Article

Weight training improves walking endurance in the healthy elderly

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Abstract

To determine the effect of a resistance-training program on walking endurance in a healthy, community-dwelling elderly population. 12- week randomized, controlled trial comparing a resistance- training group with a nonexercising control group. Hospital-affiliated outpatient exercise facility. 24 healthy men and women who were 65 years of age or older (mean age +/-SD, 70.4 +/- 4 years; range, 65 to 79 years). The primary outcome variable was exhaustive submaximal walking time measured at an intensity of 80% of baseline peak aerobic capacity. Participants in the resistance-training program increased submaximal walking endurance by 9 minutes (from 25 +/- 4 minutes to 34 +/- 9 minutes; P=0.001), a 38% increase, whereas no change was seen in controls (20 +/- 5 minutes to 19 +/- 10 minutes; P greater than 0.2; P=0.005 between groups). The relation between change in leg strength and change in walking endurance was significant (r=0.48; P=0.02). Neither group showed a change in peak aerobic capacity or in whole-body composition, although fat-free mass of the leg increased in the exercise group. Resistance training for 3 months improves both leg strength and walking endurance in healthy, community-dwelling elderly persons. This finding is relevant to older persons at risk for disability, because walking endurance and leg strength are important components of physical functioning.

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... Ao analisar os métodos diagnósticos utilizados nos 23 estudos selecionados para avaliação da composição corporal, foram identifi cadas cinco técnicas: nove utilizaram a absortimetria de raios -X em duas energias (DEXA) (19, 22, 26, 27, 31-33, 37, 39), cinco utilizaram a análise de dobras cutâneas corporais (23,32,33,25,39), três utilizaram a tomografi a computadorizada (19,20,22), quatro utilizaram a análise de impedância bioelétrica (BIA) (23,30,35,39), e um estudo utilizou conjuntamente a DEXA e a tomografi a computadorizada (29). ...
... Ao analisar os métodos diagnósticos utilizados nos 23 estudos selecionados para avaliação da composição corporal, foram identifi cadas cinco técnicas: nove utilizaram a absortimetria de raios -X em duas energias (DEXA) (19, 22, 26, 27, 31-33, 37, 39), cinco utilizaram a análise de dobras cutâneas corporais (23,32,33,25,39), três utilizaram a tomografi a computadorizada (19,20,22), quatro utilizaram a análise de impedância bioelétrica (BIA) (23,30,35,39), e um estudo utilizou conjuntamente a DEXA e a tomografi a computadorizada (29). ...
... (45) Entre os estudos analisados, quatro grupos que utilizaram exercícios de alta intensidade (80-90% 1RM) obtiveram um efeito favorável ao aumento de massa muscular (+0,64% ±1,2; 3,47% ±9,0; 2,23% ±6.9 (p<0,05); +6,14% ±3,03 ). (31,39,41) Com relação ao período de duração da intervenção, a mediana foi de 20 semanas (p: 0,008) com períodos máximo e mínimo de 96 e 6 semanas, respectivamente. Neste caso, os resultados diferiram, principalmente em amplitude, dos relatados por outros estudos na literatura. ...
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Objetivo: O objetivo deste trabalho foi analisar o efeito da intervenção de programas de exercícios na massa muscular como tratamento de indivíduos idosos com sarcopenia. Método: Revisão sistemática de ensaios clínicos comparando idosos sarcopenicos em grupo submetido a um programa de exercício (grupo intervenção) em relação à um grupo de controle. Os Critérios de seleção para esta revisão são: ensaios clínicos (tipo de estudo); indivíduos idosos, com idade igual ou superior a 60 anos, sedentários com sarcopenia (tipo de participante); programa de exercícios que tivessem, no mínimo, 04 semanas de duração e 8 sessões de treino; a intensidade média das sessões (mínimo) deveria ser de moderada à alta (igual ou maior a 60% da capacidade máxima) (Tipo de intervenção); e variação percentual da massa muscular (Tipo de desfecho). A estratégia de busca se desenvolveu nos bancos de dados virtuais como Medline, Pubmed; Bireme; Lilacs, PEDro; Science Direct; e a Biblioteca Cochrane. As buscas ocorreram no período de 2012 à 2013, sem considerar limite de tempo de publicação dos artigos incluídos. Os descritores/termos de pesquisa utilizados foram exercise, sarcopenia e clinical trial. Não houve restrições de linguagem ou ano de publicação. Resultados: Foram identificadas 1.580 referências. Após a primeira etapa da revisão, 92 estudos foram considerados elegíveis para inclusão e selecionados para a análise do texto integral. Ao final, 23 estudos foram incluídos para a revisão. Os resultados indicaram um aumento de massa muscular em vinte e dois (22) grupos de intervenção com programas de exercícios físicos. Conclusões: Os resultados da análise sugerem uma associação positiva do efeito de programas de exercício sobre a massa muscular de idosos e redução da sarcopenia.
... 60,61 In healthy older adults, the beneficial physiological effects of a structured exercise program have been conclusively demonstrated. Regular exercise that emphasizes aerobic conditioning and/or strength training increases aerobic capacity, 62, 63 muscle strength [64][65][66][67][68][69] and endurance. 66 Despite these findings, it remains unclear whether the positive effects of exercise interventions can be sustained for a sufficient duration of time and maintained at adequate intensity to prevent a clinically significant disability outcome, thereby prolonging independence. ...
... Regular exercise that emphasizes aerobic conditioning and/or strength training increases aerobic capacity, 62, 63 muscle strength [64][65][66][67][68][69] and endurance. 66 Despite these findings, it remains unclear whether the positive effects of exercise interventions can be sustained for a sufficient duration of time and maintained at adequate intensity to prevent a clinically significant disability outcome, thereby prolonging independence. Addressing this question requires new data from an intervention study with a sufficiently large sample size, a long follow-up time and appropriate disability outcome measures. ...
Data
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LIFE study protocol. (PDF)
... Significant increases in 1RM values have been reported after 6 and 12 weeks of strength training, which was associated with a concomitant increase in functional capacity gains [9][10][11]. However, the majority of studies merely test muscle strength and physical function before and after the intervention period [9,10,[12][13][14]. To our knowledge, only one study assessed muscle strength every 4 weeks during a 16-week training programme. ...
... Participants were assessed at six different time points throughout the intervention: at baseline (BL), every 4 weeks (week [4][5][6][7][8][9][10][11][12], at the end of the intervention period (week 16) and after a detraining (DET) period of 16 weeks. All participants were asked to maintain their current lifestyle and not make any changes to their level of physical activity and diet. ...
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It is generally recognised that the physical functioning of older adults is enhanced with resistance exercise. The aim of this study was to investigate the time course of changes in upper and lower body muscle strength and physical function in older individuals following a 16 week resistance training (RT) programme and a similar duration detraining (DET) period. Forty-one inactive individuals (55 to 75 years) were randomly allocated in a RT group (n = 22; three sessions per week) and a control (CON) group (n = 19). Muscle strength was assessed with 10RM leg and bench press tests, while the Timed-Up-and-Go (TUG) test was used to measure functional mobility. The Bruce treadmill test determined the participants’ submaximal endurance capacity. Data were analysed using mixed model repeated measures ANOVA and P < 0.05 was considered statistically significant. Main treatment effects were found for muscle strength (P < 0.001) and functional mobility (P < 0.05). Upper and lower body strength generally showed a statistically significant improvement after every 4 weeks in RT (the increase after 16 weeks being 7.3 ± 4.9 kg and 86.6 ± 44.4 kg, respectively; P < 0.001) while TUG performance (−0.2 ± 0.4 s; P < 0.05) and submaximal endurance capacity (0.7 ± 0.9 min; P < 0.001) only improved after 16 weeks. Although muscle strength decreased after DET, it was still better than at baseline. No significant improvements in any performance variable were observed in CON directly after the intervention period (0–16 weeks) (P > 0.05). A 16-week RT programme has positive effects on both muscular and physical function in older adults, although the time course of these adaptations is different. While the gains in muscle strength and submaximal endurance capacity were not totally lost after DET, functional mobility was completely reversed. Older adults can be reassured that if the need arises to discontinue RT for a certain period they will still retain a large amount of their acquired muscle strength, as well as a degree of physical function such as submaximal endurance capacity. The association between leg strength and submaximal endurance capacity strengthens the notion that RT should be incorporated in training and rehabilitation programmes of ageing and frail older adults.
... Una recente review ha confermato e collegato in modo documentato la relazione positiva fra forza ed equilibrio 72 . L'uso dei sovraccarichi incrementa l'economia metabolica durante compiti ordinari negli anziani 73 , alcuni studi in soggetti giovani dove il lavoro con i sovraccarichi fu aggiunto all'allenamento di endurance, mostrarono un aumento della prestazione di resistenza senza un incremento del VO 2max 74 , ciò può essere attribuito ad un miglioramento della economia della locomozione, studi su soggetti anziani mostrarono, a fronte di un incremento di forza, un incremento della resistenza al cammino 75,76 . ...
... Studies on older adults showed an increase in walking endurance with increased muscle strength. 75,76 In conclusion, over the last 10 years the idea has become widely accepted that strength training is safe in both healthy older adults and those whose conditions allow physical activity. Strength training has been shown to obtain noteworthy improvement in maintaining autonomy and preventing falling, as well as maintaining basic functional tasks such as walking, climbing stairs and executing movements requiring intense muscle contraction. ...
... Effect sizes for both were equivalent to those produced by pain medications [10]. Strength training also improved bone mass [11], aerobic capacity [12], and psychological health [13] in this population. Studies have implemented a variety of exercises, such as weight-bearing, non-weight-bearing, and neuromuscular exercises [6,[14][15][16]. ...
... Inconsistent with our hypothesis, the fitness test selected for this study demonstrated no differences between baseline and follow-up. It is not surprising that an exercise program tailored primarily to strengthen the quadriceps muscles was not a stimulus for improvement in fitness; though previous work has documented strength training can improve fitness in older adults [12]. It is important to note that the submaximal cycle ergometer test is likely not appropriate for people with knee OA. ...
Article
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Unlabelled: People with knee osteoarthritis may benefit from exercise prescriptions that minimize knee loads in the frontal plane. The primary objective of this study was to determine whether a novel 12-week strengthening program designed to minimize exposure to the knee adduction moment (KAM) could improve symptoms and knee strength in women with symptomatic knee osteoarthritis. A secondary objective was to determine whether the program could improve mobility and fitness, and decrease peak KAM during gait. The tertiary objective was to evaluate the biomechanical characteristics of this yoga program. In particular, we compared the peak KAM during gait with that during yoga postures at baseline. We also compared lower limb normalized mean electromyography (EMG) amplitudes during yoga postures between baseline and follow-up. Primary measures included self-reported pain and physical function (Knee injury and Osteoarthritis Outcome Score) and knee strength (extensor and flexor torques). Secondary measures included mobility (six-minute walk, 30-second chair stand, stair climbing), fitness (submaximal cycle ergometer test), and clinical gait analysis using motion capture synchronized with electromyography and force measurement. Also, KAM and normalized mean EMG amplitudes were collected during yoga postures. Forty-five women over age 50 with symptomatic knee osteoarthritis, consistent with the American College of Rheumatology criteria, enrolled in our 12-week (3 sessions per week) program. Data from 38 were analyzed (six drop-outs; one lost to co-intervention). Participants experienced reduced pain (mean improvement 10.1–20.1 normalized to 100; p<0.001), increased knee extensor strength (mean improvement 0.01 Nm/kg; p = 0.004), and increased flexor strength (mean improvement 0.01 Nm/kg; p = 0.001) at follow-up compared to baseline. Participants improved mobility on the six-minute walk (mean improvement 37.7 m; p<0.001) and 30-second chair stand (mean improvement 1.3; p = 0.006) at follow-up compared to baseline. Fitness and peak KAM during gait were unchanged between baseline and follow-up. Average KAM during the yoga postures were lower than that of normal gait. Normalized mean EMG amplitudes during yoga postures were up to 31.0% of maximum but did not change between baseline and follow-up. In this cohort study, the yoga-based strengthening postures that elicit low KAMs improved knee symptoms and strength in women with knee OA following a 12 week program (3 sessions per week). The program also improved mobility, but did not improve fitness or reduce peak KAM during gait. The KAM during the yoga postures were lower than that of normal gait. Overall, the proposed program may be useful in improving pain, strength, and mobility in women with knee osteoarthritis. Clinical efficacy needs to be assessed using a randomized controlled trial design. Trial registration: ClinicalTrials.gov NCT02146105.
... Resistance training increases the performance of endurance activities such as walking and alike. This is highly relevant for elderly subjects with risks for disabilities and is an important component of physical functioning [10]. The effect of resistance training has been shown to be more pronounced in older subjects (>60 years), probably related to the increased loss of muscle strength with age [11]. ...
... Implementation of strength training in cardiac rehabilitation could be crucial considering that>80% of these patients are overweight [10,19]. Volume and distribution of fat combined with reduced muscle mass often increase cardiovascular risks [20]. ...
Article
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Abstract Objective: We have measured the effect of combined strength and high intensity endurance training on physical capacity and lipid profile in patients with heart and coronary diseases. We wanted to see whether cardiac patients were able to increase training intensity to improve strength without losing endurance capacity. Methods: Thirty heart-operated subjects participated in an intervention period of 10 weeks. The age of the participants was between 52-72 years. The Resistance-Interval group (RE-INT) practiced four times a week with two intensive endurance (spinning) sessions and two strength training sessions. The endurance training consisted of intervals where the heart rate reached>90% of maximum heart rate. Strength training was performed in three series with a load of 8-12 repetition maximum (RM). The subjects in the control group (CON) performed two to three sessions per week according to a national program specialized for coronary patients (called “Ullevaal model”). We had a randomized controlled trial. Results: Maximal leg strength increased in both groups during the intervention, but the increase was higher in the RE-INT group (from 107.9 ± 8.1 kg to 162.0 ± 8.4 kg) compared to the CON group (from 110.8 ± 8.9 to 125.4 ± 9.5 ) (p<0.001). Strength in chest press, the maximal oxygen uptake and the concentration of high densitylipoprotein (HDL) protein increased in both groups during the test period. However, no differences were observed between the RE-INT and CON group. Low density-lipoprotein (LDL), blood pressure and body weight did not change during the intervention period in any of the groups. Conclusion: Cardiac patients were able to increase training intensity, strength and maximal oxygen uptake during a period of 10 weeks. We found that combined training has an effective impact on the increase in leg strength. The increase in muscle strength can be vital for the everyday quality of life in cardiac patients.
... En la misma, se llevaron a cabo 3 sesiones de 40 min semanales durante 24 semanas, donde se combinaba dentro de la misma sesión entrenamientos de resistencia aeróbica, manteniendo la intensidad en la zona de quema de grasa, con entrenamiento de fuerza (sentadilla y press de banca); los autores concluyen que el entrenamiento condujo a mejoras significativas en el VO 2 máx19 . En nuestro estudio, se realizaron de forma separada sesiones de resistencia cardiovascular y de fuerza muscular, teniendo más peso la sesiones de fuerza en el total de semanas, y reportando en su conjunto mejoras en el VO 2 máx de la muestra empleada.En otro estudio realizado con 24 sujetos estadounidenses con una media de edad de 70 años, la realización de un programa de fuerza resistencia durante 3 meses se relacionó con mejoras significativas del 38% en la resistencia cardiorrespiratoria submáxima al caminar comparando el test inicial y final27 . Asimismo, otra investigación con 30 adultos mayores de 60 años sudamericanos, que realizaron un programa de ejercicio físico durante 10 semanas (3 sesiones/sem), señaló mejoras en el VO 2 máx, incidiendo en la mejora del sistema respiratorio y la capacidad vital29 .Por otro lado, en el presente estudio, los varones alcanzan mejoras más pronunciadas que las mujeres en 2 de las 3 franjas de edad estudiadas, siendo en la franja de edad de 48-55 años, donde las mujeres mejoran más los valores medios. ...
Article
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Objective The aim of the study was to assess the influence of a physical exercise programme on VO2max in sedentary subjects with cardiovascular risk factors. Materials and methods The sample was composed of 214 patients (80 males, 134 females) with an average age of 52 years, who were referred to a physical exercise programme from 2 primary care centres of Spanish southeast. It was implemented a 10 week programme (3 training × 1 h/week) combining strength with cardiorespiratory fitness. TheVO2max was analysed through the Rockport Walk Test (RWT) comparing the pre and post programme measurements. Results The results show significant improvements on VO2max for both genders (p < 0.05). The most pronounced increase in VO2max was among males in the highest age band (56–73 years). Conclusions Prescribing and referral exercise programmes from primary care centres must be considered as a resource for improving cardiorespiratory fitness in the population studied.
... En la misma, se llevaron a cabo 3 sesiones de 40 min semanales durante 24 semanas, donde se combinaba dentro de la misma sesión entrenamientos de resistencia aeróbica, manteniendo la intensidad en la zona de quema de grasa, con entrenamiento de fuerza (sentadilla y press de banca); los autores concluyen que el entrenamiento condujo a mejoras significativas en el VO 2 máx19 . En nuestro estudio, se realizaron de forma separada sesiones de resistencia cardiovascular y de fuerza muscular, teniendo más peso la sesiones de fuerza en el total de semanas, y reportando en su conjunto mejoras en el VO 2 máx de la muestra empleada.En otro estudio realizado con 24 sujetos estadounidenses con una media de edad de 70 años, la realización de un programa de fuerza resistencia durante 3 meses se relacionó con mejoras significativas del 38% en la resistencia cardiorrespiratoria submáxima al caminar comparando el test inicial y final27 . Asimismo, otra investigación con 30 adultos mayores de 60 años sudamericanos, que realizaron un programa de ejercicio físico durante 10 semanas (3 sesiones/sem), señaló mejoras en el VO 2 máx, incidiendo en la mejora del sistema respiratorio y la capacidad vital29 .Por otro lado, en el presente estudio, los varones alcanzan mejoras más pronunciadas que las mujeres en 2 de las 3 franjas de edad estudiadas, siendo en la franja de edad de 48-55 años, donde las mujeres mejoran más los valores medios. ...
Article
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Introduction: A sedentary lifestyle is indicated in the international literature as one of the main causes for the onset of some cardiovascular risk factors. Objective: To assess the effect of a therapeutic physical exercise programme on different clinical indicators related to dyslipidaemia (total cholesterol, HDL and LDL) in sedentary subjects with a cardiovascular risk factor. Method: Intervention study with before-and-after evaluation of a sample of 340 patients (132 males and 208 females) referred from the 2 primary care centres of the municipality of Molina de Segura (Murcia), and who participated in a 30-week programme of physical exercise combining muscle-conditioning work circuits with other cardio-respiratory resistance workouts. Regarding the clinical indicators, the health professionals collected in the medical history the health indicators corresponding to the biological evolution of the process for which the subjects studied had started the physical exercise programme. Results: The statistical analyses showed a significant improvement (p<.005) in the LDL indicator and a non-significant improvement in total and HDL cholesterol indicators after a 3-month exercise programme of 3 weekly sessions. Conclusions: The prescription of physical exercise in dyslipidaemic subjects from primary care centre should be evaluated as a resource for improving the clinical indicators specific to their pathology.
... En la misma, se llevaron a cabo 3 sesiones de 40 min semanales durante 24 semanas, donde se combinaba dentro de la misma sesión entrenamientos de resistencia aeróbica, manteniendo la intensidad en la zona de quema de grasa, con entrenamiento de fuerza (sentadilla y press de banca); los autores concluyen que el entrenamiento condujo a mejoras significativas en el VO 2 máx19 . En nuestro estudio, se realizaron de forma separada sesiones de resistencia cardiovascular y de fuerza muscular, teniendo más peso la sesiones de fuerza en el total de semanas, y reportando en su conjunto mejoras en el VO 2 máx de la muestra empleada.En otro estudio realizado con 24 sujetos estadounidenses con una media de edad de 70 años, la realización de un programa de fuerza resistencia durante 3 meses se relacionó con mejoras significativas del 38% en la resistencia cardiorrespiratoria submáxima al caminar comparando el test inicial y final27 . Asimismo, otra investigación con 30 adultos mayores de 60 años sudamericanos, que realizaron un programa de ejercicio físico durante 10 semanas (3 sesiones/sem), señaló mejoras en el VO 2 máx, incidiendo en la mejora del sistema respiratorio y la capacidad vital29 .Por otro lado, en el presente estudio, los varones alcanzan mejoras más pronunciadas que las mujeres en 2 de las 3 franjas de edad estudiadas, siendo en la franja de edad de 48-55 años, donde las mujeres mejoran más los valores medios. ...
Article
Full-text available
Objective: The aim of the study was to assess the influence of a physical exercise program on VO2max in sedentary subjects with cardiovascular risk factors. Materials and methods: The sample was composed of 214 patients (80 males, 134 females) with an average age of 52 years, who were referred to a physical exercise program from 2 primary care centres of Spanish southeast. It was implemented a 10 week program (3 training×1h/week) combining strength with cardiorespiratory fitness. TheVO2max was analyzed through the Rockport Walk Test (RWT) comparing the pre and post program measurements. Results: The results show significant improvements on VO2max for both genders (p<0,05). The most pronounced increase in VO2max was among males in the highest age band (56-73 years). Conclusions: Prescribing and referral exercise programs from primary care centers must be considered as a resource for improving cardiorespiratory fitness in the population studied.
... For example, Vincent et al. noted that 6 months of wholebody PRT increased peak oxygen uptake by 22% and treadmill time to exhaustion by 26% in elderly (60-85 years) men and women [172]. Similarly, 10-12 weeks of high intensity PRT has been found to improve time to exhaustion while cycling (47%), running (12%) and walking (38%) [173,174]. ...
... While exercise can help mitigate the reductions in strength (Gross et al., 1998) and stamina (Talbot et al., 2000) with increasing age, the overall trend cannot be stopped (Ades et al., 1996;Talbot et al., 2000). The best option for many people to be mobile is then the use of assistive technologies. ...
Article
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Muscle weakness—which can result from neurological injuries, genetic disorders, or typical aging—can affect a person's mobility and quality of life. For many people with muscle weakness, assistive devices provide the means to regain mobility and independence. These devices range from well-established technology, such as wheelchairs, to newer technologies, such as exoskeletons and exosuits. For assistive devices to be used in everyday life, they must provide assistance across activities of daily living (ADLs) in an unobtrusive manner. This article introduces the Myosuit, a soft, wearable device designed to provide continuous assistance at the hip and knee joint when working with and against gravity in ADLs. This robotic device combines active and passive elements with a closed-loop force controller designed to behave like an external muscle (exomuscle) and deliver gravity compensation to the user. At 4.1 kg (4.6 kg with batteries), the Myosuit is one of the lightest untethered devices capable of delivering gravity support to the user's knee and hip joints. This article presents the design and control principles of the Myosuit. It describes the textile interface, tendon actuators, and a bi-articular, synergy-based approach for continuous assistance. The assistive controller, based on bi-articular force assistance, was tested with a single subject who performed sitting transfers, one of the most gravity-intensive ADLs. The results show that the control concept can successfully identify changes in the posture and assist hip and knee extension with up to 26% of the natural knee moment and up to 35% of the knee power. We conclude that the Myosuit's novel approach to assistance using a bi-articular architecture, in combination with the posture-based force controller, can effectively assist its users in gravity-intensive ADLs, such as sitting transfers.
... It is generally accepted that aerobic training leads to larger increases in aerobic capacity compared to resistance training [12,19]. However, while some investigators observed no effect of RT on VO 2max [20], others reported a beneficial effect on VO 2max and walking endurance [36][37][38]. ...
Article
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Background Older adults are encouraged to participate in regular physical activity to counter the age-related declines in physical and cognitive health. Literature on the effect of different exercise training modalities (aerobic vs resistance) on these health-related outcomes is not only sparse, but results are inconsistent. In general, it is believed that exercise has a positive effect on executive cognitive function, possibly because of the physiological adaptations through increases in fitness. Indications are that high-intensity interval training is a potent stimulus to improve cardiovascular fitness, even in older adults; however, its effect on cognitive function has not been studied before.Therefore, the purpose of this study was to compare the effects of resistance training, high-intensity aerobic interval training and moderate continuous aerobic training on the cognitive and physical functioning of healthy older adults. Methods Sixty-seven inactive individuals (55 to 75 years) were randomly assigned to a resistance training (RT) group (n = 22), high-intensity aerobic interval training (HIIT) group (n = 13), moderate continuous aerobic training (MCT) group (n = 13) and a control (CON) group (n = 19) for a period of 16 weeks. Cognitive function was assessed with a Stroop task and physical function with the Timed-Up-and-Go (TUG) and submaximal Bruce treadmill tests. ResultsNo significant GROUP x TIME interaction was found for Stroop reaction time (P > .05). The HIIT group showed the greatest practical significant improvement in reaction time on the information processing task, i.e. Stroop Neutral (ES = 1.11). MCT group participants had very large practical significant improvements in reaction time on the executive cognitive tasks, i.e. Stroop Incongruent and Interference (ES = 1.28 and 1.31, respectively). The HIIT group showed the largest practically significant increase in measures of physical function, i.e. walking endurance (ES = 0.91) and functional mobility (ES = 0.36). ConclusionsMCT and RT proved to be superior to HIIT for the enhancement of older individuals’ executive cognitive function; whereas HIIT were most beneficial for improvement in information processing speed. HIIT also induced the largest gains in physical function.
... Of course, it is known that resistance training requires the musculature of the body to move against some type of resistance [50]. In this way, it was demonstrated that in healthy older men, strength training elevates mood and helps to build muscle tissue and reduce body fat [51][52][53][54][55][56][57]. ...
Article
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Although the importance of resistance training for a variety of health benefits has been recognized for quite some time, its effects on the risk of different types of cancer is not yet clear and additional research into this area has been recommended. Thus, in the present report we will summarize the most important updates on how exercising and especially resistance training could be or not correlated with the very complex cancer pathology. In this way, the recommendation for moderate to vigorous physical activity and resistance training are supported by the current level of knowledge in this area, which shows a reduction in risk of death from cancer as a result of increased cardiorespiratory fitness and muscular strength. In addition, the available data suggests that physical training programs have beneficial effects on the physical or psychosocial capacity of the cancer patients, with improved aerobic capacity, muscle strength and quality of life. Based on these findings, it seems that it could be recommended for the strength training to be incorporated for decreasing the risk of developing cancer, as well as for cancer rehabilitation, with careful screening of the patients and their supervises during training.
... Resistance training has also been shown to improve walking endurance in older individuals. Ades, et al., (1996) studied the effect of a resistance training programme on walking endurance in a healthy, community-dwelling elderly population. Participants in the resistance-training programme increased submaximal walking endurance by 38%, whereas no change was seen in controls. ...
... In CHD patients, increasing muscle strength and function can help improve health features such as insulin resistance, endothelial function, and quality of life [7]. As well, resistance exercise positively affects proprioceptive abilities, thereby leading to a gradual improvement in coordination and gait control, which reduces the risk of falls [7][8][9]. ...
Article
Background: Isometric strengthening has been rarely studied in patients with coronary heart disease (CHD), mainly because of possible potential side effects and lack of appropriate and reliable devices. Objective: We aimed to compare 2 different modes of resistance training, an isometric mode with the Huber Motion Lab (HML) and traditional strength training (TST), in CHD patients undergoing a cardiac rehabilitation program. Design: We randomly assigned 50 patients to HML or TST. Patients underwent complete blinded evaluation before and after the rehabilitation program, including testing for cardiopulmonary exercise, maximal isometric voluntary contraction, endothelial function and body composition. Results: After 4 weeks of training (16 sessions), the groups did not differ in body composition, anthropometric characteristics, or endothelial function. With HML, peak power output (P = 0.035), maximal heart rate (P < 0.01) and gain of force measured in the chest press position (P < 0.02) were greater after versus before training. Conclusion: Both protocols appeared to be well tolerated, safe and feasible for these CHD patients. A training protocol involving 6 s phases of isometric contractions with 10 s of passive recovery on an HML device could be safely implemented in rehabilitation programs for patients with CHD and improve functional outcomes.
... In this regard, several studies have shown the beneficial effect of physical activity. Strength training prevents muscle wasting [55][56] and preserves physical independence, while aerobic exercise reduces the risk of cardiovascular events. [57][58] Less clear are the findings about the role of leisure-time physical activity in attenuating the development of sarcopenia and the increase of body fat, while some studies showed no effect on fat-free mass loss, 59 nor relationship with appendicular skeletal muscle mass, 60 other findings [61][62] suggest that leisure-time physical activity could delay fat-free mass loss and fat mass (FM) gain. ...
... Of course, it is known that resistance training requires the musculature of the body to move against some type of resistance [50]. In this way, it was demonstrated that in healthy older men, strength training elevates mood and helps to build muscle tissue and reduce body fat [51][52][53][54][55][56][57]. ...
... Leg strength could also be crucial for activities of daily living, playing a role in important activities such as walking, getting up and down from a chair, climbing stairs. Increases in leg strength have been significantly associated with increases in walking endurance in older adults [59]. Therefore, the final activity participants were asked to perform with the resistance bands activated the leg muscles. ...
... For example, 16 weeks of chronic aerobic exercise training increased peak oxygen uptake in muscle from older individuals and this occurred coincident with higher citrate synthase activity and mRNA levels of ETC subunits, PGC-1α, and its downstream effector proteins NRF-1 and Tfam ( Short et al. 2003). In addition to the beneficial adaptations evoked by endurance-type training on muscle mitochondria, data also support the use of resistance training in older adults ( Ades et al. 1996;Jubrias et al. 2001). A recent study investigating the effects of 8 weeks of combined endurance and resistance training in young and older adults reported greater changes in body composition, skeletal muscle mass and strength, and mitochondrial OXPHOS and biogenesis markers when compared to each of the interventions alone ( Irving et al. 2015). ...
Article
Mitochondria are negatively affected by aging leading to their inability to adapt to higher levels of oxidative stress and this ultimately contributes to the systemic loss of muscle mass and function termed sarcopenia. Since mitochondria are central mediators of muscle health, they have become highly sought after targets of physiological and pharmacological interventions. Exercise is the only known strategy to combat sarcopenia and this is largely mediated through improvements in mitochondrial plasticity. More recently a critical role for mitochondrial turnover in preserving muscle has been postulated. Specifically, cellular pathways responsible for the regulation of mitochondrial turnover including biogenesis, dynamics, and autophagy may become dysregulated during aging resulting in the reduced clearance and accumulation of damaged organelles within the cell. When mitochondrial quality is compromised and homeostasis is not re-established, myonuclear cell death is activated and muscle atrophy ensues. In contrast, acute and chronic exercise attenuates these deficits restoring mitochondrial turnover and promoting a healthier mitochondrial pool that leads to the preservation of muscle. Additionally, the magnitude of these exercise-induced mitochondrial adaptations is currently debated with several studies reporting a lower adaptability of old muscle relative to young but the processes responsible for this diminished training response are unclear. Based on these observations, understanding the molecular details of how advancing age and exercise influence mitochondria in older muscle will provide invaluable insight into the development of exercise protocols that will maximize beneficial adaptations in the elderly. This information will also be imperative for future research exploring pharmacological targets of mitochondrial plasticity. This article is protected by copyright. All rights reserved.
... The increase in leg strength is postulated as aiding older adults to work at lower percentages of their peak strength with a given workload, thereby using anaerobic mechanisms to a lesser degree. 25 In contrast, the CG experienced significantly reduced aerobic endurance, gait speed and balance. ...
... CR has been shown to decrease morbidity and mortality in patients with established and unrepaired cardiac disease, [14][15][16][17] and to be safe for patients who are elderly [18][19][20][21][22] and suffer heart failure, 16 23-25 in both hospital and community-based settings. 15 26 27 A meta-analysis of randomised controlled trials reported that patients attending CR have a 20% and 26% relative reduction in all-cause morbidity and cardiac mortality, respectively, as compared with patients not attending CR. 28 The proposed study has been designed according to the evidence-based, best practice guidelines published by the Canadian Association of Cardiac Rehabilitation, 29 the recently published Canadian Cardiovascular Society Quality Indicators for CR 30 and the guidelines for exercise prescription in patients with cardiovascular disease according to the American College of Sports Medicine. ...
Article
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Introduction Frailty is a geriatric syndrome characterised by reductions in muscle mass, strength, endurance and activity level. The frailty syndrome, prevalent in 25–50% of patients undergoing cardiac surgery, is associated with increased rates of mortality and major morbidity as well as function decline postoperatively. This trial will compare a preoperative, interdisciplinary exercise and health promotion intervention to current standard of care (StanC) for elective coronary artery bypass and valvular surgery patients for the purpose of determining if the intervention improves 3-month and 12-month clinical outcomes among a population of frail patients waiting for elective cardiac surgery. Methods and analysis This is a multicentre, randomised, open end point, controlled trial using assessor blinding and intent-to-treat analysis. Two-hundred and forty-four elective cardiac surgical patients will be recruited and randomised to receive either StanC or StanC plus an 8-week exercise and education intervention at a certified medical fitness facility. Patients will attend two weekly sessions and aerobic exercise will be prescribed at 40–60% of heart rate reserve. Data collection will occur at baseline, 1–2 weeks preoperatively, and at 3 and 12 months postoperatively. The primary outcome of the trial will be the proportion of patients requiring a hospital length of stay greater than 7 days. Potential impact of study The healthcare team is faced with an increasingly complex older adult patient population. As such, this trial aims to provide novel evidence supporting a health intervention to ensure that frail, older adult patients thrive after undergoing cardiac surgery. Ethics and dissemination Trial results will be published in peer-reviewed journals, and presented at national and international scientific meetings. The University of Manitoba Health Research Ethics Board has approved the study protocol V.1.3, dated 11 August 2014 (H2014:208). Trial registration number The trial has been registered on ClinicalTrials.gov, a registry and results database of privately and publicly funded clinical studies (NCT02219815).
... This result is similar to those previously reported, showing that resistance training improved both leg strength and walking endurance in healthy older adults. 47 Resistance training with highintensity and high-frequency for 5 months in older females significantly improved muscular strength, physical fitness, quality of life and cognitive function. 48 Besides, subjects in this study significantly increased all measurements of physical fitness and UP&GO, even though the intensity of the resistance training was 50% 1RM. ...
Article
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OBJECTIVE: To identify effects of shortening and lengthening low-intensity resistance exercise together with aerobic exercise on physical fitness and muscular strength in senior adults. METHOD: Seventeen males (58-72yrs) and sixteen females (58-68yrs) participated in this study: seven male and six female as control subjects, ten male and ten female as exercise subjects: these subjects completed an 8-week training program (two times/week) consisting of 15 minutes of aerobike exercise at 50% of VO2max and six shortening-lengthening resistance exercises (3 exercises for upper body and 3 exercises for lower body). The subjects exercised resistance training (5 sec for shortening, 5 sec for lengthening) at 50% of one repetition maximum. Primary outcome measures included physical fitness tests (grip strength, sit-ups, sit-and-reach, 6 minutes of walking, single-leg balance test with open eyes), timed up-and-go test (UP&GO), and one repetition maximum of the same six exercises. This study examined joint angle of knee flexion and elbow flexion, visual analog scale, and muscular strength test to identify delayed onset muscle soreness. RESULTS: The resting blood pressures in both exercising groups were significantly decreased after 16 sessions of exercise intervention (p < 0.05). The training group significantly increased muscular strength and improved physical fitness, UP&GO, and one repetition maximum of 6 resistance exercises (p < 0.05). The combined exercise did not induce delayed onset muscle soreness. CONCLUSION: The present study showed that the combined shortening and lengthening resistance training with aerobic exercise in senior male and female adults was effective in decreasing blood pressure and increasing muscular strength and physical fitness.
... Furthermore, as explained earlier, mitochondrial dysfunctions occur during aging and contribute to muscle failure. Resistance training may improve the physical functioning of elderly people through increases in walking endurance, leg strength, and oxidative capacity [136][137][138]. As frailty occurs frequently with aging, training intensity should be adjusted to protect old people from traumatic injuries. ...
Chapter
As we grow older, we are subjected to a decline in muscle mass and strength and global alteration in cell metabolism, leading to poor physical performance. In this chapter, the modulation of mechanisms involved in skeletal muscle organelle turnover during aging, especially mitochondria, is detailed. In the last decade, studies focused on the pivotal role of several actors involved in mitophagy (i.e., the degradation of mitochondria through autophagy) such as the energy sensor AMPK, FOXO transcription factors, and the E3 ubiquitin ligases Parkin, Mul1, and Mdm2. Importantly, studies performed in sports sciences have well recognized the central role of exercise to limit alterations of mitochondrial quality control during aging. Thus, the critical role of chronic exercise in the prevention and limitation of age-related disorders is also discussed. A better understanding of the specific functions of these pathways and the effectiveness of exercise is critical to fight detrimental muscle changes that occur with aging. Finally, perspectives are provided to encourage further exploration of this topic.
... Since RT alone improves both leg strength and walking endurance in older adults, Khadanga et al 59 set out to optimize exercise training response in women by combining intensive strength training with HIIT. 72 In this study, 56 women were randomized to either a control status of standard aerobic exercise training (70-85% of peak heart rate) with moderate-intensive RT versus HIIT (90-95% of peak heart rate) along with higher-intensive lower extremity RT three sessions/wk for 12 wk. The mean age of women in this study was 65 ± 11, with a range of 43-98 yr. ...
Article
Purpose: Despite the known benefits of cardiac rehabilitation (CR), it remains underutilized particularly among women. The aim of this review was to provide an overview regarding women in CR, addressing barriers that may affect enrollment and attendance as well as to discuss the training response and methods to optimize exercise-related benefits of CR. Review methods: The review examines original studies and meta-analyses regarding women in CR. Summary: Women are less likely to engage in CR compared with men, and this may be attributed to lack of referral or psychosocial barriers on the part of the patient. Furthermore, despite having lower levels of fitness, women do not improve their fitness as much as men in CR. This review summarizes the current literature and provides recommendations for providers regarding participation and adherence as well as optimal methods for exercise training for women in CR.
... Studies have shown that strength exercises can improve bone mineral density [13,14], lipoprotein profiles [15], glycaemic control [16], insulin resistance [17], and body composition [18]. They improve symptoms of frailty [19,20] and quality of life in elderly patients [21], positively impact on metabolic syndrome risk factors [15] . It definitely plays a major role in human health, both mental and physical. ...
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Unlike in the previous decades, strength training is gaining more scientific attention owing to its numerous benefits on human health. It has major benefits on metabolic processes, cardiovascular system, musculoskeletal system, age-related processes, and mental health. In comparison with aerobic low-intensity exercises, chest press-based strength training cardiovascular adaptations have been ignored for many years. Yet, if properly prescribed and conducted, strength training has shown to be safe and effective in people with cardiovascular disease. This narrative review aims at summarizing the available evidence about the role of chest press-based strength training on the cardiovascular system. Citation: Palermi S, Bragazzi NL, Cular D, Ardigò LP, Padulo J. How chest press-based exercises can alleviate the burden of cardiovascular diseases. Hum Mov.
... Similarly, Oesen et al. (2015) showed that moderate load elastic band resistance training, conducted twice per week during a three months period, was able to enhance functional fitness, assessed by chair stand (11 ± 4 vs 14 ± 4 for pre vs post) and arm lifting test (24 ± 10 vs 28 ± 10 for pre vs post) but not handgrip strength, suggesting that functional fitness can be improved without concomitant increase in strength parameters in elderly (Raymond et al., 2013). Interestingly, this model of resistance training was not able to improve aerobic endurance (6 min walking test), which is contrary to our and several other study findings (Ades et al., 1996;Wieser and Haber, 2007). A significant association (r = -0.632, ...
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Strength training can improve myriad health parameters in elderly cohorts. Although potentially more appropriate for the elderly, low-load resistance training protocols have been less investigated. We aimed to examine the effects of 12 weeks of chair-based, low-load resistance training with elastic band (EBT) on functional fitness and metabolic biomarkers in older women. One hundred sixty-eight women were allocated randomly to an elastic band resistance training (EBT, n = 86, 75.7 ± 8.9 years, 71.3 ± 12.2 kg) or a control group (CON, n = 82, 74.5 ± 8.2years, 70.6 ± 12.0 kg). RT protocol consisted of periodized chair-based, low-load whole-body resistance exercises (2 sets, 12-15 repetitions, 40-60% of one repetition maximum-1RM) using an elastic band, twice weekly for 12 weeks. The resistance training program was generally designed to maintain internal load over time, provided with increasing intensity using various elastic bands (Thera-Band). Functional fitness (30-s Chair Stand,30-s Arm Curl, 2-min Step Test, Chair Sit-and-Reach, Back Scratch, 8-Foot Up-and-Go, Handgrip Strength) and metabolic markers (Fasting blood glucose, triglycerides, total cholesterol, high (HDL) and low (LDL) density lipoprotein) were measured before and after the training period. To detect pre/post intervention changes and between group- differences 2x2 repeated measures ANOVA was applied. Significant improvements over time for all fitness variables for EBT comparing to CON were obtained (F = 12.78, p < 0.05 for 30-s Chair Stand; F = 14.04, p < 0.05 for 30-s Arm Curl; F = 5.18, p < 0.05 for 2-min Step Test; F = 10.90, p < 0.05 for Chair Sit-and-Reach; F = 16.57, p < 0.05 for Back Scratch; F = 11.79, p < 0.05 for 8-foot Up-and-Go; and F = 29.25, p < 0.05 for Handgrip Strength). In addition, significant improvements over time for all but one (triglycerides) biomarkers for EBT comparing to CON were obtained (F = 7.30, p < 0.05 for blood sugar levels; F = 13.36, p < 0.05 for total cholesterol; F = 8.61, p < 0.05 for HDL; and F = 11.53, p < 0.05 for LDL). Furthermore, the participants' adherence to training sessions of over 90% was reported. In conclusion, 12 weeks of EBT is safe and beneficial for improving health-related fitness and metabolic biomarkers in older women and seems to be viable model to ensure a high training adherence rate.
... No presente estudo, foi avaliada a força da musculatura extensora de joelho, a qual aumentou com quatro semanas de treinamento e se associou ao aumento na distância percorrida após o término do treinamento, em acordo com outros autores (11,22). ...
Article
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OBJETIVO: Verificar os efeitos da associação do treinamento aeróbio e resistido nas respostas cardiovasculares de idosos. MÉTODOS: Onze sujeitos (ambos os gêneros, 70 ± 5 anos) realizaram, duas vezes por semana, caminhada e exercícios resistidos para membros inferiores por 12 semanas. As avaliações foram realizadas antes, a cada quatro semanas de treinamento e após quatro semanas de destreinamento, por meio do teste de seis minutos de caminhada e aferição de pressão arterial (PA) e frequência cardíaca (FC) antes, imediatamente após e no quinto e décimo minutos subsequentes ao teste. Os resultados foram comparados pelo teste Wilcoxon (p ≤ 0,05). RESULTADOS: Quatro semanas de treinamento promoveram redução da PA sistólica e diastólica em repouso (120 ± 16 mmHg vs. 138 ± 20 mmHg, p = 0,01; 70 ± 9 mmHg vs. 84 ± 10 mmHg, p = 0,007, respectivamente) e redução da PA diastólica imediatamente após o teste (78 ± 12 mmHg vs. 86 ± 9 mmHg, p = 0,01), que persistiu após dez minutos do esforço submáximo, quando comparadas ao pré-treino. Após 12 semanas, houve aumento da distância percorrida (555 ± 65m vs. 514 ± 100 m, p = 0,04) quando comparado ao pré-treino e recuperação dos valores de repouso da FC dez minutos após o esforço. CONCLUSÃO: A associação do treinamento aeróbio e resistido, em apenas quatro semanas, promoveu adaptações cardiovasculares eficientes na redução da PA sistólica e diastólica. Após 12 semanas, houve aumento da resistência à caminhada submáxima e recuperação dos valores em repouso da FC. Mesmo com o destreinamento, todos os resultados, exceto a FC, foram mantidos.
... Typically, resistance training is not promoted as a means to improve aerobic endurance capacity. However, previous studies have noted resistance training can improve walking endurance and overall physical capacity to carry about aerobic endurancerelated tasks [25]. Regular resistance training also may enhance mitochondrial density and oxidative capacity of muscle tissue [26]. ...
Article
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Research has indicated that older adult participation in resistance training provides foundational strength for performance of activities of daily living. The purpose of this study was to investigate the effects of a six-week progressive resistance training intervention on functional fitness among community-dwelling older adults. From 2010–2015, twelve sessions of a six-week resistance training intervention included 95 community-dwelling older adult participants (37 male, 58 female; Mage=73.5+7.2). Resistance training interventions included bi-weekly, 1-hour sessions targeting all muscle groups. Assessments included arm curl, chair stand, back scratch, chair sit-n-reach, 2-minute step test, and 8 foot-up-and-go. The Wilcoxon Signed-Rank Test was performed to evaluate group differences between baseline and post-intervention. Significant differences between pre- and post-assessments were found for upper- and lower-body strength (z=6.81, p< .001; z=6.46, p< .001, respectively); upper- and lower-body flexibility (z=3.81, p< .001; z=4.85, p< .001, respectively), aerobic endurance (z=6.04, p< .001), and dynamic balance and agility (z=5.52, p< .001). The resistance training intervention resulted in significant improvements in functional fitness among community-dwelling older adult participants. Abbreviations: 1-RM, 1 Repetition Maximum
... Many studies investigating the effect of training on muscle capillarization have utilized aerobic training (Charifi et al., 2004;Gavin et al., 2015;Prior et al., 2014;Prior et al., 2016), as aerobic training is known to promote increases in maximum oxygen uptake and microvasculature improvements. However, growing evidence suggests that progressive resistance exercise training can improve muscle oxidative capacity by increasing both qualitative and quantitative mitochondrial adaptations (i.e., increased VO 2 peak, VO 2 max, CS activity and mitochondrial function) (Ades et al., 1996;Jubrias et al., 2001;Porter et al., 2015;Sparks et al., 2013). Endurance performance and metabolic health are strongly impacted by skeletal muscle mitochondrial content (Goodpaster, 2013;MacInnis et al., 2017). ...
Article
ABSTRACT Objectives: Adequate muscle perfusion supports the transport of nutrients, oxygen and hormones into muscle fibers. Aging is associated with a substantial decrease in skeletal muscle capillarization, fiber size and oxidative capacity, which may be improved with regular physical activity. The aim of this study was to investigate the relationship between muscle capillarization and indices of muscle hypertrophy (i.e. lean mass; fiber cross sectional area (CSA)) in older adults before and after 12 weeks of progressive resistance exercise training (RET). Design: Interventional study Setting and Participants: 19 subjects (10 male and 9 female; 71.1±4.3 years; 27.6±3.2 BMI) were enrolled in the study and performed a whole body RET program for 12 weeks. Subjects where then retrospectively divided into a LOW or HIGH group, based on their pre-RET capillary-to-fiber perimeter exchange index (CFPE). Physical activity level, indices of capillarization (capillaries-to-fiber ratio, C:Fi; CFPE index and capillary-to-fiber interface, LC-PF index), muscle hypertrophy, muscle protein turnover and mitochondrial function were assessed before and after RET. Results: Basal capillarization (C:Fi; CFPE and LP-CF index) correlates with daily physical activity level (C:Fi, r=0.57, p=0.019; CFPE index, r=0.55, p=0.024; LC-PF index, r=0.56, p=0.022) and CFPE and LC-PF indices were also positively associated with oxidative capacity (respectively r=0.45, p=0.06; r=0.67, p=0.004). Following RET, subjects in the HIGH group underwent hypertrophy with significant improvements in muscle protein synthesis and muscle fiber CSA (p<0.05). However, RET did not promote muscle hypertrophy in the LOW group, but RET significantly increased muscle capillary density (p<0.05). Conclusion/Implications: Muscle fiber capillarization before starting an exercise training program may be predictive of the muscle hypertrophic response to RET in older adults. Increases in muscle fiber size following RET appear to be blunted when muscle capillarization is low, suggesting that an adequate initial capillarization is critical to achieve a meaningful degree of muscle adaptation to RET.
... Leg strength could also be crucial for activities of daily living, playing a role in important activities such as walking, getting up and down from a chair, climbing stairs. Increases in leg strength have been significantly associated with increases in walking endurance in older adults [59]. Therefore, the final activity participants were asked to perform with the resistance bands activated the leg muscles. ...
... In a randomized control trial of 24 healthy older adults who underwent RT, a significant improvement in leg strength and walking endurance was seen, but peak VO 2 remained unchanged. 32 A recent meta-analysis of 34 studies examined the effects of RT on aerobic fitness and strength in older adults with coronary heart disease and found that while RT improved muscle strength, peak VO 2 and work capacity remained the same. 33 Another review, however, examined whether RT enhanced peak VO 2 in older patients and 6 of the 9 studies reported an improvement in peak VO 2 following RT regardless of the intensity. ...
Article
Cardiac rehabilitation plays a key role in the care of older patients after a coronary event. Hospitalizations are prevented and quality of life, exercise capacity, and physical function are improved. Almost 50% of cardiac rehabilitation participants are older adults (>65 years), many of whom are frail or deconditioned. Resistance training, as a component of cardiac rehabilitation, improves muscle strength, endurance, and physical function. The purpose of this review is to describe the effects of resistance training in cardiac rehabilitation for older adults with a particular focus on physical function.
... It may also improve blood pressure, dyslipidemia, markers of inflammation and catabolism, and visceral obesity, thus addressing many components of metabolic syndrome [4][5][6]. Additionally, PRT has beneficial effects on functional exercise capacity [7,8], osteoarthritis [9], bone health [10], depression and insomnia [11], and cognitive impairment [12], thus addressing many common co-morbidities in older adults with T2D and obesity. Importantly, PRT, in contrast to aerobic exercise, attenuates or prevents the loss of lean tissue accompanying dietary weight loss [13], thus addressing the potential adverse metabolic and clinical effects such a loss of muscle and bone mass may produce [14]. ...
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Background: Type 2 diabetes (T2D) is projected to affect 439 million people by 2030. Medical management focuses on controlling blood glucose levels pharmacologically in a disease that is closely related to lifestyle factors such as diet and inactivity. Physical activity guidelines include aerobic exercise at intensities or volumes potentially unreachable for older adults limited by many co-morbidities. We aim to show for the first time the efficacy of a novel exercise modality, power training (high-velocity, high-intensity progressive resistance training or PRT), in older adults with T2D as a means for improving glycemic control and targeting many associated metabolic and physiological outcomes. Eligibility criteria included community-dwelling men and women previously diagnosed with T2D who met the current definition of metabolic syndrome according to the International Diabetes Federation. Participants were randomized to a fully supervised power training intervention or sham exercise control group for 12 months. Intervention group participants performed whole body machine-based power training at 80%1RM, 3 days per week. The control group undertook the same volume of non-progressive, low-intensity training. Participants were assessed at baseline, 6 months and 12 months and followed for a further 5 years, during which time participants were advised to exercise at moderate-high intensity. Glycemic control (HbA1c) and insulin resistance as measured by the homeostatic model assessment 2 (HOMA2-IR) were the primary outcomes of the trial. Outcome assessors were blinded to group assignment and participants were blinded to the investigators' hypothesis regarding the most effective intervention. Results: We recruited 103 participants (48.5 % women, 71.6 ± 5.6 years). Participants had 5.1 ± 1.8 chronic diseases, had been diagnosed with T2D for 8 ± 6 years and had a body mass index (BMI) of 31.6 ± 4.0 kg/m(2). Fasting glucose and insulin were 7.3 ± 2.4 mmol/L and 10.6 ± 6.3 mU/L, respectively. HbA1c was 54 ± 12 mmol/mol. Eighty-six participants completed the 12-month assessment and follow-up is ongoing. This cohort had a lower-than-expected dropout (n = 14, 14 %) over the 12-month intervention period. Conclusions: Power training may be a feasible adjunctive therapy for improving glycemic control for the growing epidemic of T2D in older adults. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12606000436572 (24 September 2006).
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A fragilidade é conceituada como uma síndrome clínica, que pode ser identificada por perda de peso involuntária, exaustão, fraqueza, diminuição da velocidade da marcha e do equilíbrio e diminuição da atividade física. Cada uma dessas manifestações clínicas é preditora de uma série de reações adversas (quedas, hospitalização, institucionalização, declínio funcional e morte). O objetivo desta revisão de literatura foi expor os elementos sobre a Síndrome da Fragilidade dos Idosos, em uma revisão narrativa da literatura, dando um panorama geral sobre epidemiologia, tendências atuais, ciclo da fragilidade, sarcopenia, alterações imunológicas, alterações neuroendócrinas, diagnósticos clínico, laboratorial e diferencial e as possibilidades de intervenções fisioterapêuticas. Para esses fins, realizou-se revisão bibliográfica da literatura nacional e internacional sobre o tema. Com o conhecimento de estudos envolvendo idosos frágeis, é possível planejar as estratégias voltadas para a identificação da parcela da população que mais se beneficiaria de ações para postergar, atenuar e, se possível, reverter tais desfechos.
Article
Strength training (ST) is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density (BMD). In the past couple of decades, many studies have examined the effects of ST on risk factors for age-related diseases or disabilities. Collectively, these studies indicate that ST in the elderly: (i) is an effective intervention against sarcopenia because it produces substantial increases in the strength, mass, power and quality of skeletal muscle; (ii) can increase endurance performance; (iii) normalises blood pressure in those with high normal values; (iv) reduces insulin resistance; (v) decreases both total and intra-abdominal fat; (vi) increases resting metabolic rate in older men; (vii) prevents the loss of BMD with age; (viii) reduces risk factors for falls; and (ix) may reduce pain and improve function in those with osteoarthritis in the knee region. However, contrary to popular belief, ST does not increase maximal oxygen uptake beyond normal variations, improve lipoprotein or lipid profiles, or improve flexibility in the elderly.
Chapter
Elderly persons are often treated with pharmaceuticals for many different conditions, both for chronic diseases and common ailments in old age. Many prescribed medicines and herbal remedies as well as over the counter purchased drugs are frequently used in the older population. The resulting polypharmacy poses a challenge to physicians to master complicated pharmacological issues and combinations of drugs. Adverse drug effects and interactions between combinations of drugs essential for the medical treatment for chronic diseases such as high blood pressure, diabetes or osteoporosis, are some of the problems to be solved. Often the normal course of aging in the human body gives rise to ailments that should not really be treated with drugs at all. To “medicalise” aging, is to put our patients at risk in many potentially dangerous ways. Sometimes, in a long term perspective, the cure can be worse than the condition itself for the patient. In this chapter common geriatric conditions will be described with special attention to the pharmacological treatment and hazards of drug treatment in the elderly.A number of frequently occurring complaints and ailments in the aging population will be described in connection with drug treatment. Gastrointestinal conditions such as constipation, peptic ulcers, gastritis and dryness of the mouth will be covered as well as kidney failure, urinary incontinence, osteoporosis, falls and fractures, sarcopenia, orthostatic hypotension and vertigo. These chosen examples are conditions that can be treated with, and often should be treated with, drugs. But what are the drawbacks to this?
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Background: Loss of muscle mass and muscle function is a common side effect from androgen deprivation therapy (ADT) for prostate cancer (PCa). Here, we explored effects of heavy-load resistance training (RT) on lean body mass and muscle strength changes reported in randomized controlled trials (RCTs) among PCa patients on ADT and in healthy elderly men (HEM), by comparison of results in separate meta-analysis. Methods: RCTs were identified through databases and reference lists. Results: Seven RCTs in PCa patients (n = 449), and nine in HEM (n = 305) were included. The effects of RT in lean body mass change were similar among PCa patients (Standardized mean difference (SMD): 0.4, 95% CI: 0.2, 0.7) and HEM (SMD: 0.5, 95% CI: 0.2, 0.7). It is noteworthy that the within group changes showed different patterns in PCa patients (intervention: 0.2 kg; control: -0.6 kg) and HEM (intervention: 1.2 kg; control: 0.2 kg). The effects of RT on change in muscle strength (measured as 1 RM) were similar between PCa patients and HEM, both for lower body- (PCa: SMD: 1.9, 95% CI: 1.2, 2.5; HEM: SMD: 2.2, 95% CI: 1.0, 3.4), and for upper body exercises (PCa: SMD: 2.0, 95% CI: 1.3, 2.7; HEM: SMD: 1.9, 95% CI: 1.3, 2.6). Conclusions: The effects of RT on lean body mass and 1 RM were similar in PCa patients on ADT and HEM, but the mechanism for the intervention effect might differ between groups. It seems that RT counteracts loss of lean body mass during ADT in PCa patients, as opposed to increasing lean body mass in HEM.
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.
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[Purpose] Accurate measurement of unaffected lower extremity muscle strength on the unaffected side is useful in patients with hemiparetic stroke; however, muscle strength measurement results in patients with hemiparetic stroke vary greatly compared with those in healthy individuals. The objective of the present study was to determine the characteristics of patients with hemiparetic stroke who yield highly reliable muscle strength measurements. [Subjects and Methods] The subjects were 55 incipient patients with hemiparetic stroke. Muscle strength was measured twice. Based on the measured changes and on error ranges in repeated measurements in previous studies, the subjects were divided into two groups: subjects whose measurement results were within the acceptable range, and those whose measurement results were not within the acceptable range. Logistic regression analysis was performed with this separation of groups as the dependent variable, and demographic data, physical functioning, and functional independence measure (FIM) as independent variables. [Results] From the analysis results, the FIM cognitive subscore was selected as a criterion for patient selection; the cutoff score was 19. [Conclusion] The results of the present study indicated that muscle strength measurements were highly reliable in patients with hemiparetic stroke with an FIM cognitive subscore of ≥19.
Chapter
In planning for health care in the twenty-first century, the increased proportion of elderly patients, who often will have cardiovascular disease and often will require advanced technology diagnostic and therapeutic interventions, must be addressed.323 Comparison must be made of the resources required for and outcomes of palliative care if sophisticated techniques are not under-taken. The use of health care resources will increase not only with increasing age but with the improved expectations of older persons about their health status. At the same time, it will be necessary to avoid overzealous and redundant diagnostic and therapeutic measures. Data are needed to define interventions at old and very old age that favorably affect morbidity and mortality, functional status, and other meaningful quality of life attributes. Preventive aspects will increasingly become important components of care for elderly cardiac patients, and require the development of cost-effective preventive strategies, although it remains uncertain how much extension of years of health and decrease in disability can be anticipated in later life. The decline in premature cardiovascular mortality in recent decades appears an important component in the longevity of the elderly population; however, it is not certain whether the effect of preventive efforts in limiting or delaying cardiovascular disease will ultimately decrease overall health care costs.
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The publication is dedicated to sharing the best experiences of project Erasmus plus partners. We believe that we put together an interesting publication that may serve as motivation for existing and starting U3A but also for universities and spare-time associations which are interested realised U3A sport activities. U3A should be seen as a comprehensive educational and counselling system for the older citizens mostly in their retirement age. Demands on the organization and the educational process are different than the education of children, youth, or adults. The education of seniors has its own specifics which should be respected. In the monograph are best practise from Slovakia (Zvolen), Poland (Lubsko), Czech Republic (Brno), Portugal (RUTIS) and Spain (Coruna). We believe this publication is going to urge the progress of senior sport activities in Europe and it is going to aid in drawing attention to the words – University of the third age.
Article
Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res XX(X): 000-000, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.
Thesis
L'insuffisance cardiaque chronique (ICC) est une maladie dite " systémique " caractérisée notamment par le dérèglement de la balance végétative cardiaque et par un remodelage de l'architecture du tissu cardiaque. En rééducation cardiovasculaire, l'activité physique (AP) modérée et régulière joue un rôle majeur : améliorant les symptômes, la qualité de vie, l'aptitude physique des patients, elle permet de réduire les ré-hospitalisations et impacte favorablement la morbi-mortalité. Dans un premier travail bibliographique nous proposons une synthèse des effets bénéfiques de l'AP chez l'ICC, sur le rééquilibrage de l'activité orthosympathique et parasympathique. Puis, dans un deuxième travail, nous montrons que le réentraînement à l'effort par intervalles, court, intense, avec récupération passive améliore plus efficacement la capacité physique et le tonus vagal chez le patient ICC comparativement à un entraînement d'intensité modérée et continue. Enfin dans un troisième travail initié chez le rongeur en IC systolique post-ischémique, les analyses histologiques indiquent que l'entraînement débuté très tôt après la phase aigüe (J+7), provoque à la fois une hypertrophie et une amélioration de l'organisation structurelle des cardiomyocytes (alignement de l'appareil contractile, réorganisation de l'agencement des mitochondries inter-fibrillaires et des disques intercalaires). Par contre, la question de la prolifération des cardiomyocytes induite par l'entraînement reste entière pour le moment. En synthèse, notre projet Doctoral s'articule autour d'un projet clinique chez le patient ICC et d'une étude fondamentale chez la souris IC post-ischémique. L'objectif général de ces travaux est de déterminer de nouvelles caractéristiques pour les programmes d'exercice physique dans l'ICC, utilisables en pratique clinique courante au cours de la réadaptation cardiovasculaire.
Article
Purpose: Directly measured peak aerobic capacity or oxygen uptake (VO2peak) is a powerful predictor of prognosis in individuals with cardiovascular disease. Women enter phase 2 cardiac rehabilitation (CR) with lower VO2peak and their response to training, compared with men, is equivocal. We analyzed VO2peak at entry and exit in patients participating in CR and improvements by diagnosis to assess training response. We also identified sex differences that may influence change in VO2peak. Methods: The cohort included consecutive patients enrolled in CR between January 1996 and December 2015 who performed entry exercise tolerance tests. Data collected included demographics, index diagnosis, VO2peak, and exercise training response. Results: The cohort consisted of 3925 patients (24% female). There was a significant interaction between baseline VO2peak and diagnosis (P < .001), with percutaneous coronary intervention and myocardial infarction greater than other diagnoses. Surgical patients demonstrated greater improvement in VO2peak than nonsurgical diagnoses (n = 1789; P < .001). Women had lower VO2peak than men for all diagnoses (P < .02) and demonstrated less improvement (13 vs 17%, P < .001). Percent improvement using estimated metabolic equivalents of task (METs) were similar for women and men (33 vs 31%, P = NS). Despite overall increases in VO2peak, 18% of patients (24% women, 16% men) failed to demonstrate any improvement (exit VO2peak ≤ entry VO2peak). Conclusions: While there were no differences in training effect estimated by METs, directly measured VO2peak showed a significantly lower training response for women despite adjusting for covariates. In addition, 18% of patients did not see any improvement in VO2peak. Alternatives to traditional CR exercise programming need to be considered.
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Background Reductions in muscle size and strength occur with aging. These changes can be mitigated by participation in resistance training. At present, it is unknown if sex contributes to differences in adaptation to resistance training in older adults. Objective The aim of this systematic review was to determine if sex differences are apparent in adaptations to resistance training in older adults. Design Systematic review with meta-analysis. Data Sources Web of Science; Science Direct; SPORTDiscus; CINAHL; and MEDLINE were searched from inception to June 2020. Eligibility Criteria Studies where males and females older than 50 years of age performed identical resistance training interventions and had outcome measures of muscle strength or size. Results We initially screened 5337 studies. 30 studies (with 41 comparison groups) were included in our review (1410 participants; 651 males, 759 females). Mean study quality was 14.7/29 on a modified Downs and Black checklist, considered moderate quality. Females gained more relative lower-body strength than males (g = − 0.21 [95% CI − 0.33, − 0.10], p = 0.0003) but there were no differences in relative change for upper-body strength (g = − 0.29 [95% CI − 0.62, 0.04], p = 0.08) or relative muscle size (g = 0.10 [95% CI − 0.04, 0.23], p = 0.16). Males gained more absolute upper-body strength (g = 0.48 [95% CI 0.09, 0.88], p = 0.016), absolute lower-body strength (g = 0.33 [95% CI 0.19, 0.47], p < 0.0001), and absolute muscle size (g = 0.45 [95% CI 0.23, 0.66], p < 0.0001). Conclusion Our results indicate that sex differences in adaptations to resistance training are apparent in older adults. However, it is evident that the interpretation of sex-dependent adaptations to resistance training is heavily influenced by the presentation of the results in either an absolute or relative context. Study Registration Open Science Framework (osf.io/afn3y/).
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The regulation of skeletal muscle mass and organelle homeostasis is dependent on the capacity of cells to produce proteins and to recycle cytosolic portions. In this investigation, the mechanisms involved in skeletal muscle mass regulation—especially those associated with proteosynthesis and with the production of new organelles—are presented. Thus, the critical roles of mammalian/mechanistic target of rapamycin complex 1 (mTORC1) pathway and its regulators are reviewed. In addition, the importance of ribosome biogenesis, satellite cells involvement, myonuclear accretion, and some major epigenetic modifications related to protein synthesis are discussed. Furthermore, several studies conducted on the topic of exercise training have recognized the central role of both endurance and resistance exercise to reorganize sarcomeric proteins and to improve the capacity of cells to build efficient organelles. The molecular mechanisms underlying these adaptations to exercise training are presented throughout this review and practical recommendations for exercise prescription are provided. A better understanding of the aforementioned cellular pathways is essential for both healthy and sick people to avoid inefficient prescriptions and to improve muscle function with emergent strategies (e.g., hypoxic training). Finally, current limitations in the literature and further perspectives, notably on epigenetic mechanisms, are provided to encourage additional investigations on this topic.
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Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown.Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults. Our primary outcome was body fat percentage; secondary outcomes were body fat mass and visceral fat.DesignSystematic review with meta-analysis.Data SourcesWe searched five electronic databases up to January 2021.Eligibility CriteriaWe included randomised trials that compared full-body resistance training for at least 4 weeks to no-exercise control in healthy adults.AnalysisWe assessed study quality with the TESTEX tool and conducted a random-effects meta-analysis, with a subgroup analysis based on measurement type (scan or non-scan) and sex (male or female), and a meta-regression for volume of resistance training and training components.ResultsFrom 11,981 records, we included 58 studies in the review, with 54 providing data for a meta-analysis. Mean study quality was 9/15 (range 6–15). Compared to the control, resistance training reduced body fat percentage by − 1.46% (95% confidence interval − 1.78 to − 1.14, p < 0.0001), body fat mass by − 0.55 kg (95% confidence interval − 0.75 to − 0.34, p < 0.0001) and visceral fat by a standardised mean difference of − 0.49 (95% confidence interval − 0.87 to − 0.11, p = 0.0114). Measurement type was a significant moderator in body fat percentage and body fat mass, but sex was not. Training volume and training components were not associated with effect size.Summary/Conclusions Resistance training reduces body fat percentage, body fat mass and visceral fat in healthy adults.Study Registrationosf.io/hsk32.
Article
Importance Despite lower baseline fitness levels, women in cardiac rehabilitation (CR) do not typically improve peak aerobic exercise capacity (defined as peak oxygen uptake [peak Vo2]) compared with men in CR. Objective To evaluate the effect of high-intensity interval training (HIIT) and intensive lower extremity resistance training (RT) compared with standard moderate intensity continuous training (MCT) on peak Vo2 among women in CR. Design, Setting, and Participants This randomized clinical trial conducted from July 2017 to February 2020 included women from a community-based cardiac rehabilitation program affiliated with a university hospital in Vermont. A total of 56 women (mean [SD] age, 65 [11] years; range 43-98 years) participating in CR enrolled in the study. Interventions MCT (70% to 85% of peak heart rate [HR]) with moderate intensive RT or HIIT (90% to 95% of peak HR) along with higher-intensity lower extremity RT 3 times per week over 12 weeks. Main Outcomes and Measures The primary outcome was the between-group difference in change in peak Vo2 (L/min) from baseline to 12 weeks. Results Peak Vo2 increased to a greater degree in the HIIT group (+23%) than in the control group (+7%) (mean [SD] increase, 0.3 [0.2] L/min vs 0.1 [0.2] L/min; P = .03). Similarly, the change in leg strength was greater in the HIIT-RT group compared with the control group (mean [SD] increase, 15.3 [0.3] kg vs 6.4 [1.1] kg; P = .004). Conclusions and Relevance An exercise protocol combining HIIT and intensive lower extremity RT enhanced exercise training response for women in CR compared with standard CR exercise training. Women randomized to HIIT experienced significantly greater improvements in both peak Vo2 and leg strength during CR. Trial Registration ClinicalTrials.gov Identifier: NCT03438968
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Mitochondrial dysfunction may contribute to age-associated muscle atrophy. Previous data has shown that resistance exercise (RE) increases mitochondrial gene expression and enzyme activity in older adults; however, the acute response to RE has not been well characterized. To characterize the acute mitochondrial response to unaccustomed RE, healthy young (21±3 y) and older (70±4 y) men performed a unilateral RE bout for the knee extensors. Muscle biopsies were taken at rest and 3, 24 and 48 h following leg press and knee extension exercise. The expression of the mitochondrial transcriptional regulator PGC-1α mRNA was increased at 3 h post-exercise; however, all other mitochondrial variables decreased over the post-exercise period, irrespective of age. ND1, ND4 and CS mRNA were all lower at 48 h post-exercise, along with specific protein subunits of complex II, III, IV and ATP synthase. Mitochondrial DNA (mtDNA) copy number decreased by 48 h post-exercise, and mtDNA deletions were higher in the older adults and remained unaffected by acute exercise. Elevated mitophagy could not explain the reduction in mitochondrial proteins and DNA, as there was no increase in ubiquitinated VDAC or its association with Pink1 or Parkin, and elevated p62 content indicated an impairment or reduction in autophagocytic flux. In conclusion, age did not influence the response of specific mitochondrial transcripts, proteins and DNA to a bout of RE. Copyright © 2014, American Journal of Physiology - Regulatory, Integrative and Comparative Physiology.
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