in healthy elderly persons free of chronic disease [35,48495051 . ...
Article
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The balance between muscle protein synthesis (MPS) and muscle protein breakdown (MPB) is dependent on protein consumption and the accompanying hyperaminoacidemia, which stimulates a marked rise in MPS and mild suppression of MPB. In the fasting state, however, MPS declines sharply and MPB is increased slightly. Ultimately, the balance between MPS and MPB determines the net rate of muscle growth. Accretion of new muscle mass beyond that of normal growth can occur following periods of intense resistance exercise. Such muscle accretion is an often sought-after goal of athletes. There needs to be, however, an increased appreciation of the role that preservation of muscle can play in offsetting morbidities associated with the sarcopenia of aging, such as type 2 diabetes and declines in metabolic rate that can lead to fat mass accumulation followed by the onset or progression of obesity. Emerging evidence shows that consumption of different types of proteins can have different stimulatory effects on the amplitude and possibly duration that MPS is elevated after feeding; this may be particularly significant after resistance exercise. This effect may be due to differences in the fundamental amino acid composition of the protein (i.e., its amino acid score) and its rate of digestion. Milk proteins, specifically casein and whey, are the highest quality proteins and are quite different in terms of their rates of digestion and absorption. New data suggest that whey protein is better able to support MPS than is soy protein, a finding that may explain the greater ability of whey protein to support greater net muscle mass gains with resistance exercise. This review focuses on evidence showing the differences in responses of MPS, and ultimately muscle protein accretion, to consumption of milk- and soy-based supplemental protein sources in humans.
... Incorporation of resistance training into a fitness regimen has been widely recommended for maintaining or improving overall health, as well as athletic performance [1]. Resistance training has been shown to decrease blood pressure, improve glucose tolerance and insulin sensitivity, and reduce osteoporosis, among a myriad of other potential benefits [2][3][4][5]. Reductions in total body fat, local adipose tissue, and increased basal metabolic rate have also been noted previously in those performing resistance training [6] Relative to athletic performance, a specific resistance training program can increase muscular strength, power, speed, muscle size, endurance, balance, and coordination [7]. The health benefits of resistance training are widely noted, and improvements in athletic characteristics, like muscular strength, are often seen as a result of resistance training [8]. ...
... The American College of Sports Medicine recommends using periodized over non-periodized training in healthy adults [14]. Periodization, at its core, has three fundamental goals: (1) to provide an outline for maintaining a certain level of physical fitness pertinent to success in sport, (2) to reduce the potential for overtraining, and (3) to reach maximum physical fitness at the most appropriate time, i.e., competition [15,16]. The concept can be divided into two overarching categories: linear, or "traditional," and nonlinear. ...
... An emerging concept in training athletes is repurposing the concept of prehabilitation. Once limited to a pre-surgical exercise prescription designed to encourage quicker and more successful outcomes post-surgery [24], prehabilitation has been applied to training programs for injury prevention purposes in healthy athletes [2,25,102]. Strictly speaking, prehabilitation programs are designed to optimize function and pain measures before injury and should be used as an adjunct to a broader strength and conditioning program [24,25]. ...
Chapter
The optimization of performance is a defining goal with regard to the long-term development of any athlete. The process of performance optimization in football players is constantly evolving as our knowledge and understanding of the factors which act to influence player performance increase. Consistent with this evolution in our understanding and continual drive toward ever-increasing player performance is the development and emergence of new concepts, ideas, and technologies to help toward this goal. This chapter presents some of these emerging concepts and issues related to the optimization player performance. An overview of new approaches to the processes involved strength and conditioning training, strategies for enhancing nutritional intake and timing to maximize recovery, and an introduction to new and developing technologies which can be utilized to inform training practices, monitor player training intensity, and optimize sleep-wake schedules to promote increased levels of recovery. In addition, the complexities of integrating and managing all the information associated with the adoption of emerging strategies and technologies are discussed in an effort to further optimize player performance.
... Cuanto a la evaluación de la fuerza máxima, la presente investigación corroboró con otras que también utilizaron el test de 1RM (ADAMS et al., 2001; Devito et al., 2003; EVANS, 1996 EVANS, , 1999 KRAEMER et al., 1997; TRAPPE et al., 2002;). Estudios muestran que incrementos de fuerza con programas de alta intensidad pueden proporcionar una mejora de hasta 227% de 1RM (EVANS, 1996EVANS, , 1999 RASO et al., 1997). ...
... Cuanto a la evaluación de la fuerza máxima, la presente investigación corroboró con otras que también utilizaron el test de 1RM (ADAMS et al., 2001; Devito et al., 2003; EVANS, 1996 EVANS, , 1999 KRAEMER et al., 1997; TRAPPE et al., 2002;). Estudios muestran que incrementos de fuerza con programas de alta intensidad pueden proporcionar una mejora de hasta 227% de 1RM (EVANS, 1996EVANS, , 1999 RASO et al., 1997). Cuanto a la mensuración de los niveles básales de IGF-1, se observó que las mayores del presente estudio presentaron valores hormonales dentro de los patrones de normalidad, de acuerdo con sus franjas etarias; lo que corrobora con otros trabajos (MONTEIRO et al., 2003la; 2003b;). ...
... From a public health perspective, there is strong evidence to suggest that sarcopenia and weakness are treatable conditions and that aging persons with early sarcopenia are probably the most likely to benefit from strategic exercise treatment interventions (22,30,34,39,77). Health care delivery must ultimately contend with exaggerated costs because of continual increases in average life expectancy and a subsequent increased number of people aged 65 or older. ...
Article
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MUSCULAR ATROPHY AND WEAKNESS ARE BELIEVED TO PLAY A PRINCIPAL ROLE IN THE PATHOGENESIS OF AGE-RELATED FUNCTIONAL IMPAIRMENT AND ARE CONTRIBUTING RISK FACTORS FOR NUMEROUS DISEASE PROCESSES. THERE IS STRONG EVIDENCE TO SUGGEST THAT THESE DECLINES ARE REVERSIBLE AND THAT AGING PERSONS WITH EARLY-ONSET SARCOPENIA ARE PROBABLY THE MOST LIKELY TO BENEFIT FROM STRATEGIC RESISTANCE EXERCISE INTERVENTIONS. RESISTANCE EXERCISE IS AN EFFICIENT MODE OF EXERCISE FOR AGING ADULTS AND MAY ELICIT SIGNIFICANT INCREASES IN LEAN MUSCLE MASS AND MUSCULAR FITNESS. IMPROVEMENTS IN THESE PARAMETERS ARE IMPORTANT FOR THE PRESERVATION OF FUNCTIONAL INDEPENDENCE, HEALTH, AND OVERALL WELL- BEING OF THIS POPULATION.
... The positive effects of resistance training on health and human performance have been well documented and include, reduced percentage of body fat and total body fat, increased insulin sensitivity and blood glucose tolerance in the elderly, rehabilitation of orthopedic injuries, a reduction of systolic blood pressure, increased bone mineral density, and a moderate increase in basal metabolic rate (BMR) [32,33,[35][36][37][38][39]. Yet due to the relatively small amount of energy utilized, even during the most strenuous resistance workouts, this type of training has not been recommended as an effective method for controlling weight [8]. ...
Article
Although there are limited data to support significant increases in resting metabolic rate (RMR) following resistance training, recent investigations have shown excess post-exercise oxygen consumption (EPOC) to be significantly elevated above baseline for up to 72 hours in untrained and trained men. PURPOSE: To compare the effects of two acute bouts of resistance exercise of differing loads on EPOC. METHODS: Eight experienced resistance trained males (22 ± 3 yrs.) were recruited to participate in this investigation. Subjects participated in two randomized acute resistance training bouts separated by at least one week with a total volume of weight lifted of 10,000 kg and 20,000 kg. A high intensity lifting protocol was used with subjects lifting approximately 85% of their repetition maximum for each of the following 4 lifts; bench press, barbell squat, barbell row and Romanian deadlift. Exercise energy expenditure and resting metabolic rate (RMR) were measured by indirect calorimetry during both exercise bouts and for 30 minutes approximately 8.5 and 1.5 hours prior to each acute bout of exercise (baseline measurements) and again approximately 12, 24, 36, and 48 hours following exercise. Creatine kinase and ratings of perceived muscle soreness were measured with all post exercise metabolic measurements and immediately prior to and post exercise. Repeated measures analysis of variance was used to analyze dependent measures. Significance was accepted at p
... In the present study, RT significantly increased serum follistatin concentrations and significantly decreased serum myostatin and GDF11 concentrations and MFR in the RT group. Numerous studies have indicated that elderly individuals maintain the capacity to increase muscle mass and strength using RT (Evans, 1996;2002;Phillips et al., 2009). The response of skeletal muscle regulatory markers to RT is controversial. ...
Article
Purpose: We aimed to determine the effects of 12 weeks of soy milk consumption combined with resistance training (RT) on body composition, physical performance, and skeletal muscle regulatory markers in older men. Methods: In this randomized clinical trial study, 60 healthy elderly men (age = 65.63 ± 3.16 years) were randomly assigned to four groups: resistance training (RT; n = 15), soy milk consumption (SMC; n = 15), resistance training + soy milk (RSM; n = 15), and control (CON; n = 15) groups. The study was double-blind for the soy milk/placebo. Participants in RT and RSM groups performed resistance training (3 times/week) for 12 weeks. Participants in the SMC and RSM groups consumed 240 mL of soy milk daily. Body composition [body mass (BM), body fat percent (BFP), waist-hip ratio (WHR), and fat mass (FM)], physical performance [upper body strength (UBS), lower body strength (LBS), VO2max, upper anaerobic power, lower anaerobic power, and handgrip strength], and serum markers [follistatin, myostatin, myostatin-follistatin ratio (MFR), and growth and differentiation factor 11 (GDF11)] were evaluated before and after interventions. Results: All 3 interventions significantly (p < 0.05) increased serum follistatin concentrations (RT = 1.7%, SMC = 2.9%, RSM = 7.8%) and decreased serum myostatin (RT = −1.3% SMC = −5.4%, RSM = −0.5%) and GDF11 concentrations (RT = −1.4%, SMC = −1.4%, RSM = -9.0%), and MFR (RT = −2.6%, SMC = −3.2%, RSM = −12%). In addition, we observed significant reduction in all 3 intervention groups in BFP (RT = −3.6%, SMC = −1.4%, RSM = −6.0%), WHR (RT = −2.2%, SMC = −2.1%, RSM = −4.3%), and FM (RT = −9.6%, SMC = −3.8%, RSM = −11.0%). Moreover, results found significant increase only in RT and RSM groups for muscle mass (RT = 3.8% and RSM = 11.8%), UBS (RT = 10.9% and RSM = 21.8%), LBS (RT = 4.3% and RSM = 7.8%), upper anaerobic power (RT = 7.8% and RSM = 10.3%), and lower anaerobic power (RT = 4.6% and RSM = 8.9%). Handgrip strength were significantly increased in all 3 intervention groups (RT = 7.0%, SMC = 6.9%, RSM = 43.0%). VO 2max significantly increased only in RSM (1.7%) after 12 weeks of intervention. Additionally, significant differences were observed between the changes for all variables in the RSM group compared to RT, SMC, and CON groups (p < 0.05). Conclusions: There were synergistic effects of soy milk and RT for skeletal muscle regulatory markers, body composition, and physical performance. Results of the present study support the importance of soy milk in conjunction with RT for older men.
... Ese incremento en la fuerza máxima también fue encontrado en los estudios de Porter et al. (2002). Otras investigaciones muestran que incrementos de fuerza con programas de alta intensidad pueden llegar a mejoras de hasta 227% de 1RM (EVANS, 1996EVANS, , 1999 RASO et al., 1997). GERALDES, 2000; KRAEMER et al., 1997; PORTER et al., 2002; SCHOT et al., 2003; STADLER et al., 1996; VALE, 2004). ...
... introdução Ao longo dos últimos anos, o treinamento resistido (TR) tem sido recomendado como importante componente em programas de exercícios físicos para indivíduos idosos 1 . Dentre os benefícios decorrentes do TR, os aumentos da força e massa musculares estão bem evidenciados na literatura [2][3][4][5] . Adicionalmente, há evidências de que indivíduos que realizam 30 minutos ou mais de TR por sessão possam apresentar um risco reduzido em 23% para infarto agudo do miocárdio (IAM) e doenças cardiovasculares fatais, quando comparados aos que não realizam esse tipo de exercício 6 . ...
Article
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FUNDAMENTO: Em razão das controvérsias existentes na literatura quanto aos possíveis benefícios do treinamento resistido (TR) sobre a pressão arterial de repouso (PA) e por causa da escassez de estudos com indivíduos idosos e hipertensos, o TR é pouco recomendado como forma de tratamento não-farmacológico da hipertensão arterial. OBJETIVO: Verificar os efeitos do TR progressivo sobre a pressão arterial de repouso (PA), a freqüência cardíaca (FC) e o duplo produto (DP) em idosas hipertensas controladas. MÉTODOS: Vinte mulheres idosas (66,8 ± 5,6 anos de idade) sedentárias, controladas com medicação anti-hipertensiva, realizaram 12 semanas de TR, compondo o grupo do treinamento resistido (GTR). Vinte e seis idosas (65,3 ± 3,4 anos de idade) hipertensas controladas não realizaram exercícios físicos durante a pesquisa, constituindo o grupo-controle. RESULTADOS: Houve redução significativa nos valores de repouso da pressão arterial sistólica (PAS), da pressão arterial média (PAM) e do DP após o TR. Não foram encontradas reduções significativas na pressão arterial diastólica (PAD) e na FC de repouso após o TR em ambos os grupos. A magnitude da queda no GTR foi de 10,5 mmHg, 6,2 mmHg e 2.218,6 mmHg x bpm para a PAS, PAM e o DP, respectivamente. CONCLUSÃO: O TR progressivo reduziu a PAS, PAM e o DP de repouso de idosas hipertensas, controladas com medicação anti-hipertensiva.
... Her aerobic power was measured on a treadmill using the modified Naughton protocol and a Parvo-Medics Metabolic system (Sandy, UT). Ventricular function was measured with echocardiography performed during a standard lifting test as recommended by Evans (1). The lifting test consisted of a warm-up set performed at 50% of pre-determined 1-repetition maximum (1RM) followed by three sets of exercise performed at 70% of 1RM. ...
... Like-wise, individuals with chronic obstructive pulmonary disease suffer skeletal muscle weakness and reduced exercise tolerance leading to limited functional mobility (Bernard et al., 1998). Exercise and physical activity can reverse or attenuate the loss of muscle function due to sarcopenia, cachexia, and ICU-acquired weakness in clinical populations and during aging (Evans, 1996;Gould et al., 2013;Jones et al., 2015;Knols et al., 2005;Wischmeyer & San-Millan, 2015). It is critically important to determine the exercise modality that induces the maximum benefit at the lowest frequency and intensity, since many clinical populations and the elderly have limited capacity for physical activity. ...
Article
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Muscle power training with emphasis on high‐velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail or have an ongoing acute or chronic disease, condition or illness; (3) study participants over the age of 18; (4) publication in English language; (5) included physical function as the primary or secondary outcome measures. Two independent reviewers assessed articles for inclusion and graded the methodological quality using Cochrane Risk‐of‐Bias tool for RCTs. Fourteen RCTs met the inclusion criteria. In seven studies, muscle power training was more effective at improving physical function compared to control activities with a mean fixed effect size (ES) of 0.41 (p = 0.006; 95% CI 0.12 to 0.71). Power training and conventional resistance training had similar effectiveness in eight studies with a mean fixed ES of 0.10 (p = 0.061; 95% CI –0.01 to 0.40). Muscle power training is just as efficacious for improving physical function in individuals diagnosed with frailty and chronic disease when compared to traditional resistance training. The advantages of power training with reduced work per session may support power training as a preferential exercise modality for clinical populations. The findings should be interpreted with caution since generalizability is questioned due to the heterogeneity of patient populations enrolled and participants were relatively mobile at baseline. This systematic review assesses the efficacy of different training methods on chronically ill adults. The goal of this review was to determine if power training was more effective than traditional resistance training in chronically ill populations.
... 23,26,27 Exercise programs that involve lower extremity muscle strengthening in the elderly have been shown to have a positive effect on balance [28][29][30] and gait velocity. [31][32][33] Increases in ankle dorsiflexion ROM have been linked to improved balance after 4 weeks of daily stretching performed twice a day by elders. 34 A variety of exercise strategies are reported to influence ROM, strength, balance, and gait in the elderly. ...
Article
Purpose: Reductions in hip and ankle strength and range of motion (ROM) in elderly subjects have been associated with decreased functional mobility and risk of falls. The purpose of this research was to determine if short duration hip or ankle interventions designed to increase ROM and strength could improve ROM and strength of those joints, as well as improve balance and gait outcomes. Methods: Well elderly volunteers recruited from retirement communities and a senior citizen center were randomly assigned to a hip or ankle intervention group. Both groups performed a home exercise program (HEP) of stretching 5 days a week and strengthening 3 times a week for 8 weeks.The HEP was focused on the hip or ankle joint depending on group assignment. Results: Thirty-five subjects completed the exercise program. Neither group demonstrated statistically significant change from pretest to post-test in hip or ankle ROM or strength, or in balance or gait measures. Conclusions: The 8-week HEP was insufficient, perhaps in duration intensity, to effect change in impairments or functional limitations in a group of well elderly subjects. Physical therapists should be aware of limitations when giving unsupervised targeted exercises for a short duration. Grant Support: The NYPTA Designated Research Fund funded part of the Stride Analyzer and The Hygienic Corporation provided the Thera-Band(R) Resistive Bands. (C) 2004 Lippincott Williams & Wilkins, Inc.
... When extrapolating this to a whole body level, merely 5 days of bed-rest would result in ∼1 kg of muscle tissue lost. Structured and prolonged resistance-type exercise training is effective for muscle mass gain in the elderly (Evans, 1996;Fiatarone et al., 1990) and so should be considered vital in the recovery from a period of disuse. However, current clinical practice does not mandate such a rehabilitation program following a period of disuse, and elderly individuals generally show low adherence to non-supervised, structured resistance-type exercise training (Dunstan et al., 2006;Kohler et al., 1994;Miller et al., 2008). ...
... Im Leben älterer Menschen findet sich eine Vielfalt von körperlicher Bewegung, angefangen von regelrechter Sportaktivität wie Wandern, Gehen und Radfahren, über Gartenarbeit und muskulärer Aktivität, die beispielsweise bei der Bewältigung des Haushalts erbracht wird, bis hin zu Physiotherapie zur Kompensation von Gesundheitsproblemen und Behinderung. Auch für ausgewählte Gruppen älterer und alter Menschen, beispielsweise mit erhöhtem Sturzrisiko [17], Osteoporose [18] oder Sarkopenie [19] existieren spezifische Bewegungsprogramme. Auf Bevölkerungsebene jedoch führt die Synthese neuerer Literatur über gesundheitsrelevante Bewegungsempfehlungen zur Schlussfolgerung, dass der Kenntnisstand über optimale Methoden und Dosen der Aktivität zum Erreichen gesundheitsrelevanter Effekte sowie über minimale Aktivitätsschwellen für die Wirksamkeit un-zureichend ist [20]. ...
Article
Regular physical activity is key to avoiding or delaying age-related health problems and minimising their impact. In Western societies, the old and older population (the 75+ population segment in particular) is the least likely to exercise or do the recommended amount of health-enhancing physical activity. Thus far, there has been insufficient understanding of and research on the prevalence, impact and effectiveness of the wide array of physical activities that the old and older population can do to improve their health and degree of independence. Along this line, non-sports-related activities should receive special attention. Due to the limited extent of knowledge, there are few age-specific recommendations for physical activity. Subsequent research should focus more on the problems and realities of physical activity in the older and old population. This may serve to clarify and consolidate a scientific and practical consensus leading up to age-specific guidelines for physical activity.
... Regardless of the mechanism, what is known is that an aged muscle responds similarly to exercise as a young muscle (Hunter, McCarthy, & Bamman, 2004;Koopman et al., 2006;Yarasheski et al., 1999). In addition, numerous studies have shown that elderly subjects retain the capacity to increase their muscle mass in response to resistance exercise (for reviews see Evans, 1996Evans, , 2002Kosek, Kim, Petrella, Cross, & Bamman, 2006); hence, the same chronic increase in MPS to exceed MPB must occur in the elderly, as it does in the young, to bring about an increase in muscle fiber size. ...
... Sarcopenia, defined as increased loss of muscle mass and strength due to advanced age, is associated with a functional decline, affecting independent living [1], [2] . It is well established that exercise is effective in counteracting the negative consequences of aging on muscle mass and function [3], [4] throughout live (and thus positively impacts functional capacity and health). ...
Conference Paper
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In this paper we present a novel automatic system to supervise and support rehabilitation and fitness exercises. Goal of the system is to enable autonomous training of rehabilitation patients to support their recovery from movement restrictions as well as the prevention of age-related diseases such as osteoporosis. The system uses time-of-flight technology in order to measure movement angles in real-time. This novel setup is compared to a standard tracking system using visual markers. The measurements of both systems correlate with r values between 0.99 and 0.97 depending on the task domain. The mean error of the angle measurements is between 13 and 17 degrees.
... There is an age related loss of muscular strength and power, predominantly as a result of loss of muscle mass. With increasing age and the low activity levels seen in the elderly, muscle strength is a critical component of walking ability (Evans, 1996). Reduced lower extremity strength has been associated with reduction in gait speed (Bendall, et al., 1989;Chandler, et al., 1998), balance, stair-climbing ability (Fiatarone, et al., 1990) and getting up from a seated position (Bassey, et al., 1992;Chandler, et al., 1998). ...
Article
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There is increasing research evidence for the efficacy of resistance training programs for improving health and functional status in older adults. Resistance training has been shown to be an effective method to avoid age related losses in skeletal muscle tissue. Resistance training appears to be a potential solution for prevention purposes by inducing increases in strength, power and muscle cross sectional area, in addition to moderately improving endurance. There are also improvements in some aspects of functional status such as walking speed. Further research is required to determine the efficacy of resistance exercise for fall prevention. It does appear that muscular power and rate of force development are important indicators of health and functional status in older adults. Therefore resistance training programs should incorporate some of these aspects into the program design. Resistance training also provides an alternative method of rehabilitation for various disease states such as cardiovascular disease and type II diabetes. It now appears that resistance training is a critical component of exercise programs designed to improve health in older populations and should receive similar emphasis to aerobic activities such as walking.
... Strength training, specifically progressive resistance strength training (PRT), can restore muscle strength [14]. In PRT, people exercise muscles against certain resistance force that is gradually increased over the course of training to become stronger. ...
Article
The decline of muscle strength is associated with physical disability in late adulthood. Progressive resistance strength training has been demonstrated to be an effective intervention to increase muscle strength, however, its effect on reducing physical disability in older adults is unclear. The purpose of this study is to examine the effect of progressive resistance strength training on physical disability via meta-analysis. Two reviewers independently searched for qualified trials, assessed trial quality and extracted data. Trial inclusion criteria are: (1) Randomised controlled trials, (2) Mean age of participant sample is ≥ 60 years, (3) Progressive resistance strength training as the primary intervention and (4) the trial included outcome measures of physical disability (i.e. physical function domain of the Short-Form 36). Thirty-three trials were analysed. Although the effect size is small, the intervention groups showed reduced physical disability when compared to the control groups (SMD = 0.14, 95% CI = 0.05 to 0.22). Progressive resistance strength training appears to be an effective intervention to reduce physical disability in older adults. To maximise the effect, we suggest therapists use responsive outcome measures and multi-component intervention approach.
... Since strength capacity appears to also be indicative of disability (Janssen et al., 2002; Visser et al., 2002), resistance exercise (RE) may serve as an effective mode of physical activity to directly improve functional capacity. There is strong evidence to indicate that muscle weakness is a treatable cause of disability, and that aging persons with early-onset deterioration are probably the most likely to benefit from strategic interventions (Evans, 1996; Frontera et al., 1988; Hakkinen and Hakkinen, 1995; Hurley et al., 1995). Specifically, RE is considered to be a safe and effective method for increasing strength and lean muscle tissue in young (Hubal et al., 2005; Lowndes et al., in press) and older adults (Fiatarone et al., 1990; Frontera et al., 1988; Hakkinen et al., 1998 Reeves et al., 2004; Vincent et al., 2002; Welle et al., 1995). ...
Article
The effectiveness of resistance exercise for strength improvement among aging persons is inconsistent across investigations, and there is a lack of research synthesis for multiple strength outcomes. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. A meta-analysis was conducted to determine the effect of resistance exercise (RE) for multiple strength outcomes in aging adults. Randomized-controlled trials and randomized or non-randomized studies among adults > or = 50 years, were included. Data were pooled using random-effect models. Outcomes for 4 common strength tests were analyzed for main effects. Heterogeneity between studies was assessed using the Cochran Q and I(2) statistics, and publication bias was evaluated through physical inspection of funnel plots as well as formal rank-correlation statistics. A linear mixed model regression was incorporated to examine differences between outcomes, as well as potential study-level predictor variables. Forty-seven studies were included, representing 1079 participants. A positive effect for each of the strength outcomes was determined however there was heterogeneity between studies. Regression revealed that higher intensity training was associated with greater improvement. Strength increases ranged from 9.8 to 31.6 kg, and percent changes were 29+/-2, 24+/-2, 33+/-3, and 25+/-2, respectively for leg press, chest press, knee extension, and lat pull. RE is effective for improving strength among older adults, particularly with higher intensity training. Findings therefore suggest that RE may be considered a viable strategy to prevent generalized muscular weakness associated with aging.
... Resistance training recently has become a form of exercise recommended for improving strength, balance, and bone mineral density in older populations (12); however, the effects of this type of exercise on blood lipid profiles are not clear. Resistance training interventions in subject populations of different genders or ages (i.e., young, middle-aged) have yielded variable results, with some studies reporting favorable changes in blood lipids (17), whereas others found no effect (5,22,26). ...
Article
The purpose of this study was to examine the effects of a 16-week Dynaband resistance exercise program and body mass index (BMI) on the lipoprotein-lipid patterns of post-menopausal women aged 60-80 years. Eighteen female volunteers recruited from 3 senior nutrition sites in the Oklahoma City area completed the study. Subjects were tested for resting heart rate and blood pressure, skinfolds and circumferences, and fasting blood samples were obtained for the lipoprotein assays before and after the training program. The exercise program included a 10-minute warm up, followed by progressive resistance exercises (10-15 repetitions, 1-2 sets, 3[middle dot]/week) utilizing Dynabands to train 7 muscle groups and concluded with a 5-minute cool-down. There were no significant changes in body weight, % body fat, or in waist-to-hip ratios resulting from the training program, and BMI did not appear to modulate the findings. Improvements in high-density lipoprotein cholesterol (HDL-C) concentrations and in the total cholesterol/HDL-C ratio were observed after training. In conclusion, the Dynaband resistance training program was associated with improvements in HDL-C that were not accounted for by weight loss. (C) 2000 National Strength and Conditioning Association
... This increase in maximum strength was also found in the studies of Porter et al. (2002). Other studies showed that the increases of strength with high intensity programs may achieve some improvements of up to 227% of 1RM (Evans, 1996(Evans, , 1999Raso et al., 1997). However, for a program of low intensity the gains are about 20% in the same period of training (Matsudo, 2001). ...
... Among older adults, the loss of muscle strength and/or mass has been associated with functional decline and disability (83)(84)(85), falls (86), hip fractures (87), and mortality (88). Fortunately, older adults and even the "oldest old", show positive adaptations to both short-term and long-term RT, including improvements in muscle size and strength (89)(90)(91). Importantly, RT appears to be more effective at preserving lean mass than AT (92). Latham and colleagues (91) concluded that progressive RT improves muscle strength and physical function, both of which have a profound impact on the daily life of older adults. ...
... There is an age related loss of muscular strength and power, predominantly as a result of loss of muscle mass. With increasing age and the low activity levels seen in the elderly, muscle strength is a critical component of walking ability (Evans, 1996). Reduced lower extremity strength has been associated with reduction in gait speed (Bendall, et al., 1989; Chandler, et al., 1998), balance, stair-climbing ability (Fiatarone, et al., 1990) and getting up from a seated position (Bassey, et al., 1992; Chandler, et al., 1998). ...
... Whether the adaptive response to RET is equivalent in both young and old adults is still debatable, as several investigations have reported no difference between age groups (Häkkinen et al., 1998;Roth et al., 2001;Newton et al., 2002;Walker and Häkkinen, 2014), while others have reported a blunted response in OAs (Raue et al., 1985;Lemmer et al., 2000;Macaluso et al., 2000;Martel et al., 2006). Regardless, RET is clearly beneficial for musculoskeletal health, and is likely the most effective strategy for maintaining and/or increasing muscle mass and strength with age (Law et al., 2016) in turn preventing and potentially reversing sarcopenia and delaying loss of independence (Evans, 1996). Muscle quality, fatigue resistance, and physical function are also improved with RET (Hunter et al., 2004). ...
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Optimal health benefits from exercise are achieved by meeting both aerobic and muscle strengthening guidelines, however, most older adults (OAs) do not exercise and the majority of those who do only perform one type of exercise. A pragmatic solution to this problem may be emphasizing a single exercise strategy that maximizes health benefits. The loss of muscle mass and strength at an accelerated rate are hallmarks of aging that, without intervention, eventually lead to physical disability and loss of independence. Additionally, OAs are at risk of developing several chronic diseases. As such, participating in activities that can maintain or increase muscle mass and strength, as well as decrease chronic disease risk, is essential for healthy aging. Unfortunately, there is a widely held belief that adaptations to aerobic and resistance exercise are independent of each other, requiring the participation of both types of exercise to achieve optimal health. However, we argue that this assertion is incorrect, and we discuss crossover adaptations of both aerobic and resistance exercise. Aerobic exercise can increase muscle mass and strength, though not consistently and may be limited to exercise that overloads a particular muscle group, such as stationary bicycling. In contrast, resistance exercise is effective at maintaining muscle health with increasing age, and also has significant effects on cardiovascular disease (CVD) risk factors, type 2 diabetes (T2D), cancer, and mortality. We posit that resistance exercise is the most effective standalone exercise strategy for improving overall health in OAs and should be emphasized in future guidelines.
... Additionally, efforts should be taken to prospectively identify patients with sarcopenia as high risk and in need of additional intervention, as early action may potentially allow for reversal of symptoms and increase in strength leading to improved outcomes. 45,46 Rapidly performed measures such as bedside ultrasound have recently been described and strongly correlated to assessments of frailty in a critically ill surgical population. 47 Validation of additional widely available techniques to obtain quantifiable measures of sarcopenia should be further investigated to assist with assessment of frailty. ...
Article
Sarcopenia is strongly associated with poor outcomes and mortality following injury among the geriatric population. Diagnosis using psoas area is most common, but may be unavailable given limited radiographic evaluation following low impact injuries. Masseter area (M-area) has recently been identified as an available alternative and associated with two year mortality following injury. We sought to validate this measure and its association with early mortality following severe TBI (sTBI) using a retrospective analysis of all geriatric trauma patients with sTBI admitted from 2011-2016 to an ACS verified level one trauma center. Admission Glasgow Coma Score (GCS) ≤8 was used to identify TBI. Bilateral masseter area was measured 2 cm below the zygomatic arch and the mean used for analysis. Sarcopenia was defined as mean M-area one standard deviation or less from the sex based mean. Analysis included chi-square or Student t-test, followed by multivariate analysis with logistic regression and Cox proportional hazard models. Kaplan-Meier survival curves were generated and evaluated by log rank. The primary outcome of interest was 30 day mortality. 108 patients were identified with sTBI age 55 or older. Males had significantly larger M-area compared to females (4.55 vs 3.43 cm2, p=<0.001). Twenty-five patients, 16 male and 9 female, had sarcopenia with mean M-areas of 2.81±0.45 cm2 and 2.24±0.42 cm2, respectively. Patients with sarcopenia had significantly increased rates of 30 day mortality (80.0% vs. 50.6%, p=0.01). Sarcopenia (OR 2.95; 95% C.I. 1.03-8.49) and decreasing M-area were significantly associated with 30 day mortality (OR 0.66; 95% C.I. 0.46-0.95) in multivariate modeling. M-area is a readily available and objective measure to determine sarcopenia. Sarcopenia is significantly associated with increased 30 day mortality following sTBI.
... There is an age related loss of muscular strength and power, predominantly as a result of loss of muscle mass. With increasing age and the low activity levels seen in the elderly, muscle strength is a critical component of walking ability (Evans, 1996). Reduced lower extremity strength has been associated with reduction in gait speed (Bendall, et al., 1989; Chandler, et al., 1998), balance, stair-climbing ability (Fiatarone, et al., 1990) and getting up from a seated position (Bassey, et al., 1992; Chandler, et al., 1998). ...
Article
The aim of this study was to assess the relationship between external measures of resistance training (RT) workload and intensity, volume load (VL) and training intensity (TI), and related internal measures, session load and session rating of perceived exertion (sRPE), across a chronic RT intervention and between different models of RT in older adults. Forty-one healthy, untrained older adults (female, 21; male, 20; age, 70.9 ± 5.1 years; height, 166.3 ± 8.2 cm; weight, 72.9 ± 13.4 kg) were randomly stratified into 3 RT groups: nonperiodized (NP), block periodized (BP), or daily undulating periodized (DUP). They completed a 22-week RT intervention at a frequency of 3 d·wk-1. All training was executed on RT machines, and training volume was equalized between training groups based on total repetitions. Session RPE was measured 10-15 minutes after each training session. There were no meaningful relationships between VL and session load or TI and sRPE. Also, no significant differences were detected between training groups for mean sRPE across the training intervention. Based on these results, session load and sRPE do not appear to be valid markers of RT workload and intensity when compared with established external measures in healthy untrained older adults. However, sRPE and session load may hold promise as monitoring tools in RT that do not involve training to muscular failure. Furthermore, sRPE does not significantly differ between NP, BP, and DUP RT models, highlighting that this measure is not sensitive to such periodization as evident in the present study.
... In this regard, it is important to note that modifiable risk factors for abdominal obesity, or behaviours to selectively reduce waist circumference, are generally unknown. Thigh muscle mass, on the other hand, can be selectively increased by lower body physical activity, [25][26][27][28] and a clear public health recommendation to change this risk factor can be easily communicated. ...
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To examine associations between thigh circumference and incident cardiovascular disease and coronary heart disease and total mortality. Prospective observational cohort study with Cox proportional hazards model and restricted cubic splines. Random subset of adults in Denmark. 1436 men and 1380 women participating in the Danish MONICA project, examined in 1987-8 for height, weight, and thigh, hip, and waist circumference, and body composition by impedance. 10 year incidence of cardiovascular and coronary heart disease and 12.5 years of follow-up for total death. A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below around 60 cm. Above the threshold there seemed to be no additional benefit of having larger thighs in either sex. These findings were independent of abdominal and general obesity, lifestyle, and cardiovascular risk factors such as blood pressure and lipid concentration. A low thigh circumference seems to be associated with an increased risk of developing heart disease or premature death. The adverse effects of small thighs might be related to too little muscle mass in the region. The measure of thigh circumference might be a relevant anthropometric measure to help general practitioners in early identification of individuals at an increased risk of premature morbidity and mortality.
... De facto, foi demonstrado anteriormente que um programa de atividade física pode alterar favoravelmente fenótipos relacionados à sarcopenia e a OS (Goodpaster et al., 2008). Em particular, o treino resistido vem sendo consistentemente apontado como eficaz intervenção para o aumento de força muscular de indivíduos idosos (Evans, 1996;Rabelo et al., 2011). De forma interessante, foi previamente demonstrado que um programa de treino resistido promoveu melhoria no desempenho funcional de idosos (Rabelo, Oliveira, & Bottaro, 2004). ...
Article
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Sarcopenia e obesidade sarcopénica (OS) são condições geriátricas que apresentam consequências negativas em idosos, entretanto, a associação com a capacidade funcional precisa ser mais investigada. O objetivo do estudo foi verificar a associação entre força muscular, sarcopenia e OS com o desempenho funcional de idosas. Participaram 137 voluntárias (67.76±5.67 anos; 64.63±10.79 kg; 154.13±0.06 cm), submetidas à análise da composição corporal através de DXA. O desempenho funcional foi avaliado por meio dos testes de levantar e sentar, Timed Up & Go, flexão de cotovelo e caminhada de 6 minutos. A força muscular foi avaliada por meio da dinamometria isocinética e pela preensão manual (FPM). A prevalência de sarcopenia e de OS foi de 13.9% e 23.4%, respetivamente. Nenhuma das variáveis funcionais diferiu significativamente entre as mulheres sarcopénicas e não sarcopénicas. As voluntárias classificadas com OS apresentaram maior percentual de gordura e menor massa livre de gordura, porém, não houve diferença para as variáveis funcionais. Em contrapartida, a força muscular (i.e., pico de torque e FPM) apresentou associação com os testes funcionais. Os resultados indicam que não há associação entre as classificações estudadas de sarcopenia e OS com os testes funcionais. Porém, a força muscular apresenta relação positiva com o desempenho funcional de idosas.
... 3 Los cambios en la composición corporal (específicamente la pérdida de la masa muscular) y sus implicaciones en la funcionalidad y supervivencia de los ancianos se presentan en el cuadro II. 1,2,16,20,26,27 El cuadro III muestra los efectos clínicos de la sarcopenia. 2,14,28,29 La sarcopenia tiene aspectos claramente modificables. ...
Article
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El envejecimiento provoca múltiples cambios en la composición corporal como la pérdida de músculo esquelético (sarcopenia). La sarcopenia es un componente clave del modelo de fragilidad y su causa es desconocida. Diversas estrategias se han utilizado para preservare incluso aumentar' la masa muscular y la función en los ancianos.
... In addition, these studies are generally characterized by relatively small sample sizes and/or the use of an indirect method (i.e., total body potassium) for estimating muscle tissue. Given the importance of SM in both clinical and applied medicine (13,14), there is a need to establish reference values on the basis of age and gender. Moreover, understanding the independent influence of age and gender on SM mass may be useful in the development of therapeutic strategies designed to preserve SM, improve functional capacity, and decrease health risks, particularly for elderly men and women. ...
Article
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... As estratégias para preservar ou aumentar a massa muscular nos indivíduos da terceira idade devem ser implementadas porque a sacopenia e a fraqueza podem ser uma característica universal em idades avançadas. O aumento da força muscular, e níveis aumentados de atividade espontânea têm sido visto tanto em homens como mulheres, indivíduos da terceira idade saudáveis e com boas condições de vida como nos indivíduos da terceira idade frágeis e muito mais velhos (EVANS, 1996). ...
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RESUMO Esta pesquisa teve como objetivo identificar os benefícios do treinamento com pesos para a terceira idade, a correlação deste treinamento com o envelhecimento e identificar a relação da força, resistência e hipertrofia em indivíduos da terceira idade praticantes de treinamento com pesos na musculação, através de uma pesquisa bibliográfica. Foram utilizados como fonte de pesquisa livros, apostilas, textos, periódicos, monografias e dissertações. A coleta dos dados foi executada no período de agosto de 2004 a maio de 2005. Os dados coletados revelaram que o treinamento com pesos trazem muitos benefícios aos indivíduos da terceira idade entre eles; aumento da força muscular, manutenção e até ganho da massa muscular e do metabolismo, melhora na mobilidade articular, redução da gordura corporal, aumento da densidade óssea mineral e redução nos fatores de risco de doenças cardiovasculares. A melhora mais significativa foi relacionada com o ganho de força muscular, onde pesquisas apontaram um ganho de mais de 177% em indivíduos da terceira idade. Todos os benefícios servem para uma melhor qualidade de vida e facilidade na realização de tarefas do cotidiano para a população investigada. Palavras-Chave: Treinamento com Pesos, Terceira Idade, Atividade Física. ABSTRACT This research aimed to identify the benefits of weight training for seniors, the relation of this training with aging and identify the relationship of strength, endurance and hypertrophy in elderly individuals practicing resistance training in the gym, through a literature. Were used as a research resource books, handouts, texts, journals, monographs and dissertations. Data collection was performed from August 2004 to May 2005. The data collected showed that weight training brings many benefits to seniors among them, increased muscle strength, maintain and even gain muscle mass and metabolism, improvement in joint mobility, reducing body fat, increased bone density mineral and reduction in risk factors for cardiovascular disease. The most significant improvement was related to gain muscle strength, where polls showed a gain of more than 177% in seniors. All benefits are for a better quality of life and ease in performing daily tasks for the population investigated.
... There is a positive relationship between the size and function (e.g. muscular strength, endurance and power) of skeletal muscle [13][14][15][16][17]. Similarly, reductions in trunk muscle mass are associated with low back pain [18][19][20] and decreased functional capacity [21][22][23], while exerciserelated increases in skeletal muscle mass are associated with better clinical outcome in patients with lumbar spine disorders [14,18,24,25]. ...
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Background: Skeletal muscle plays an important role in maintaining the stability of the lumbar region. However, there is conflicting evidence regarding the effects of exercise on trunk muscle morphology. Objective: To systematically review the literature on the effects of exercise training on lower trunk muscle morphology to determine the comparative effectiveness of different exercise interventions. Data source and study selection: A systematic search strategy was conducted in the following databases: PubMed, SportDiscus, CINAHL, the Cochrane Library and PEDro. We included full, peer-reviewed, prospective longitudinal studies, including randomized controlled trials and single-group designs, such as pre- to post-intervention and crossover studies, reporting on the effect of exercise training on trunk muscle morphology. Study appraisal and synthesis: Study quality was assessed with the Cochrane risk-of-bias tool. We classified each exercise intervention into four categories, based on the primary exercise approach: motor control, machine-based resistance, non-machine-based resistance or cardiovascular. Treatment effects were estimated using within-group standardized mean differences (SMDs). Results: The systematic search identified 1,911 studies; of which 29 met our selection criteria: motor control (n = 12), machine-based resistance (n = 10), non-machine-based resistance (n = 5) and cardiovascular (n = 2). Fourteen studies (48 %) reported an increase in trunk muscle size following exercise training. Among positive trials, the largest effects were reported by studies testing combined motor control and non-machine-based resistance exercise (SMD [95 % CI] = 0.66 [0.06 to 1.27] to 3.39 [2.80 to 3.98]) and machine-based resistance exercise programmes (SMD [95 % CI] = 0.52 [0.01 to 1.03] to 1.79 [0.87 to 2.72]). Most studies investigating the effects of non-machine-based resistance exercise reported no change in trunk muscle morphology, with one study reporting a medium effect on trunk muscle size (SMD [95 % CI] = 0.60 [0.03 to 1.16]). Cardiovascular exercise interventions demonstrated no effect on trunk muscle morphology (SMD [95 % CI] = -0.16 [-1.14 to 0.81] to 0.09 [-0.83 to 1.01]). Limitations: We excluded studies published in languages other than English, and therefore it is possible that the results of relevant studies are not represented in this review. There was large clinical heterogeneity between the included studies, which prevented data synthesis. Among the studies included in this review, common sources of potential bias were random sequence generation, allocation concealment and blinding. Finally, the details of the exercise parameters were poorly reported in most studies. Conclusion: Approximately half of the included studies reported an increase in lower trunk muscle size following participation in an exercise programme. Among positive trials, studies involving motor control exercises combined with non-machine-based resistance exercise, as well as machine-based resistance exercises, demonstrated medium to large effects on trunk muscle size. Most studies examining the effect of non-machine-based resistance exercise and all studies investigating cardiovascular exercise reported no effect on trunk muscle morphology. However, these results should be interpreted with caution because of the substantial risk of bias and suboptimal reporting of exercise details in the included studies. Additional research, using methods ensuring a low risk of bias, are required to further elucidate the effects of exercise on trunk muscle morphology.
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Sarcopenia is a major component of age-related frailty and also a strong predictor of disability, morbidity, and mortality in the aging population. Resistance exercise could be the most effective intervention that improves muscle mass, muscle strength, and physical performance, thus preventing sarcopenia in older adults. The benefits of these exercise programs correlate with the intensity and the frequency of the exercise regimes used in the trials. Clinical trials vary in terms of population, setting, and exercise regimes; hence, more standardized clinical trials are required. In this review, we focus on the effects of resistance exercise on muscle mass, strength, cognitive and physical function, and the principle and applications of resistance exercise considering recent trends that include high-intensity interval training, high speed power training, eccentric exercise, and whole-body vibration exercise.
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Resistance training is recommended by national health organizations for incorporation into a comprehensive fitness program that includes aerobic and flexibility exercise. Its potential benefits on health and performance are numerous; it has been shown to reduce body fat, increase basal metabolic rate, decrease blood pressure and the cardiovascular demands to exercise, improve blood lipid profiles, glucose tolerance, and insulin sensitivity, increase muscle and connective tissue cross-sectional area, improve functional capacity, and relieve low back pain. Many improvements in physical function and athletic performance are associated with the increases in muscle strength, power, endurance, and hypertrophy observed during resistance training. The key element to effective resistance training is supervision by a qualified professional and the proper prescription of the program variables. Proper program design, ie, that which uses progressive overload, variation, and specificity, is essential to maximize the benefits associated with resistance training.
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Background: Sarcopenia, or age-related loss of muscle mass, is measureable by computed tomography (CT). In elderly trauma patients, increased mortality is associated with decreased psoas muscle cross-sectional area (P-Area) on abdominal CT. Fall is the leading cause of injury in the elderly and head CT is more often obtained. Masseter muscle cross-sectional area (M-Area) is readily measured on head CT. Hypothesizing that M-Area is a satisfactory surrogate for P-Area, we compared the two as markers of sarcopenia and increased mortality in elderly trauma patients. Methods: All blunt-injured patients aged 65 years or older admitted to our trauma center during 2010 were included. Two-year post-discharge mortality was identified by matching records to county, state and national death indices. Bilateral M-Area was measured on admission head CT at two centimeters below the zygomatic arch. Bilateral P-Area was measured on abdominal CT at the fourth vertebral body. Average M-Area and P-Area values were calculated for each patient. Cox proportional hazards models evaluated the relationship of M-Area and P-Area with mortality. Model predictive performance was calculated using concordance statistics. Results: Among 487 patients, 357 with M-Area and 226 with P-Area were identified. Females had smaller M-Area (3.43 cm vs 4.18 cm; p < 0.050) and P-Area (6.50 cm vs 10.9 cm; p < 0.050) than males. M-Area correlated with P-Area (rho: 0.38, p < 0.001). Adjusted Cox regression models revealed decreased survival associated with declining M-Area (Hazard Ratio [HR]: 0.76, 95% Confidence Interval [CI] 0.60-0.96) and P-Area (HR: 0.68, 95% CI 0.46-1.00). M-Area and P-Area discriminated equally well in best-fit models. Conclusions: In elderly trauma patients, M-Area is an equally valid and more readily available marker of sarcopenia and two-year mortality than P-Area. Future study should validate M-Area as a metric to identify at-risk patients who may benefit from early intervention. Level of evidence: Level III, prognostic study.
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Growing evidence supports the conclusion that consumption of protein in close temporal proximity to the performance of resistance exercise promotes greater muscular hypertrophy. We can also state with good certainty that merely consuming energy, as carbohydrate for example, is also not sufficient to maximise muscle protein synthesis leading to anabolism and net new muscle protein accretion. Recent work also indicates that certain types of proteins, particular those that are rapidly digested and high in leucine content (i.e. whey protein), appear to be more efficient at stimulating muscle protein synthesis. Continued practice of consumption of these types or proteins after exercise should lead to greater hypertrophy. Reviews of numerous training studies indicate that studies in which milk proteins and principally whey protein show an advantage of these proteins over and above isoenergetic carbohydrate and soya protein in promoting hypertrophy. Thus, the combined evidence suggests a strategic advantage of practising early post-exercise consumption of whey protein or dairy-based protein to promote muscle protein synthesis, net muscle protein accretion and ultimately hypertrophy.
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This article seeks to provide an alternative to the "problem" approach that dominates gerontological research in many countries. In this article I propose a conceptual framework for examining the social value that older adults provide society by exploring and expanding upon social capital literature. The theoretical underpinnings of social capital are reviewed, exploring the essential components of social capital as a tool for examining the creation of social value. Gerontological frameworks that contribute to increased awareness of the positive aspects of aging are examined. These two approaches are linked using a social capital framework for studying aging, presented here as a new orientation to aging and as a step toward a change in the current culture of aging and aging research.
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We employed a whole body magnetic resonance imaging protocol to examine the influence of age, gender, body weight, and height on skeletal muscle (SM) mass and distribution in a large and heterogeneous sample of 468 men and women. Men had significantly ( P < 0.001) more SM in comparison to women in both absolute terms (33.0 vs. 21.0 kg) and relative to body mass (38.4 vs. 30.6%). The gender differences were greater in the upper (40%) than lower (33%) body ( P < 0.01). We observed a reduction in relative SM mass starting in the third decade; however, a noticeable decrease in absolute SM mass was not observed until the end of the fifth decade. This decrease was primarily attributed to a decrease in lower body SM. Weight and height explained ∼50% of the variance in SM mass in men and women. Although a linear relationship existed between SM and height, the relationship between SM and body weight was curvilinear because the contribution of SM to weight gain decreased with increasing body weight. These findings indicate that men have more SM than women and that these gender differences are greater in the upper body. Independent of gender, aging is associated with a decrease in SM mass that is explained, in large measure, by a decrease in lower body SM occurring after the fifth decade.
Chapter
Muscle disease symptoms and myopathies are not uncommon in the elderly population. Inflammatory and noninflammatory myopathies lead primarily to proximal extremity or axial weakness and are superimposed upon the intrinsic age-related changes that occur in muscle mass, strength, and function (sarcopenia). This chapter surveys the more common myopathies in the elderly population based upon a review of the process of sarcopenia, and how these age-related changes in muscle structure and function affect the results of the standard assessments of muscle disease in the elderly individual. KeywordsMuscle-Myopathy-Myositis-Sarcopenia
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Aim. The study was designed to determine the effects of aerobic training alone and resistance alone on glycosylated hemoglobin (HbA1c), plasmatic glucose and blood pressure control in adults with type 2 diabetes (T2DM). Methods. A quantitative, descriptive cross-sectional study of 26 subjects volunteered were divided into two groups: 13 subjects of Group Aerobic (G1) -female =53.8% and male=46.2%, age =61.5±8.1 years: carried out walking exercises and 13 of Group Resistance (G2) - female = 84.6% and male = 15.4%, age = 61.0 ± 9.1 years: strength training program consisted of bodybuilding sessions. HbA1c, blood pressure, and plasmatic glucose were measured before training and after 13 weeks of training period. Results. The 13 weeks exercise training program had a decrease of blood pressure after training in the resistance group. The average differences of plasmatic glucose before and after training were higher in the both groups (P<0.05). In resistance group a decrease of HbA1c was observed (P<0.05). The participants had an improvement in capillary glycemia, blood pressure and HbA1c. Conclusion. Our findings showed that aerobic training alone and resistance alone improves HbA1c, glucose and blood pressure control of individuals with T2DM. We propose that an optimal exercise program for individuals with diabetes should include a resistance training component to be effective in improving the overall glycemic profile, and thus reduce the risk for long term diabetic complications in T2DM.
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IntroductionAdequacy of Current Dietary Protein Recommendations for Older AdultsThe Effect of Age on Protein Anabolism in Response to MealsProtein Quantity and QualityExercise and NutritionDietary Supplementation as an Adjunct Treatment for SarcopeniaPriority Areas for Targeted Nutrition InterventionsConclusion AcknowledgementsReferences
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The objective of this study was analyze the effect of the inclusion of a resistance training program (RTP) in anthropometric profile and in motor capacities of physically active women. The sample was consisted of 26 women (57,62±7,58 years old; 60,2±10,29 kg; 1,49±0,05 m) participants of the Agita Santarém Project (ASP) of Campus XII - Santarém, in the University of State of Pará, which were divided randomly into two groups (GI e GII) for three situations evaluation. An RTP was administered during 4 weeks (2 sessions per week) and the group that did not start the RTP continued to participate of Project¿s lessons. After this period the groups reversed the actuation. The proposed RTP emphasized exercises that stimulate the large muscle groups. We used the Student t test for independent samples both for independent samples and for related samples with p
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Transthyretin (TTR) is a 55-kDa protein secreted mainly by the choroid plexus and the liver. Whereas its intracerebral production appears as a stable secretory process allowing even distribution of intrathecal thyroid hormones, its hepatic synthesis is influenced by nutritional and inflammatory circumstances working concomitantly. Both morbid conditions are governed by distinct pathogenic mechanisms leading to the reduction in size of lean body mass (LBM). The liver production of TTR integrates the dietary and stressful components of any disease spectrum, explaining why it is the sole plasma protein whose evolutionary patterns closely follow the shape outlined by LBM fluctuations. Serial measurement of TTR therefore provides unequalled information on the alterations affecting overall protein nutritional status. Recent advances in TTR physiopathology emphasize the detecting power and preventive role played by the protein in hyperhomocysteinemic states, acquired metabolic disorders currently ascribed to dietary restriction in water-soluble vitamins. Sulfur (S)-deficiency is proposed as an additional causal factor in the sizeable proportion of hyperhomocysteinemic patients characterized by adequate vitamin intake but experiencing varying degrees of nitrogen (N)-depletion. Owing to the fact that N and S coexist in plant and animal tissues within tightly related concentrations, decreasing LBM as an effect of dietary shortage and/or excessive hypercatabolic losses induces proportionate S-losses. Regardless of water-soluble vitamin status, elevation of homocysteine plasma levels is negatively correlated with LBM reduction and declining TTR plasma levels. These findings occur as the result of impaired cystathionine-β-synthase activity, an enzyme initiating the transsulfuration pathway and whose suppression promotes the upstream accumulation and remethylation of homocysteine molecules. Under conditions of N- and S-deficiencies, the maintenance of methionine homeostasis indicates high metabolic priority.
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The Standing Strong fall prevention program is an evidence-based exercise and education program for older adults at risk of falls. The goal of the program is to reduce risk of falls through a well-rounded exercise program including strength and balance exercises using readily accessible elastic bands and foam pads. In addition, behavioral change strategies are implemented to help increase physical activity levels after the program. Participants in Standing Strong have significantly improved balance (82%) and lower extremity strength (13%–20%), as well as significantly decreased fall rate (from 58%–16%).
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In vivo neutron activation has provided investigators with a powerful tool for research on body composition. Total-body nitrogen (TBN), total-body potassium (TBK), and total-body water (TBW) were measured in 133 normal subjects. TBN, measured by neutron activation, is a measure of total-body protein, an index of body cell mass. TBK, also measured by a nuclear reaction, is an index of body cell mass as well as lean body mass. The mass and protein content of two compartments, muscle and nonmuscle lean tissue, were determined from the combined TBN-TBK data by compartmental analysis. In this study, nitrogen was separated into the actively metabolizing body cell mass component and the slowly metabolizing structural component. The TBK, which is 95% intracellular, was found to be more closely related to the actively metabolizing nitrogen than to TBN. The relationship of body cell mass, a concept originally proposed by Moore, to lean body mass, is shown through the relationship of TBN and TBK. The clinical significance of this study, is that TBK is the more sensitive and reliable indicator of changes in body cell mass. Maximum information on body composition, however, is obtained by the measurement of both TBK and TBN.