Article

Effects of 8-week kettlebell training on body composition, muscle strength, pulmonary function, and chronic low-grade inflammation in elderly women with sarcopenia

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Abstract

Objectives: To examine the effect of kettlebell training on body composition, muscle strength, pulmonary function, and chronic low-grade inflammatory markers among elderly people with sarcopenia. Design: Randomized controlled trial. Setting: Community center and research center. Participants: A total of 33 elderly women with sarcopenia (aged 65-75 years) were recruited. Intervention: The participants were randomly assigned to a kettlebell training (KT) group or a control (CON) group. The KT group received an 8-week training intervention involving 60-min sessions twice a week, whereas the CON group members continued their daily lifestyles without participating in any exercise training. Four weeks of detraining were organized to observe the retention effect of the training program on the KT group. Measurements: The participants' body composition, muscle strength, pulmonary function, and chronic low-grade inflammatory markers were measured and analyzed before training (at Week 0, W0), after 8 weeks of training (at Week 8, W8), and after 4 weeks of detraining (at Week 12, W12). Results: In the KT group, appendicular skeletal muscle mass (ASM) and the sarcopenia index measured at W8 and W12 were significantly higher than those at W0(p = .004; p = .005). At W8 and W12, the sarcopenia index was significantly higher in the KT group than the CON group(p = .020; p = .019). In the CON group, the skeletal muscle mass levels measured at W8 and W12 were significantly lower than that at W0(p = .029; p = .005), and the ASM and the sarcopenia index measured at W8 were significantly lower than those at W0(p = .037; p = .036). Additionally, the measured left handgrip strength(p = .006), back strength(p = .011; p = .018), and peak expiratory flow (PEF) (p = .008; p = .006) were significantly higher in the KT group than the CON group at W8 and W12. At W8, the measured right handgrip strength was significantly higher in the KT group than the CON group(p = .043). In the KT group, the back strength and PEF levels measured at W8 and W12 were significantly higher than those at W0(p = .000; p = .004), and the left and right handgrip strength levels at W8 were significantly higher than those at W0(p = .004; p = .013). By contrast, in the CON group, the left(p = .004; p = .006)and right(p = .002; p = .004)handgrip strength levels and PEF(p = .018; p = .012) measured at W8 and W12 were significantly lower than those at W0. Moreover, compared with the high-sensitivity C-reactive protein (hs-CRP) levels measured at W0, those measured at W8 and W12 were significantly lower in the KT group(p = .006; p = .013)but significantly higher in the CON group(p = .005; p = .009). There was no significant difference in hs-CRP, IL-6, TNF-α between the KT and CON group. Conclusion: For elderly people with sarcopenia, participating in kettlebell training significantly increases the sarcopenia index, grip strength, back strength, and PEF. In addition, the retention effect of the training program continued after 4 weeks of detraining.

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... All the trials used parallel designs. [23][24][25][26][27][28][29][30][31][32][33][34] The studies included 482 postmenopausal women (age, 52-89 y). The studies were ...
... 29 Most of the studies (8, 67%) included postmenopausal women with different comorbidities and cardiovascular risk factors, such as high blood pressure, type II diabetes, dyslipidemia, fibromyalgia, osteoarthritis, rheumatoid arthritis, hypothyroidism, sarcopenia, metabolic syndrome, obesity, and Crohn's disease. [23][24][25][26][29][30][31]34 Two trials (17%) investigated healthy women, 32,33 and two (17%) did not provide this information on comorbidities (Table 1). 27,28 Description of the interventions Most of the RT programs comprised an initial warm-up of 10 minutes, followed by 35 to 40 minutes of RT and a cool-down period of 10 minutes (ie, stretching). ...
... The most common prescription frequency was three sessions per week. The RT programs were fully supervised in 10 studies (83%) [24][25][26][27][28][29][31][32][33][34] and partially supervised in one study (8%), 23 whereas the remaining studies did not report this information (1, 8%). 30 The intensity of RT was consistent among the included studies. ...
Article
Importance Menopause is a biological stage associated with increased cardiovascular morbidity and mortality due to changes in sex hormone levels. Objective This systematic review aimed to investigate the benefits and harms of RT in menopausal and postmenopausal women. Evidence Review We searched PubMed, Embase, CENTRAL, Scopus, and Web of Science from inception to 2021, and clinical trial registries. Randomized controlled trials (RCT) in menopausal and postmenopausal women that compared women undergoing RT programs with a control group were included. The primary outcomes were C-reactive protein level and adverse events; and, the secondary outcomes were lipid profile and waist circumference. Two reviewers independently selected the studies, extracted data, and assessed the completeness of RT programs, risk of bias, and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE). A random-effects model was used. Statistical significance was set at P < 0.05. Findings Twelve RCTs published from 2012 to 2020 met the inclusion criteria (n = 482). Four follow-up periods were assessed. RT caused reductions in C-reactive protein levels compared to those in the control group in postmenopausal women in the short- to long-term follow-up (mean difference, −0.47 mg/dL; 95% confidence interval, −0.66 to −0.29; P < 0.00001). Furthermore, RT may reduce C-reactive protein levels even at moderate and moderate-to-high intensity (P < 0.0001 and P = 0.0005, respectively). Similar findings were found for lipid profiles in the short- to long-term follow-up (P < 0.05). RT may have had little to no effect on waist circumference. The certainty of the body of evidence was assessed as very low and downgraded owing to serious study limitations, inconsistency, imprecision, and publication bias. Conclusions and Relevance There was very low-quality evidence supporting the benefits of RT compared with control for C-reactive protein levels and lipid profile. No benefits were found for the outcome of waist circumference in postmenopausal women with different comorbidities or risk factors. Safety data were scarce. We have little confidence in the results, and the true effect is likely to be substantially different. Further well-conducted and well-reported RCTs are warranted to strengthen the evidence. Protocol registration PROSPERO CRD42020213125.
... A higher intensity of resistance training (RT) is consistently associated with improvements in skeletal muscle mass (Peterson, Sen & Gordon, 2011) and strength (Schoenfeld, Grgic, Ogborn & Krieger, 2017), so international guidelines recommend regular and adequate-intensity RT to obtain favorable neuromuscular adaptations in both healthy older adults and those with chronic conditions (Fragala, Cadore & Dorgo, 2019). Sarcopenia studies evaluating the effects of moderate-intensity RT on respiratory muscle strength have not reported consistent results (Cebrià i Iranzo, Balasch-Bernat, Tortosa-Chuliá & Balasch-Parisi, 2018;Chen, Wu, Chen, Ho & Chung, 2018;Jeon, Shin & Kim, 2018). Some have not observed statistical improvements in MRP after moderate-intensity mechanical squat exercises, while others have reported improvements in MRP and PEF (Cebrià i Iranzo et al., 2018;Chen et al., 2018;Jeon et al., 2018). ...
... Sarcopenia studies evaluating the effects of moderate-intensity RT on respiratory muscle strength have not reported consistent results (Cebrià i Iranzo, Balasch-Bernat, Tortosa-Chuliá & Balasch-Parisi, 2018;Chen, Wu, Chen, Ho & Chung, 2018;Jeon, Shin & Kim, 2018). Some have not observed statistical improvements in MRP after moderate-intensity mechanical squat exercises, while others have reported improvements in MRP and PEF (Cebrià i Iranzo et al., 2018;Chen et al., 2018;Jeon et al., 2018). Physical exercise could also impact lung function parameters, although there are few studies in old people with sarcopenia (Chen et al., 2018;Jeon et al., 2018;Jung, Kim & Park, 2019). ...
... Some have not observed statistical improvements in MRP after moderate-intensity mechanical squat exercises, while others have reported improvements in MRP and PEF (Cebrià i Iranzo et al., 2018;Chen et al., 2018;Jeon et al., 2018). Physical exercise could also impact lung function parameters, although there are few studies in old people with sarcopenia (Chen et al., 2018;Jeon et al., 2018;Jung, Kim & Park, 2019). Again, results are disparate among different lung parameters, but forced vital capacity (FVC) and forced expiratory volume (FEV 1 ) were the most commonly analyzed. ...
Article
Purpose of the research : Ageing entails a decrease in muscle mass and strength, known as sarcopenia, which also affects respiratory function. Physical exercise is an appropriate intervention to treat both conditions. This study aims to assess the efficacy of high-intensity resistance training (HIRT) on clinical parameters of respiratory function and health-related quality of life (QoL) in community-dwelling older women with sarcopenia. Methods : Fifty-one sarcopenic community-dwelling women aged 70 years and older were randomized to either six months of HIRT (n=24) or control (n=27). At baseline and post-intervention, participants were assessed for skeletal-muscle sarcopenia; respiratory sarcopenia status; respiratory function: spirometry (FEV1, FVC, FEV1/FVC, and FEF25-75) and expiratory (MEP) and inspiratory (MIP) respiratory muscle strength parameters; and health-related QoL (EURO-QOL 5D-3L). Results : A group-by-time interaction effect for MEP (p=0.044, Ƞ²=0.108) was observed. CG showed a significant decrease in FEV1 (mean difference [MD] −0.12 L; 95% confidence interval [CI] −0.20, −0.05; p=0.002); and FVC (MD −0.18 L; 95% CI −0.33, −0.03; p=0.024) after six months, whereas the HIRT maintained respiratory function without change. Post-intervention, mean EQ-VAS increased in the HIRT and decreased in CG, resulting in a significant between-group difference (mean 73.0 standard deviation [SD] 16.99 vs 61.1 SD 18.2 points, respectively; p=0.044). Respiratory sarcopenia status was reverted in the HIRT. Conclusions : HIRT increased muscle strength and halted age-related respiratory function decline in sarcopenic old women. A strength intervention could benefit health-related QoL and physical well-being.
... The aerobic + resistance exercise mode had a better effect than the other exercise modes in reducing IL-6 in the elderly (Figure 4). [7,[13][14][15][16][17][18][19]21,22,[24][25][26][27][28][31][32][33][34]36,[38][39][40][41]. ...
... Effects of different exercise modes on TNF-α in the elderly [7,14,16,17,21,23,24,26,28,[30][31][32][33][34][35]39,40,42]. ...
... Risk of bias summary[14,15,16,17,19,20,21,22,25,30,32,33,34,35,36,37,38,40,41]. ...
Article
Full-text available
The aim of this study was to investigate the effects of different exercise modes on improving inflammatory response in the elderly. For the research methodology, databases such as CNKI (China National Knowledge Infrastructure), Wanfang Data, Pubmed, Web of Science, and EBSCO were selected for searching. The Cochrane Risk of Bias (ROB) tool was used to evaluate the methodological quality of the included studies, and RevMan5.4.1 analysis software was applied for the statistical analysis. A total of 31 studies (20 randomized controlled trials and 11 self-controlled trials) with 1528 subjects were included. The results of this meta-analysis showed that aerobic exercise, resistance exercise, aerobic + resistance exercise, and HIIT all significantly reduced the levels of IL-6, TNF-α, and CRP in the elderly, and the improvement effects of aerobic + resistance exercise on IL-6, HIIT on TNF-α, and resistance exercise on CRP in the elderly were better than those of the other three exercise modes, respectively. In conclusion, aerobic exercise, resistance exercise, aerobic + resistance exercise, and HIIT all contribute to ameliorating the inflammatory status of the elderly, among which resistance exercise is a noteworthy exercise mode for the elderly to improve inflammatory status.
... Only two longitudinal trials have been conducted to address conditions associated with ageing; sarcopenia in females [13] and Parkinson's disease [14]. These studies reported improvements in sarcopenia index, grip strength, back strength, respiratory function, and inflammatory markers [13], Timed Up and Go, upper limb strength, and lower limb strength [14]. ...
... Only two longitudinal trials have been conducted to address conditions associated with ageing; sarcopenia in females [13] and Parkinson's disease [14]. These studies reported improvements in sarcopenia index, grip strength, back strength, respiratory function, and inflammatory markers [13], Timed Up and Go, upper limb strength, and lower limb strength [14]. Although these results are encouraging, a focus on clinical conditions and limited reporting of trial protocols in these studies, offer little guidance for training otherwise healthy older adults. ...
... Secondary outcomes included a core set of clinical field tests of health-related physical fitness [25]. Sample size was calculated based on the primary outcome from existing data [13] to detect an effect size change of 0.88 [26]. A total of 19 participants were required to detect 95% power (1-ß = 0.05) and test the null hypothesis of equality (α = 0.05). ...
Article
Full-text available
The Ballistic Exercise of the Lower Limb (BELL) trial examined the efficacy and safety of a pragmatic hardstyle kettlebell training program in older adults. Insufficiently active men and women aged 59–79 years, were recruited to a 6-month repeated measures study, involving 3-months usual activity and 3-months progressive hardstyle kettlebell training. Health-related physical fitness outcomes included: grip strength [GS], 6-min walk distance [6MWD], resting heart rate [HR], stair-climb [SC], leg extensor strength [LES], hip extensor strength [HES], Sit-To-Stand [STS], vertical jump [CMVJ], five-times floor transfer [5xFT], 1RM deadlift, body composition (DXA), attendance, and adverse events. Sixteen males (68.8 ± 4.6 yrs, 176.2 ± 7.8 cm, 90.7 ± 11.0 kg, 29.2 ± 2.6 kg/m²) and sixteen females (68.6 ± 4.7 yrs, 163.9 ± 5.4 cm, 70.4 ± 12.7 kg, 26.3 ± 4.9 kg/m²) were recruited. Compliance with the supervised exercise program was very high (91.5%). Kettlebell training increased GS (R: MD = 7.1 kg 95% CI [4.9, 9.3], L: MD = 6.3 kg 95% CI [4.1, 8.4]), 6MWD (41.7 m, 95% CI [17.9, 65.5]), 1RM (16.2 kg, 95% CI [2.4, 30.0]), 30 s STS (3.3 reps, 95% CI [0.9, 5.7]), LES (R: MD = 61.6 N, 95% CI [4.4, 118.8]), HES (L: MD = 21.0 N,95% CI [4.2,37.8]), appendicular skeletal lean mass (MD = 0.65 kg, 95% CI [0.08, 1.22]), self-reported health change (17.1%, 95% CI [4.4, 29.8]) and decreased SC time (2.7 s, 95% CI [0.2, 5.2]), 5xFT time (6.0 s, 95% CI [2.2, 9.8]) and resting HR (7.4 bpm, 95% CI [0.7, 14.1]). There were four non-serious adverse events. Mean individual training load for group training sessions during the trial was 100,977 ± 9,050 kg. High-intensity hardstyle kettlebell training was well tolerated and improved grip strength and measures of health-related physical fitness in insufficiently active older adults. Trial registration: Prospectively registered: 20/08/2019, Australian New Zealand Clinical Trials Registry (ACTRN12619001177145).
... In 15 studies [20,25,27-34, 39,41,48] participants were only women, 13 studies [19,[21][22][23]26,36,37,40,42,43,46,49,50] had participants of both genders and one [38] did not report the gender of the participants. In terms of the place where the studies were carried out, seven studies were carried out in Taiwan [22,23,27,[33][34][35]47], seven in Japan [30][31][32]36,37,44,50], five in Korea [26,28,29,40,41], two in Brazil [25,48], two in Poland [38,39] and only one in the United States of America (USA) [19], China [46], Italy [43], Canada [21], Iran [20], and Greece [42]. ...
... Regarding the three types of interventions categorized, 19 studies had a resistance-type exercise intervention [19][20][21]23,[25][26][27][30][31][32][33][34][35]38,41,43,44,47,48,50], three studies had an aerobic-type intervention [23,29,39], and nine had a mixed intervention (resistance + aerobic exercise) [22,23,28,31,36,37,40,42,46]. Regarding the duration of the intervention for the resistance exercise intervention, 12 studies their intervention lasted 12 weeks [26,27,31,34,39,42,46,48], in three studies lasted less than 12 weeks [23,47,51], and in four studies it lasted longer than 12 weeks [19,25,37,52]. ...
... Regarding the three types of interventions categorized, 19 studies had a resistance-type exercise intervention [19][20][21]23,[25][26][27][30][31][32][33][34][35]38,41,43,44,47,48,50], three studies had an aerobic-type intervention [23,29,39], and nine had a mixed intervention (resistance + aerobic exercise) [22,23,28,31,36,37,40,42,46]. Regarding the duration of the intervention for the resistance exercise intervention, 12 studies their intervention lasted 12 weeks [26,27,31,34,39,42,46,48], in three studies lasted less than 12 weeks [23,47,51], and in four studies it lasted longer than 12 weeks [19,25,37,52]. Regarding the number of sessions, the mode was three sessions of physical exercise per week. ...
Article
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The demographic transition makes it necessary to establish new recommendations about the components that are most affected by aging, such as: muscle mass, fat mass, bone mass, muscle strength, and physical performance. Exercise has been identified as a factor that improves those conditions. The aim of this review is to synthetize and analyze the results of exercise interventions on muscle mass, fat mass, bone mass, strength and physical performance in community dwelling older adults (OA). A systematic search was carried out in eleven databases, using validated terms as "aged", "exercise" and others. For the meta-analysis, we differentiated by type of exercise and outcome. Twenty-nine randomized clinical trials were obtained for the review and 24 clinical trials for meta-analysis. This study identified an increase of 1.0 kg (95% Confidence Interval [CI] 0.3-1.7) in total muscle mass (TMM) and 0.4 kg (95%CI 0.0,0.7) in appendicular muscle mass (AMM); a decrease of-3.7 kg (95% CI-5.8,-1.5) in total fat mass and-3.7% (95%CI-5.8,-1.5) in fat percentage after the resistance exercise intervention by 2-3 times per week. A-3.0% (95%CI-4.6,-1.3) decrease was observed in fat percentage after the aerobic exercise intervention. The quality of the evidence was ranked from high to very low; the risk of bias most common was performance bias and other bias. This study suggests that resistance exercise is the intervention that shows a positive effect on muscle fat mass, and bone mass. More research is needed for other exercise interventions.
... Very few investigations of kettlebell training have involved older adults. Only two longitudinal trials have been conducted to address conditions associated with aging; sarcopenia in females (12) and Parkinson's disease (13) . These studies reported improvements in sarcopenia index, grip strength, back strength, respiratory function, and inflammatory markers (12) , Timed Up and Go, upper limb strength, and lower limb strength (13) . ...
... Only two longitudinal trials have been conducted to address conditions associated with aging; sarcopenia in females (12) and Parkinson's disease (13) . These studies reported improvements in sarcopenia index, grip strength, back strength, respiratory function, and inflammatory markers (12) , Timed Up and Go, upper limb strength, and lower limb strength (13) . Although these results are encouraging, a focus on clinical conditions and limited reporting of trial protocols in these studies, offer little guidance for training otherwise healthy older adults. ...
... Secondary outcomes included a core set of clinical field tests of health-related physical fitness (22) . Sample size was calculated based on the primary outcome from existing data (12) to detect an effect size change of 0.88 (23) . A total of 19 participants were required to detect 95% power (1-ß = 0.05) and test the null hypothesis of equality (α = 0.05). ...
Preprint
Full-text available
The Ballistic Exercise of the Lower Limb (BELL) trial examined efficacy and safety of a pragmatic hardstyle kettlebell training program in older adults. Insufficiently active men and women aged 59-79 years, were recruited to a 6-month repeated measures study, involving 3-months usual activity and 3-months progressive hardstyle kettlebell training. Health-related physical fitness outcomes included: grip strength [GS], 6-min walk distance [6MWD], resting heart rate [HR], stair-climb [SC], leg extensor strength [LES], hip extensor strength [HES], Sit-To-Stand [STS], vertical jump [CMVJ], five-times floor transfer [5xFT], 1RM deadlift, body composition (DXA), attendance, and adverse events. Sixteen males (68.8 ± 4.6 yrs, 176.2 ± 7.8 cm, 90.7 ± 11.0 kg, 29.2 ± 2.6 kg/m ² ) and sixteen females (68.6 ± 4.7 yrs, 163.9 ± 5.4 cm, 70.4 ± 12.7 kg, 26.3 ± 4.9 kg/m ² ) were recruited. Compliance to the supervised exercise program was very high (91.5%). Kettlebell training increased GS (R: MD = 7.1 kg 95% CI [4.9, 9.3], p < 0.001, L: MD = 6.3 kg 95% CI [4.1, 8.4], p < 0.001), 6MWD (41.7 m, 95% CI [17.9, 65.5], p < .001), 1RM (16.2 kg, 95% CI [2.4, 30.0], p = 0.013), 30s STS (3.3 reps, 95% CI [0.9, 5.7], p = 0.003), LES (R: MD = 61.6 N, 95% CI [4.4, 118.8], p = 0.028), HES (L: MD = 21.0 N, 95% CI [4.2, 37.8], p = 0.007), appendicular skeletal lean mass (MD = 0.65 kg, 95% CI [0.08, 1.22], p = 0.016), self-reported health change (17.1%, 95% CI [4.4, 29.8], p = 0.002) and decreased SC time (2.7 sec, 95% CI [0.2, 5.2], p = 0.025), 5xFT time (6.0 sec, 95% CI [2.2, 9.8], p < 0.001) and resting HR (7.4 bpm, 95% CI [0.7, 14.1], p = 0.032). There were four non-serious adverse events. Mean individual training load for group training sessions during the trial was 100,977 ± 9,050 kg. High-intensity hardstyle kettlebell training was well tolerated and improved grip strength and measures of health-related physical fitness in insufficiently active older adults.
... The age ranged from 52.2 (Yoon et al., 2018) to 88.9 (Urzi et al., 2019) years, and the BMIs ranged from 23.9 (Yoon et al., 2018) to 34.7 (Rezende et al., 2016) kg/m 2 . In our meta-analysis, all participants were post-menopausal women but exhibited a wide range of health and disease characteristics, including healthy (absence of disease) (Lee et al., 2012;Bergström et al., 2009;Tartibian et al., 2011;Tartibian et al., 2015), overweight and obese (Santiago et al., 2018;Vasconcelos et al., 2020;Nunes et al., 2016;Yoon et al., 2018;Abdollahpour et al., 2017;Chagas et al., 2017;Gómez-Tomás et al., 2018;Phillips et al., 2012;Saeidi et al., 2019;Shabani et al., 2018;Tomeleri et al., 2016;Tomeleri et al., 2018), nonalcoholic fatty liver disease (Rezende et al., 2016), overweight or obese with elevated systolic blood pressure (Arsenault et al., 2009) and abdominal obesity (Park et al., 2015), obese with and without dyslipidemia (Biteli et al., 2021), elderly with sarcopenia (Chen et al., 2018), elderly with cognitive impairment (Chupel et al., 2017), elderly with metabolic syndrome (Osali, 2020) and breast cancer (Am et al., 2011;Fairey et al., 2005;Dieli-Conwright et al., 2018;Jones et al., 2013). ...
... Exercise sessions were performed two-six times per week, with three sessions being the most common (n = 22). For exercise training interventions, aerobic training (Arsenault et al., 2009;Rodrigues-Krause et al., 2018;Rezende et al., 2016;Tartibian et al., 2011;Tartibian et al., 2015;Abdollahpour et al., 2017;Osali, 2020;Fairey et al., 2005;Jones et al., 2013;Kortas et al., 2020) and resistance training (Santiago et al., 2018;Urzi et al., 2019;Chupel et al., 2017;Gómez-Tomás et al., 2018;Phillips et al., 2012;Saeidi et al., 2019;Tomeleri et al., 2016;Tomeleri et al., 2018;Chen et al., 2018;Cunha et al., 2019) and combined training (Biteli et al., 2021;Am et al., 2011;Bergström et al., 2009;Chagas et al., 2017;Shabani et al., 2018;Park et al., 2015;Dieli-Conwright et al., 2018;Chupel et al., 2018) were the most common types, and other intervention used and yoga (Lee et al., 2012). In addition, in other studies, aerobic and resistance training (Yoon et al., 2018), functional and traditional training (Vasconcelos et al., 2020) and low and high volume of resistance training (Nunes et al., 2016) were used as separate exercise arms. ...
... The current systematic review included IL-6, TNF-α, CRP and adiponectin as the commonly assessed inflammatory markers of interest. Circulating (serum or plasma) levels of IL-6 were assessed in 18 studies (Arsenault et al., 2009;Santiago et al., 2018;Chupel et al., 2017;Vasconcelos et al., 2020;Nunes et al., 2016;Biteli et al., 2021;Am et al., 2011;Tartibian et al., 2011;Tartibian et al., 2015;Abdollahpour et al., 2017;Chagas et al., 2017;Tomeleri et al., 2016;Tomeleri et al., 2018;Chen et al., 2018;Osali, 2020;Dieli-Conwright et al., 2018;Jones et al., 2013;Chupel et al., 2018), TNF-α in 14 (Arsenault et al., 2009;Santiago et al., 2018;Chupel et al., 2017;Vasconcelos et al., 2020;Nunes et al., 2016;Rodrigues-Krause et al., 2018;Biteli et al., 2021;Am et al., 2011;Rezende et al., 2016;Tartibian et al., 2011;Tartibian et al., 2015;Abdollahpour et al., 2017;Chagas et al., 2017;Phillips et al., 2012;Tomeleri et al., 2016;Tomeleri et al., 2018;Park et al., 2015;Chen et al., 2018;Jones et al., 2013;Chupel et al., 2018) Rodrigues-Krause et al., 2018;Bergström et al., 2009;Tartibian et al., 2015;Gómez-Tomás et al., 2018;Phillips et al., 2012;Shabani et al., 2018;Tomeleri et al., 2016;Tomeleri et al., 2018;Chen et al., 2018;Osali, 2020;Fairey et al., 2005;Dieli-Conwright et al., 2018;Jones et al., 2013;Cunha et al., 2019) and adiponectin in 6 studies (Arsenault et al., 2009;Lee et al., 2012;Phillips et al., 2012;Saeidi et al., 2019;Dieli-Conwright et al., 2018;Kortas et al., 2020). ...
Article
Background The postmenopausal stage of life is associated with increased systemic inflammation that may be mitigated through exercise training. The effects of exercise training on inflammatory markers in postmenopausal women, however, require further elucidation. We therefore performed a systematic review and meta-analysis to investigate the available high-quality research on the effects of exercise training on inflammatory markers in postmenopausal women. Method Electronic searches in PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Google Scholar were conducted to identify articles published through April 2021, for studies comparing exercise training to a control condition, on inflammatory markers including CRP, IL-6, TNF-α and adiponectin in postmenopausal women. Randomized or non-randomized controlled trials of exercise training were included according to the following criteria: (A) English language articles; (B) involving women participants who were post-menopausal; (C) providing measures of inflammatory markers including IL-6, TNF-α, CRP or adiponectin at baseline and after completion of the intervention; (D) an exercise training intervention duration of ≥4 weeks. Results Results were extracted from the included studies and standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Thirty-two studies (representing 38 intervention groups) involving 1510 postmenopausal women were retrieved from the databases for analyses. Overall, exercise training significantly reduced IL-6 [−0.75 (95% CI: −1.07 to −0.42), p < 0.001; 20 interventions], TNF-α [−0.64 (95% CI: −0.91 to −0.37), p < 0.001; 24 interventions] and CRP [−0.64 (95%CI: −0.91 to −0.38), p < 0.001; 21 interventions] and increase adiponectin [0.98 (95% CI: 0.10 to 1.86), p = 0.02; 6 interventions], when compared with control. Furthermore, subgroup analyses suggested that aerobic, resistance, and combined training significantly reduced IL-6, TNF-α and CRP (p < 0.05). Exercise training improved IL-6, TNF-α and CRP in both younger (age < 64 years) and older (age ≥ 64 years) participants (p < 0.05). Conclusion These results suggest that exercise training may be an effective intervention for reducing pro-inflammatory markers and increasing adiponectin in postmenopausal women.
... Interventions performed 3 times per week tended to have a larger effect (SMD = 1.98 (0.50-3.45)) than interventions performed 2 times per week (SMD = 1.12 (0.78-1.47)), but the subgroup difference was not statistically significant (p = 0.27 for subgroup differences). Two RT studies reported back extensor strength [45,70] and showed a statistically significant increase (MD = 7.97 kg (3.07-12.88 kg); p < 0.001; I 2 = 0.0%) (Figure 3). ...
... p < 0.001; I 2 = 90%) (Figure 3). Grip strength was reported in 19 RT studies [44,45,49,52,53,55,56,59,61,65,67,69,70,[74][75][76][77][78][79]. There was a mean increase of 1.48 kg (0.26-2-23 kg; p < 0.001) across studies with pre-post mean differences ranging from −1.00 to 5.70 kg. ...
... Muscle mass was reported in 7 RT studies (8 intervention groups) [45,52,70,71,74,78,80]. Compared to control groups, there was not a statistically significant increase in muscles mass in intervention groups across studies (MD = 0.60 kg (−0.18-1.37 kg); p = 0.13; I 2 = 83%) (Figure 4). ...
Article
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It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) on muscle strength, body composition, and functional performance in older adults. A thorough literature review was conducted, and the analyses were limited to randomized controlled trials. In total, 63 studies were included in the meta-analysis (48 RT, 11 WBV, and 4 EMS). The results showed that RT and WBV are comparably effective for improving muscle strength, while the effects of EMS remains debated. RT interventions also improved some outcome measures related to functional performance, as well as the cross-sectional area of the quadriceps. Muscle mass was not significantly affected by RT. A limitation of the review is the smaller number of WBV and particularly EMS studies. For this reason, the effects of WBV and EMS could not be comprehensively compared to the effect of RT for all outcome measures. For the moment, RT or combinations of RT and WBV or EMS, is probably the most reliable way to improve muscle strength and functional performance, while the best approach to increase muscle mass in older adults remains open to further studies.
... Significant improvements were reported for the Timed Up and Go, Sit and Lift, elbow flexion and lower limb strength and torque measures compared to the Non-Periodic Activities Group which performed bodybuilding and stretching exercises. Very encouraging medium to large effect size increases in handgrip strength, back strength and sarcopenia index were reported in a good-quality RCT in women with sarcopenia [98]. Improvements in axial skeletal muscle mass and sarcopenia index were maintained at four weeks after cessation of training, with signification reductions in the same measures occurring in matched controls. ...
... Encouraging for the primary care clinician are improvements in axial skeletal muscle mass, sarcopenia index, grip strength and back strength, from a goodquality randomised controlled trial with sarcopenic elderly females [98]. During the 8-week training period controls had significant reductions in muscle mass and grip strength, with significant increase in visceral fat area. ...
... In research and clinical practice, hand grip strength is one component of the algorithm used to make a clinical diagnosis of sarcopenia [148] and improvements in grip strength from kettlebell training have been reported [98,101,102,113]. This is encouraging as poor hand grip strength is a consistent predictor of falls and fractures in both sexes among older adults [149], and an independent predictor of all-cause mortality and cardiovascular diseases in community-dwelling populations [150][151][152][153]. Lower limb muscle strength is also independently associated with elevated risk of all-cause mortality, regardless of muscle mass, metabolic syndrome, sedentary time, or leisure time physical activity [154]. ...
Article
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Background: A scoping review of scientific literature on the effects of kettlebell training. There are no authoritative guidelines or recommendations for using kettlebells within a primary care setting. Our review objectives were to identify the extent, range and nature of the available evidence, to report on the types of evidence currently available to inform clinical practice, to synthesise key concepts, and identify gaps in the research knowledge base. Methods: Following the PRISMA-ScR Checklist, we conducted a search of 10 electronic databases from inception to 1 February 2019. There were no exclusions in searching for publications. A single reviewer screened the literature and abstracted data from relevant publications. Articles were grouped and charted by concepts and themes relevant to primary care, and narratively synthesised. Effect sizes from longitudinal studies were identified or calculated, and randomised controlled trials assessed for methodological quality. Results: Eight hundred and twenty-nine records were identified to 1 February 2019. Four hundred and ninety-six were screened and 170 assessed for eligibility. Ninety-nine publications met the inclusion criteria. Effect sizes were typically trivial to small. One trial used a pragmatic hardstyle training program among healthy college-age participants. Two trials reported the effects of kettlebell training in clinical conditions. Thirty-three studies explicitly used 'hardstyle' techniques and 4 investigated kettlebell sport. Also included were 6 reviews, 22 clinical/expert opinions and 3 case reports of injury. Two reviewers independently evaluated studies using a modified Downs & Black checklist. Conclusions: A small number of longitudinal studies, which are largely underpowered and of low methodological quality, provide the evidence-informed therapist with little guidance to inform the therapeutic prescription of kettlebells within primary care. Confidence in reported effects is low to very low. The strength of recommendation for kettlebell training improving measures of physical function is weak, based on the current body of literature. Further research on reported effects is warranted, with inclusion of clinical populations and investigations of musculoskeletal conditions common to primary care. There is a need for an externally valid, standardised approach to the training and testing of kettlebell interventions, which better informs the therapeutic use of kettlebells in primary care.
... In this sense, results from a recent systematic review showed higher activation of core muscles for S-RT compared to weight resistance training in the push-up, inverted row, prone bridge, and hamstring curl exercises (Aguilera-Castells et al., 2020). Other studies have also shown that S-RT might be an efficient strategy to improve body composition, sleep quality and fatigue tolerance in both men and women (Campa et al., 2018(Campa et al., , 2021Chen et al., 2018;Vikberg et al., 2019;Jiménez-García et al., 2021;Hayes et al., 2022). As expected, a program of 8-weeks of S-RT has shown benefits on glycemic and lipid profiles in women with Type 2 Diabetes (Samadpour Masouleh et al., 2021). ...
... Similar positive results were obtained by Björkgren et al. (2021). Chen et al. (2018) demonstrated the effectiveness and safety of a medium-to-high load kettlebells-based resistance training program that included multi-joint exercises (i.e., deadlift and squat) in participants between 65 and 75 years old. Interestingly, the results were maintained for 4 weeks after the duration of the study (8 weeks). ...
Article
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The loss of muscle mass and strength in elderly population (especially after the age of 65–70) represents a public health problem. Due to the high prevalence of frailty in older adults, cardiovascular or low-intensity exercise is implemented as first choice option. Although beneficial these training schemes are not as effective as strength-based resistance training for increasing muscle strength and hypertrophy. In fact, when performed progressively and under professional supervision, strength-based training has been proposed as an important and valid methodology to reduce sarcopenia-related problems. In this mini-review, we not only summarize the benefits of weight resistance training but also highlight practical recommendations and other non-conventional methods (e.g., suspension training) as part of an integral anti-sarcopenia strategy. Future directions including cluster set configurations and high-speed resistance training are also outlined.
... By these characteristics may become interesting to the field of public health (as an inexpensive alternative), although it is still little used for this purpose. For example, Chen et al., 2018 demonstrated among elderly people that kettlebell exercise decreases sarcopenia levels and increases grip/back strength and peak expiratory flow. Additionally, the authors observed a retention effect, of the kettlebell training, after 4 weeks of detraining. ...
... In the context of the positive adaptations associated with the practice of physical exercise (Pascoe et al., 2020), in a wide literature review showed that physical exercise is a promising factor to mental health promotion. In general, it is well-established positive physiological/psychological effects associated with physical exercise practice because could to improve mood state and ameliorate/ prevent anxiety and depressive symptoms and disorders (Pascoe et al., 2020;Shaphe and Chahal, 2020;Chen et al., 2018;Viana et al., 2017;Stanton et al., 2012;Hale et al., 2002), mood state (Pascoe et al., 2020;Jaggers et al., 2015) and sleep and life quality (Alley et al., 2015). ...
... Previous studies have indicated that older individuals with sarcopenia who receive RET interventions with training durations of 8-24 weeks can achieve greater changes in appendicular LM (MD = 0.45-1.20 kg) [15,[48][49][50] and AMI (MD = 0.17-1.16 kg/m 2 ) [48][49][50] compared with their untrained peers, regardless of the RET protocol. ...
... Previous studies have indicated that older individuals with sarcopenia who receive RET interventions with training durations of 8-24 weeks can achieve greater changes in appendicular LM (MD = 0.45-1.20 kg) [15,[48][49][50] and AMI (MD = 0.17-1.16 kg/m 2 ) [48][49][50] compared with their untrained peers, regardless of the RET protocol. The training period required to achieve evident LM gains in response to RET was estimated as 8-12 weeks for older individuals [51]. ...
Article
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1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T 0) and postoperative at 1 month (T 1 ; before RET) and 4 months (T 2 ; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T 1 and T 2 from T 0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T 2 , the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.
... The overhead shoulder press is an exercise involving multiple joints and muscles with the potential to reach high loads. This exercise is used in many sports and functional and rehabilitation training programs for the arm, shoulder, and scapula [6,7,26,27]. Moreover, it can be observed that, recently, exercises with kettlebells are replacing those with dumbbells. ...
Article
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The overhead press is a multi-joint exercise that has the potential to use a high external load due to the cooperation of many muscle groups. The purpose of this study was to compare the activity of shoulder and back muscles during the overhead press with a kettlebell and a dumbbell. Surface electromyography (EMG) for the anterior and posterior deltoid, upper and lower trapezius, serratus anterior, and spinal erectors was analysed for 20 subjects. Participants performed the four trials of pressing kettlebell and dumbbell, weighted at 6 kg, and 70% of one maximum repetition (1RM) in the sitting position. Statistical analysis was performed using a non-parametric Friedman test and a post-hoc test of Dunn Bonferroni. No significant differences were found in the activation of assessed muscles when comparing dumbbell to kettlebell press trials with the same load (6 kg and 70% of 1RM). However, muscle activity of all muscles except the upper trapezius was always higher for kettlebell pressing. Different center of gravity locations in the kettlebell versus the dumbbell can increase shoulder muscle activity during the overhead press. However, more studies are required to confirm these results.
... 93 In older patients with whole-body sarcopenia, whole-body strength training significantly improved maximum expiratory flow, appendicular skeletal muscle mass and handgrip strength compared with controls. 94 The effects of respiratory muscle training on physical function and QoL in healthy older adults are unclear and require further study. 91 In patients with COPD, IMT improved MIP, forced expiratory volume in 1-s, exercise tolerance, dyspnea and HRQoL. ...
Article
We defined respiratory sarcopenia as a coexistence of respiratory muscle weakness and decreased respiratory muscle mass. Although respiratory muscle function is indispensable for life support, its evaluation has not been included in the regular assessment of respiratory function or adequately evaluated in clinical practice. Considering this situation, we prepared a position paper outlining basic knowledge, diagnostic and assessment methods, mechanisms, involvement in respiratory diseases, intervention and treatment methods, and future perspectives on respiratory sarcopenia, and summarized the current consensus on respiratory sarcopenia. Respiratory sarcopenia is diagnosed when respiratory muscle weakness and decreased respiratory muscle mass are observed. If respiratory muscle mass is difficult to measure, we can use appendicular skeletal muscle mass as a surrogate. Probable respiratory sarcopenia is defined when respiratory muscle weakness and decreased appendicular skeletal muscle mass are observed. If only respiratory muscle strength is decreased without a decrease in respiratory function, the patient is diagnosed with possible respiratory sarcopenia. Respiratory muscle strength is assessed using maximum inspiratory pressure and maximum expiratory pressure. Ultrasonography and computed tomography are commonly used to assess respiratory muscle mass; however, there are insufficient data to propose the cutoff values for defining decreased respiratory muscle mass. It was jointly prepared by the representative authors and authorized by the Japanese Society for Respiratory Care and Rehabilitation, Japanese Association on Sarcopenia and Frailty, Japanese Society of Respiratory Physical Therapy and Japanese Association of Rehabilitation Nutrition. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2022; ••: ••–••.
... (B) Effect of resistance training on gait speed. (C) Effect of resistance training on skeletal muscle index[17][18][19][20][21][22][23][24][25][26][27][28][29]. ...
Article
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Resistance training is considered to be an efficient treatment for age-related sarcopenia and can improve muscle strength and quality in patients. However, there are currently no recommendations on resistance training parameters to improve muscle strength and quality in elderly patients with sarcopenia. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and included 13 eligible RCTs. Resistance training significantly improved grip strength, gait speed, and skeletal muscle index in patients with age-related sarcopenia, and kettle-bell was found to be the most effective modality. However, it is noteworthy that the elastic band is also a recommended form of resistance training considering that the kettlebell intervention was tested in only one study, while the elastic band was confirmed by multiple studies. Elastic band training (Hedges's g = 0.629, 95%CI = 0.090-1.168, p < 0.05) (40-60 min per session, more than three times per week for at least 12 weeks) was the most efficient training method. Thus, resistance training can significantly improve muscle strength and muscle quality in elderly patients with sarcope-nia. In addition, moderate-intensity resistance training using elastic bands may be the best training prescription for elderly patients with sarcopenia.
... Resultados y discusiónser considerada sarcopenia(Dodds & Sayer, 2016) que en 2019 fue definida como una enfermedad causada por una insuficiencia muscular (Arc-Chagnaud et al., 2019; Cruz-Jentoft et al., 2019). Sin embargo, si esta pérdida de peso viene dada por una reducción de la masa grasa puede suponer una reducción de uno de los factores de riesgo cardiometabólico (McLeod et al., 2021).En este sentido, hemos revisado varios trabajos(Chen et al., 2017(Chen et al., , 2018Hassan et al., 2016) en los que se observa una reducción del peso medio en los grupos que han seguido una intervención con programas de ejercicio, confirmándolo como una de las mejores estrategias para la mejora de la composición corporal en el adulto mayor. ...
Thesis
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Intervención con ejercicio físico multicomponente sobre el adulto mayor frágil en la vida real (Real-Life intervention) Tesis Doctoral presentada por:
... Third, if one lowers one's center of gravity, the pressure on the hands and torso against the ground will be reduced. The population targeted in this study included older individuals with sarcopenia, and exercise is one of the interventions used to treat this condition (34)(35)(36)(37). It not only effectively improves the patient's mobility but also delays the decline of skeletal muscle function due to aging (38, 39). ...
Article
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Background Sarcopenia is the age-related loss of skeletal muscle mass and function; it is a risk factor for falls among older individuals. Few studies have focused on training such individuals to adopt a safe-landing strategy that would protect them from fall-related injuries. Ditangquan is a traditional Chinese martial art comprising movements that conform to the principles of safe landing. This study aims to investigate the effectiveness of Ditangquan in preventing fall-related injuries among older individuals with sarcopenia. Methods A total of 70 participants (21 males and 49 females with sarcopenia) between 60 and 80 years of age were recruited from three local communities and randomly assigned to the Ditangquan exercise group (DG) or the control group (CG) in a 1:1 ratio. Three times a week for 24 weeks, both the DG and CG received an hour of conventional exercise and an hour of Ditangquan exercise based on safe landing. Primary outcomes were the modified falls efficacy scale (MFES), the number of falls, and fall injuries; the secondary outcome was the Timed Up & Go (TUG) test. Results The DG had significantly fewer falls (1 vs. 8, P = 0.028) and fall injuries (0 vs. 6, P = 0.025) than the CG. Furthermore, at the end of the study, the DG had a significantly improved MFES (mean difference: 32.17 scores; 95% CI: 21.32, 43.02; P <0.001) and TUGT (mean difference: −4.94 s; 95% CI: −7.95, −1.93; P = 0.002) as compared with the CG. Conclusion Ditangquan exercise based on the safe-landing strategy effectively improves the functional mobility of the elderly, reduces the occurrence of falls and injuries, and increases the individual's confidence in preventing falls.
... A kettlebell is a type of free weight resembling a cannonball with a handle, with which a wide range of resistance exercises may be performed. Kettlebell training, popularised by Pavel Tsatsouline in the 1990s and early 2000s [36], has been shown to improve the physical function of older adults with Parkinson's disease [37], and body composition, strength, and pulmonary function in older females with sarcopenia [38]. Data from younger adults also suggests the potential to improve dynamic balance [39], further adding to its interest in healthcare as an attractive intervention for an ageing population. ...
Article
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Objectives This study examined older adults’ experiences of participating in the Ballistic Exercise of the Lower Limb (BELL) trial, involving 12-weeks of group-based hardstyle kettlebell training. Methods In the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59–79 years) completed six weeks of face-to-face group training, and six weeks of home-based training. In-depth semi-structured interviews were audio recorded, transcribed, and inductively coded, with themes constructed from patterns of shared meaning. Results Four higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done”—enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!”—change in a long-term health condition, (3) “It put me on a better course”—overcoming challenges, and (4) “I wasn’t just a number”—feeling part of a group/community. Discussion Findings highlight the perceived physical and psychological benefits of older adults participating in hardstyle group kettlebell training, and the value attributed to being part of an age-matched community of like-minded people engaged in group exercise. Implications for program design and delivery, and future research, are discussed.
... It is observed that the individuals in this study did not adhere to any regular physical activity program (Table 1) There were no changes in the variables BMI and WC. Although, the normative values of BMI indicated that most individuals were overweight in both moments (Table 1) On the other hand, in our study, the body fat percentage increased (14.5%), which may be associated with changes in the body composition due to advancing age, such as the loss of muscle mass and the accumulation of fat 22 Behavior of health indicators of rural workers after health education actions in which from the age of 25 there is a loss of muscle mass of 3-10% per decade of life, also leading to a reduction in the functional capacity of 1-2% per year from 50 years, and until 3% after 60 years old 23,24 . Another possible explanation for this increase in the body fat percentage is the use of pesticides, which are related to genetic polymorphisms, and the use of pesticides can cause anthropometric changes 25 . ...
Article
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INTRODUCTION: In Brazil, 16 of 90 million workers perform their work activities in rural areas, which is the country's economy closely associated with rural production. However, health care provided to rural areas is less than that offered to the urban population. The diseases that affect these populations are similar, but, there is higher mortality in the rural environment. PURPOSE: This study aimed to identify the behavior of the metabolic, morphologic, and physical fitness parameters of rural workers after health education. METHODS: Metabolic, morphologic, and physical fitness parameters of seventeen rural workers were assessed. After health education, the subjects returned to the laboratory three years later and repeated the assessments. RESULTS: Reductions in metabolic variables: total cholesterol (-8.0%; p = 0.031), LDL-c (-19.1%; p = 0.005), and triglycerides (-19.1%; p = 0.044); while increases in HDL-c (18.1%; p = 0.001), resting heart rate (9.5%; p = 0.046), and body fat (14.5%; p = 0.001) also has been founded. FINAL CONSIDERATIONS: Health education promotes positive changes in the lipid profile, but not in the morphologic and physical fitness parameters of the rural workers. It is suggested that less frequent education actions can minimize health risks, contributing to improving the health of rural workers.
... In this sense, physiological factors, food consumption and physical inactivity can intensify changes in body composition and degree of sarcopenia 5 , which makes engagement in physical exercises an alternative to bring about changes in both body composition and sarcopenia 6 . Among the types of physical exercise, playing recreational soccer emerges as a possibility of intervention, as it is characterized as an activity of a lower energy expenditure assimilation compared to conventional soccer, promotes intrinsic motivation among members, and is played with a large amount of people and a game size smaller than that of the official one 7 . ...
Article
Objective: To verify the effect of recreational soccer on bone mineral density and sarcopenia in the elderly. Methods: Fourteen elderly people aged 65.9 ± 3.4 years were selected. They were separated into two groups: the intervention group and the control group; the intervention group played recreational soccer for 12 weeks on two days of the week. Assessments were performed for bone mineral density and body muscle mass before and after the intervention. For statistical analysis, the repeated measures ANOVA with Bonferroni’s post hoc test was used. Results: After 12 weeks, there was a significant change in bone mineral density in the region of the total femur (p = 0.020). Analyzing the participants’ sarcopenia, no significant results were found after the intervention period. Conclusion: Playing recreational soccer causes a significant improvement in the total femur and maintains bone regions in the spine, whole body, and femoral neck. Also, it promotes a removal from the threshold for sarcopenia screening in the elderly.
... The American College of Sports Medicine and the World Health Organization recommends that older people maintain 150 min of moderate-intensity aerobic exercise per week or 75 min of high-intensity aerobic exercise per week, and perform resistance exercise 2-3 times per week to prevent chronic or debilitating conditions and/or treat disease [19,20]. Previous studies have demonstrated that exercise (e.g., resistance training [RT], whole body vibration training [WBVT], mixed training [MT, such as resistance training combined with balance and aerobic training]) have a positive effect on increasing muscle mass [21], muscle strength [22] and physical performance [23]) in older people with sarcopenia. ...
Article
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Objective: We conducted a systematic review and meta-analysis to clarify the effects of different exercise modes (resistance training [RT], whole body vibration training [WBVT], and mixed training [MT, resistance training combined with other exercises such as balance, endurance and aerobic training]) on muscle strength (knee extension strength [KES]) and physical performance (Timed Up and Go [TUG], gait speed [GS] and the Chair Stand [CS]) in older people with sarcopenia. Method: All studies published from January 2010 to March 2021 on the effects of exercise training in older people with sarcopenia were retrieved from 6 electronic databases: Pubmed, Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure (CNKI), and Wanfang Database. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Pooled analyses for pre- and post- outcome measurements were performed using Review Manager 5.4 with standardized mean differences (SMDs) and fixed-effect models. Result: Twenty-six studies (25 randomized controlled trails [RCTs] and one non-randomized controlled trail) were included in this study with 1191 older people with sarcopenia (mean age 60.6 ± 2.3 to 89.5 ± 4.4). Compared with a control group, RT and MT significantly improved KES (RT, SMD = 1.36, 95% confidence intervals [95% CI]: 0.71 to 2.02, p < 0.0001, I2 = 72%; MT, SMD = 0.62, 95% CI: 0.29 to 0.95, p = 0.0002, I2 = 56%) and GS (RT, SMD = 2.01, 95% CI: 1.04 to 2.97, p < 0.0001, I2 = 84%; MT, SMD = 0.69, 95% CI: 0.29 to 1.09, p = 0.008, I2 = 81%). WBVT showed no changes in KES (SMD = 0.65, 95% CI: - 0.02 to 1.31, p = 0.06, I2 = 80%) or GS (SMD = 0.12, 95% CI: - 0.15 to 0.39, p = 0.38, I2 = 0%). TUG times were significantly improved with all exercise training modes (SMD = -0.66, 95% CI: - 0.94 to - 0.38, p < 0.00001, I2 = 60%). There were no changes in CS times with any of the exercise training modes (SMD = 0.11, 95% CI: - 0.36 to 0.57, p = 0.65, I2 = 87%). Conclusions: In older people with sarcopenia, KES and GS can be improved by RT and MT, but not by WBVT. All three training modes improved TUG times, but not improved CS times.
... 48 Ten included middle-aged adults without reported diagnosed chronic disease, including those who were overweight or obese, 30,45,46,50 apparently healthy, 34,43 inactive, 35,58 and post-menopausal. 47,61 Twenty-two interventions included older adults (65+ years), where five included those with chronic disease, including type-II diabetes mellitus, 39,52 heart failure, 53 sarcopenia, 17 and obesity. 65 Seventeen interventions included older adults without reported diagnosed chronic disease, including those who were apparently healthy, 15,23,26,28,38,57,59,62,64,66,68,70 postmenopausal, 29,51 pre-frail, 37 in-care residents, 67 and untrained. ...
Article
Objectives To determine the pooled effect of resistance training compared with a control, on chronic inflammation in adults through systematic review and meta-analysis (osf.io/xastp). Methods Intervention trials that assessed resistance training versus control, on peripheral, chronic pro-inflammatory markers [c-reactive protein (CRP), interleukin (IL)-6 and tumour necrosis factor (TNF)-α] in adults were included, from four databases. Random-effect meta-analyses were conducted to calculate standardised mean differences (SMD) in post-intervention values between groups. Meta-regression explored the influence of age, chronic disease, body mass index, progressive resistance training (PRT), and intervention intensity, volume, duration and ‘optimal prescription’ on the pooled effect. Results Of 3,186 studies identified, 59 were included. Resistance training reduced CRP (SMD= -0.28; 95% CI= -0.46, -0.10), but not IL-6 (SMD= -0.12; 95% CI= -0.31, 0.07) or TNF-α (SMD= -0.07; 95% CI= -0.31, 0.16). Some heterogeneity was explained by interventions of lower intensity (<75% 1RM; 11.47%) or volume between 201-300 reps (6.14%). Conclusion Resistance training instigates small but significant reductions in CRP, but not IL-6 or TNF-α. Reductions in inflammation caused by resistance training may be influenced by intensity and volume, warranting further investigation. Resistance training should be implemented for chronic disease prevention or reduced progression, given pooled reductions in CRP.
... 18 Reportedly, only one week of detraining can reverse the inflammatory profile in the blood, with higher perirenal fat mass and highsensitivity C-reactive protein (hsCRP) levels recorded in Sprague-Dawley (SD) rats (6-7 weeks old). 19 Conversely, Chen et al 20 found that four weeks of a detraining intervention induces low hsCRP expression in elderly women. However, it remains unclear whether lifelong exercise and long-term detraining fully affect the levels of circulating inflammatory cytokines, SASP-associated inflammation, and potential signaling pathway control in perirenal fat and the liver. ...
Article
The primary aims of this study were to determine the effects of lifelong exercise and detraining on age‐related alterations in mitochondrial function, inflammation associated with senescence‐associated secretory phenotype (SASP), and lipolysis in the perirenal fat and liver of rats. Female Sprague–Dawley rats were randomly assigned to four groups: young control (n = 12), old control (n = 12), detraining (n = 12), and lifelong exercise (n = 12). We then investigated mitochondrial function, SASP‐associated inflammation, and lipolysis in the perirenal fat and liver using qRT‐PCR and western blotting to assess the expression of AKT, hypoxia‐inducible factor 1α (HIF‐1α), nuclear factor‐kappa B (NF‐κB), c‐jun kinase (JNK), and p38 mitogen‐activated protein kinase (p38MAPK). In the tissues of both the perirenal fat and liver, lifelong exercise significantly improved mitochondrial function, SASP‐associated inflammation, and lipolysis. Meanwhile, pathways associated with inflammatory regulation were inhibited, predominantly via the activation of phosphorylated‐AKT (p‐AKT) and suppression of HIF‐1α in both tissues, and via JNK in the perirenal fat and p38MAPK in the liver. Furthermore, detraining activated NF‐κB expression in both tissues and induced the upregulation of serum high‐sensitivity C‐reactive protein (hsCRP) levels. Collectively, lifelong exercise was found to exert beneficial effects by ameliorating age‐related alterations in mitochondrial function, SASP‐associated inflammation, and lipolysis in perirenal fat and liver tissues, potentially inhibiting inflammation via the JNK and p38 MAPK pathways, respectively, as well as the HIF‐1α and AKT pathways in both tissues. In contrast, detraining induced high levels of circulating hsCRP by activating the NF‐κB signaling pathway in both tissues.
... Results have been varied, from no significant difference after 12 months of training, to extraordinarily large increases many times greater than mean change reported in meta-analyses (13,22) . Novel methods of utilising resistance training equipment with older adults, such as kettlebells (23) and weighted vests (24) , allow researchers to determine how changing program variables may influence the bone response to exercise. These investigations are valuable as exercise interventions thus far, appear to have been more effective at maintaining rather than increasing bone mass. ...
Preprint
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The purpose of this case study was to report clinically significant increases in bone mineral density (BMD) in a female and a male over 70 years of age with osteoporosis, following 16 weeks of hardstyle kettlebell training. Both case subjects were insufficiently active prior to participating in the BELL trial. Subjects trained five days a week accruing a large training load volume (calculated as kettlebell weight multiplied by repetitions performed) during structured group-based classes (74,872 kg and 110,132 kg, respectively). Regional dual-energy X-ray absorptiometry was used to assess BMD at the hip and lumbar spine. Increases in BMD of 12.7% and 5.9% at the femoral neck and lumbar spine (L2-L4) respectively were observed for the female, and 2.5% and 6.0% respectively for the male. Magnitude of change in BMD (g/cm ² ) at the lumbar spine was 2.0 and 1.9 times larger than the least significant change for the female and male respectively, and sufficient to advance the female subject's status from osteoporosis to osteopenia. Although these results do not show a definitive causal relationship between kettlebell training and increased BMD, further investigation of the effects of kettlebell training on BMD in older adults with osteoporosis and osteopenia is warranted.
... Group exercise in particular is rewarding (25) , and previously trained older adults returning to resistance training, describe a renewed enthusiasm for it (26) . Kettlebell training has previously shown to be efficacious, for improving function in older adults with Parkinson's disease (27) , and body composition, strength, and pulmonary function in older women sarcopenia (28) . Data from kettlebell training in younger adults, show improvements in dynamic balance (29) , which adds to its' potential benefits as a helpful mode of exercise for the older adult. ...
Preprint
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Objectives This study examined older adults’ experiences of participating in the BELL trial, involving 12-weeks of group-based hardstyle kettlebell training. Methods In the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59-79 years) completed 6 weeks of face-to-face group training, and 6 weeks of home-based training. In-depth semi-structured interviews were audio recorded and transcribed, inductively coded, with themes constructed thematically from patterns of shared meaning. Results Four higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done” - enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!” - change in a long-term health condition, (3) “It put me on a better course” - overcoming challenges, (4) “I wasn’t just a number” - feeling part of a group/community. Discussion Findings highlight the perceived physical and psychological benefits of participating in hardstyle group kettlebell training, the value attributed to being part of an age-matched community of like-minded people engaged in group-exercise, as well as the challenges participants faced, and the sense of achievement in overcoming them. Implications for program design and delivery, and future research are discussed.
... Physical inactivity is an etiology for sarcopenia [1], and increasing physical activity is effective in preventing and improving sarcopenia [12][13][14][15][16]. Other studies have also reported the benefits of physical activity on muscle strength, flexibility, psychological distress, and quality of life [17][18][19]. ...
Article
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Background Previous studies reported that sarcopenia and physical inactivity affected clinical outcome in older adults; however, the association with functional outcome has not been studied in a rehabilitation setting.AimThis study aimed to assess the association of sarcopenia and physical activity with the functional outcome in older hospitalized rehabilitation patients.MethodsA cross-sectional study was performed in older patients consecutively admitted to convalescent rehabilitation wards. Sarcopenia was diagnosed based on the Asia Working Group for Sarcopenia 2019 criteria, and physical activity time (light-intensity physical activity, LIPA; moderate-to-vigorous physical activity, MVPA) was measured using an activity monitor with a triaxial accelerometer. The association of sarcopenia and physical activity with functional outcome, measured by the Functional Independence Measure (FIM) motor function, was determined using multiple regression analysis adjusted for age, sex, primary disease diagnosis, length of acute hospital stay, Charlson comorbidity index, body mass index, and mini-nutritional assessment-short form score. ResultsOut of 211 rehabilitation older inpatients [median (interquartile range) age 78 (11) years, 150 women (71%)], 104 patients (49%) were diagnosed with sarcopenia. Patients with sarcopenia had significantly lower LIPA (p < 0.001) and MVPA (p = 0.002) than those without sarcopenia. In multiple regression analysis, LIPA (β = 0.39, p < 0.001) and MVPA (β = 0.12, p = 0.02) were associated with FIM-motor function even after they were adjusted for confounding factors, including sarcopenia.Conclusions In rehabilitation older inpatients, sarcopenia and physical activity were independently associated with functional outcome, and physical activity was lower in sarcopenia patients than in those without sarcopenia.
... Concurrently, growing scientific data propose exercise interventions as effective measures to mitigate or even partially reverse this age associated decay and prevent adverse outcomes (Nawrat-Szoltysik et al., 2018;Wisdom et al., 2015;Cesari et al., 2015;Cadore et al., 2014;Chen et al., 2018;Moore et al., 2018;Seldeen et al., 2018). Importantly, different exercise modalities in that regard exhibit a very distinct profile regarding both feasibility in the elderly as well as efficacy in terms of achieving meaningful training results and overall improvements. ...
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Background Aging is associated with progressive loss of musculoskeletal performance. Exercise interventions can improve physical function in the elderly but there is a paucity of comparative assessments in order to understand what specific goals can be achieved particularly with less demanding exercise interventions readily accessible for untrained men. Methods Prospective randomized, controlled, single center exploratory trial to compare four distinct exercise interventions, i.e. Resistance Training (RT), Whole Body Vibration Exercise (WBV), Qi Gong (QG) and wearing a Spinal orthosis (SO) for 6 months in men at risk for osteoporosis aged 65–90 years. Primary endpoint was change in isometric one repetition maximum force trunk strength for extension (TSE) and flexion (TSF) compared to baseline, secondary endpoints covered key parameters of geriatric functional assessment, including Handgrip Strength (HS), Chair-Rise-Test (CRT), Usual Gait Speed (UGS) and Timed-Up-and-Go (TUG). Results Altogether 47 men (mean age 77 ±6.1 years) were randomized to RT, (n = 11) WBV (n = 13), QG (n = 10) and SO(n = 13). RT, defined as reference exercise intervention, lead to significant improvements for TSE (p = 0.009) and TSF (p = 0.013) and was significantly superior in the between-group analysis for TSE (p = 0.038). Vibration exercise caused sign. Improvements in TSE (p = 0.014) and CRT (p = 0.005), the Spinal orthosis improved CRT (p = 0.003) and Gait Speed (p = 0.027), while the QG intervention did not attain any sig. Developments. Subgroup analyses revealed most pronounced musculoskeletal progress in vulnerable patients (age ≥ 80 years, pre-sarcopenia, multimorbidity ≥3chronic diseases). Irrespective of the type of exercise, participants ≥80 years experienced significant gains in TSE (p = 0.029) and CRT (p = 0.017). Presarcopenic subjects (Skeletal muscle Index (SMI) ≤10.75 kg/m²) improved in TSE (p = 0.003), CRT (p = 0.001) and UGS (p = 0.016). Multimorbid participants achieved sig. Gains in TSE (p < 0.001), TSF (p = 0.002), UGS (p = 0.036) and HS (p = 0.046). Conclusions In this exploratory trial we found that simple exercise interventions are feasible in elderly men eliciting specific benefits, i.e. improvements are attained in those tasks addressed with the respective exercise modality. While targeted resistance training is superior in increasing TSE, alternative simple exercise interventions also appear to elicit beneficial effects, even in vulnerable patients, i.e. those with low muscle mass, above 80 years of age or multimorbidity.
... The process of concealed allocation was used in seven studies. The methods of single-or double-blinding of assessor and intentionto-treat analysis were used in nine studies (34, 36, 38-40, 42-44, 46) and seven studies (31,32,38,39,41,44,46), respectively. As for the other characteristics, such as similarity on key measures at baseline, comparison with more than one outcome was fully reported in the included studies. ...
Article
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Background: Sarcopenia is a muscle disease in loss of muscle strength, mass, and function associated with aging. Although protective effects of exercise on muscle mass and function are generally recognized, research findings in sarcopenic adults are inconsistent. It is necessary to conduct a systematic review to determine the effects of exercise on muscle strength, body composition, and physical performance in older adults with sarcopenia, and to examine the potential moderators including sociodemographic characteristics and exercise-related factors. Methods: Six electronical academic databases (Medline, Embase, CINAHL, Scopus, Cochrane Library, and SPORTDiscus) were used to retrieve the eligible studies from inception to May 2020. Two reviewers independently selected and extracted the data from each included study, and effect sizes were calculated by employing random-effect models with 95% confidential interval (CI). The Physiotherapy Evidence Database (PEDro) scale was used to assess study quality. Results: Seventeen studies (985 participants with sarcopenia, aged 67.6–86 years) were included in this review study. The meta-analytic results showed significant improvements in muscle strength [grip strength, SMD = 0.30, 95% CI (0.15, 0.45), I ² = 6%, p < 0.01; knee extension, SMD = 0.32, 95% CI (0.15, 0.50), I ² = 0%, p < 0.01; and chair and stand, SMD = 0.56, 95% CI (0.30, 0.81), I ² = 36%, p < 0.01], in physical performance [timed up and go, SMD = 0.74, 95% CI (0.48, 1.00), I ² = 0%, p < 0.01; and gait speed, SMD = 0.59, 95% CI (0.35, 0.82), I ² = 62%, p < 0.01], and in body composition [skeletal muscle mass index, SMD = 0.37, 95% CI (0.15, 0.58), I ² = 16%, p < 0.01; and appendicular skeletal muscle, SMD = 0.31, 95% CI (0.13, 0.49), I ² = 20%, p < 0.01]. However, there were no significant differences in other body composition (SMD = 0.20–0.36). Additionally, meta-regression revealed that the higher percent of female participants was significantly associated with improved gait speed (β = 0.0096, p = 0.03) and decreased skeletal muscle mass index (β = −0.0092, p = 0.01). Conclusions: The current meta-analysis suggests that exercise is a beneficial therapy, which has protective effects for older adults with sarcopenia. Some beneficial effects may be moderated by gender and exercise intensity.
... It has also been shown that Japanese people aged 20 to 64 years with high HL have a lower smoking rate and drinking frequency, and an increase in exercise behavior [28]. The need for exercise in maintaining the health of old-old adults is obvious and has been reported to improve physical function as well as the quality of life [29][30][31][32]. ...
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Health literacy is important for promoting and maintaining good health in old-old adults. It may influence the implementation of exercise in the coronavirus disease epidemic. The present cross-sectional study investigated the association of each dimension of health literacy with the implementation of exercise during the declaration of a state of emergency due to coronavirus disease in community-dwelling old-old adults. We collected data from 483 community-dwelling old-old adults (52.8% women) aged between 77 and 99 years who participated in a mail survey. Participants were divided into exercise or nonexercise groups based on the implementation of exercise during the declaration of a state of emergency. Health literacy was assessed using a 14-item health literacy scale. There were 327 (67.7%) participants in the exercise group and 156 (32.3%) in the nonexercise group. A significantly higher score of health literacy was observed in the exercise group than in the nonexercise group (communicative health literacy score = 14.0 ± 3.6 vs. 12.7 ± 3.8, p = 0.001). In a multivariate logistic regression model adjusted for potential confounders, high communicative health literacy scores were significantly associated with the implementation of exercise during the declaration of a state of emergency (odds ratio = 1.88, 95% confidence interval = 1.20–2.93). Approximately two-thirds of community-dwelling old-old adults implement exercise during the declaration of a state of emergency. High communicative health literacy was associated with the implementation of exercise during this period.
... Chen et al. (6) randomized 33 elderly women (65-75 years) with sarcopenia to either an 8-week kettlebell training intervention (60 minutes per session twice a week) or a control group intervention followed by 4 weeks of detraining. The authors found a significant increase in appendicular skeletal muscle Strength and Conditioning Journal | www.nsca-scj.com ...
Article
The coronavirus pandemic and the adopted social isolation to contain the virus spread led to several negative consequences including the decrease in the population's physical activity levels and increased physical inactivity and sedentary behavior. Home-based physical exercise assumes fundamental importance to maintain physical activity and fitness levels. Among the various exercise possibilities of home-based exercise, the kettlebell exercise can be a useful and low-cost tool. The kettlebell is a round-shaped steel or cast-iron weight, commonly described as resembling a cannonball with a handle whose dimensions increase with weight that varies from 2 to 92 kg. Kettlebell exercise offers an opportunity to train multiple muscles through functional exercises that could be performed at home to improve and maintain health-related physical fitness (e.g., cardiorespiratory capacity, muscle strength, and body composition) and mental health. In addition, kettlebell exercise (with a progressive increase in training overload) could be an alternative of home-based exercise program for the general population during pandemic outbreaks.
... Also, their high-sensitivity C-reactive protein levels were lower than they were at baseline. At follow-up, handgrip strength, back strength, and PEF were higher than in a control group (79). ...
Article
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The condition of muscle fiber atrophy and weakness that occurs in respiratory muscles along with systemic skeletal muscle with age is known as respiratory sarcopenia. The Japanese Working Group of Respiratory Sarcopenia of the Japanese Association of Rehabilitation Nutrition narratively reviews these areas, and proposes the concept and diagnostic criteria. We have defined respiratory sarcopenia as “whole-body sarcopenia and low respiratory muscle mass followed by low respiratory muscle strength and/or low respiratory function.” Respiratory sarcopenia can be caused by various factors such as aging, decreased activity, undernutrition, disease, cachexia, and iatrogenic causes. We have also created an algorithm for diagnosing respiratory sarcopenia. Respiratory function decreases with age in healthy older people, along with low respiratory muscle mass and strength. We have created a new term, “Presbypnea,” meaning a decline in respiratory function with aging. Minor functional respiratory disability due to aging, such as that indicated by a modified Medical Research Council level 1 (troubled by shortness of breath when hurrying or walking straight up hill), is an indicator of presbypnea. We also define sarcopenic respiratory disability as “a disability with deteriorated respiratory function that results from respiratory sarcopenia.” Sarcopenic respiratory disability is diagnosed if respiratory sarcopenia is present with functional disability. Cases of respiratory sarcopenia without functional disability are diagnosed as “at risk of sarcopenic respiratory disability.” Functional disability is defined as a modified Medical Research Council grade of 2 or more. Rehabilitation nutrition, treatment that combines rehabilitation and nutritional management, may be adequate to prevent and treat respiratory sarcopenia and sarcopenic respiratory disability.
... Muscle strength and muscle mass decline with aging; Comparatively, the decline is faster for muscle strength, and can lead to difficulties in daily activities, weakness, disability, decrease in quality of life, and early mortality [2]. Several factors, such as lifestyle, diet quality and dietary patterns [3], low protein intake [4], obesity [5] and physical activity [6] may elicit negative effects on muscle strength. Many nutritional studies that have investigated the effect of single macro-and micro-nutrients on skeletal muscle function have reported equivocal findings [7,8]. ...
Article
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Objective: There is limited evidence regarding the association between dietary acid load and muscle strength. Thus, in this study, we investigated the association between dietary acid-base load indices and muscle strength among Iranian adults. Results: This cross-sectional study was conducted on 270 Iranian adults, aged 18-70 year. Dietary acid load indexes, were calculated by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Muscle strength was measured by a digital handgrip dynamometer. There was a significant increase in mean muscle strength of left-hand (MSL), muscle strength of right-hand (MSR) and the mean of the MSL and MSR (MMS) across tertiles of Potential Renal Acid Load (PRAL), Net Endogenous Acid Production (NEAP), and Dietary Acid Load (DAL). Significant linear relationships between PRAL and; MSL (β = 0.24, p < 0.001), MSR (β = 0.23, p < 0.001) and MMS (β = 0.24, p < 0.001), between NEAP and MSL (β = 0.21, p < 0.001), MSR (β = 0.19, p = 0.002), and MMS (β = 0.20, p = 0.001) and between DAL and MSL (β = 0.25, p < 0.001), MSR (β = 0.23, p < 0.001) and MMS (β = 0.24, p < 0.001), were attenuated after controlling for potential confounders. However, the nonlinear relationship between dietary acid load indicators and muscle strength were significant (p < 0.001 for all).
... Muscle hypertrophy seems to take place with an optimal combination between mechanical tension, [110]. In addition, a reduction of CRP in the resistance exercise group was also reported in this study, without differences for IL-6 and TNF in comparison to control group ( Figure 2). ...
... Concurrently, growing scientific data propose exercise interventions as effective measures to mitigate or even partially reverse this age associated decay and prevent adverse outcomes (17)(18)(19)(20)(21)(22)(23). ...
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Background: Aging is associated with progressive loss of musculoskeletal performance. Exercise interventions can improve physical function in the elderly but there is a paucity of comparative assessments in order to understand what specific goals can be achieved particularly with less demanding exercise interventions readily accessible for untrained men. Methods: Prospective randomized, controlled, single center trial to compare efficacy and feasibility of four distinct exercise interventions for 6 months in men at risk for osteoporosis aged 65-90 years. Primary endpoint was change in isometric one repetition maximum force trunk strength for extension (TSE) and flexion (TSF) compared to baseline, secondary endpoints covered key parameters of geriatric functional assessment, including Handgrip Strength (HS), Chair-Rise-Test (CRT) Usual Gait Speed (UGS) and Timed-Up-and-Go (TUG). Results: Altogether 47 men (mean age 77 +/-6.1years) were randomized to Resistance Training (RT, n=11), Whole Body Vibration Exercise (WBV, n=13), Qi Gong (QG, n=10) and wearing a Spinal Orthosis (SO, n=13). RT lead to significant improvements for TSE (p=0.009) and TSF (p=0.013). Vibration exercise caused sign. Progress in TSE (p=0.014) and CRT (p=0.005), the Spinal Orthosis improved CRT (p=0.003) and Gait Speed (p=0.027), while the QG Group did not attain any sig. developments. Subgroup analyses revealed most pronounced musculoskeletal progress in vulnerable patients (age ≥80years, pre-sarcopenia, multimorbidity ≥3chronic diseases). Irrespective of the type of exercise, participants ≥80years experienced significant gain in TSE (p=0.029) and CRT (p=0.017). Presarcopenic subjects (Skeletal muscle Index (SMI) ≤10.75 kg/m²) improved in TSE (p=0.003), CRT (p=0.001) and UGS (p=0.016). Multimorbid participants achieved sig. gains in TSE (p<0.001), TSF (p=0.002), UGS (p=0.036) and HS (p=0.046). Conclusions: Simple exercise interventions are feasible in elderly men with specific efficacy, i.e. improvements are attained in those tasks addressed with the training. Consequently, exercise strategies in elderly men should comprise multiple modalities to comprehensively cover various deficits. For vulnerable patients, any simple training appears beneficial.
Article
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Diet and lifestyle as modifiable factors play an effective role in muscle strength and muscle endurance. In addition, inflammatory reactions may have an association with the etiology of a a lower muscle strength and muscle endurance. We aimed to investigate the association of dietary and lifestyle inflammation scores (DLIS) with muscle strength and muscle endurance in a sample of Iranian adults. In this cross-sectional study, 270 adults aged 20 to 59 years (55.9% female) were selected. The dietary intakes were collected using a 168-item semi-quantitative food frequency questionnaire. The DLIS was calculated using the dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS). Muscle endurance and muscle strength were measured by a digital-handgrip-dynamometer. Multivariate adjusted means for muscle strength and endurance across quartiles of the DIS, LIS, and DLIS were determined by the ANCOVA test. Multiple linear regression analysis was used to evaluate the association between inflammation scores (i.e., DIS, LIS, and DLIS), and muscle strength, muscle endurance. The DLIS ranged between −2.94 and 3.09. The adjusted P-value of muscle strength of the right hand (MSR) along quartiles of DIS was significantly lower (P = 0.024). MSR (β: −1.19; P-value: 0.020) and mean muscle strength (MMS) (β: −0.95; P-value: 0.047) had significant association with DIS. MSR (β: −0.85; P-value: 0.050) had a marginally significant association with DLIS. Overall, we found that a high adherence to a pro-inflammatory diet might be associated to a lower muscle strength. However, a lifestyle with greater inflammatory potential was not related to any components of muscle endurance. Further studies with prospective designs are needed to confirm the present findings in further details.
Article
Background Resistance training is recommended for preventing sarcopenia, but the benefits for the quality and quantity of muscle mass are uncertain. Objective To assess the effects of high-intensity resistance training (HIRT) on clinical and magnetic resonance imaging (MRI) parameters in women with sarcopenia. Methods A researcher-blinded randomized clinical trial was conducted. Community-dwelling older women with sarcopenia were randomized to six months of HIRT or a control group (CG). Body composition was assessed with bioimpedance equipment, and participants underwent strength and functional performance tests (short physical performance battery [SPPB] and gait speed). MRI scans of the thigh were taken to quantify muscle mass and quality. Results Thirty-eight women completed the study (20 in the HIRT group). Sarcopenia remitted in 50 % of the HIRT group. HIRT elicited a significant group × time interaction effect for muscle mass (p = 0.027 Ƞ² = 0.129), muscle mass index (p = 0.023 Ƞ² = 0.135), fat mass (p = 0.048, Ƞ² = 0.103) and all strength variables (p < 0.05; Ƞ² > 0.120). Moreover, the HIRT group obtained higher scores on the SPPB (mean difference [MD] 1.2; p = 0.005) and the 5 times sit-to-stand test (MD = 0.7; p = 0.009). Regarding MRI parameters, infiltrated microscopic fat decreased significantly (HIRT: MD = −0.01; p < 0.05), while hydration (T2) decreased in the CG (MD = 3.6 ms; p = 0.053) at six months. There were significant between-group differences at six months for water diffusion (HIRT: 1.09 × 10⁻³ mm²/s vs CG: 1.26 × 10⁻³ mm²/s) and total muscular volume (HIRT: 832.4 L vs CG: 649.2 L). Conclusions HIRT led to the remission of sarcopenia in half of the older women, as seen in muscle mass, strength, and functional performance and MRI biomarkers, with significant increases in muscle quality. Registered in ClinicalTrials.gov NCT03834558.
Thesis
La broncho-pneumopathie chronique obstructive (BPCO) représente la troisième cause de décès dans le monde. Elle touche 15 millions Français mais seul 1/3 reçoivent un diagnostic médical. Le dépistage et l’évaluation initiale des patients représentent un enjeu essentiel dans la prise en charge à long terme de la BPCO dans l’objectif d’améliorer la qualité de vie et de diminuer le handicap.La réhabilitation respiratoire (RR) est un traitement efficace de la BPCO, qui consiste en une prise en charge globale du malade comportant un réentrainement à l’effort, de la kinésithérapie respiratoire et une éducation thérapeutique du patient.Le test de marche de 6 minutes (TM6) est le test universel utilisé pour évaluer la performance physique du patient et constitue l’outil principal d’évaluation de l’effet de la réhabilitation. Toutefois, il persiste des patients non-répondeurs selon ce critère mais qui expriment une amélioration de leur état général selon d’autres critères. En effet, ce test est facile à réaliser mais n’évalue que la capacité globale à la marche au cours d’un test court, alors que le succès du programme de réhabilitation dépend d’autres acquisitions physiques (force, équilibre, endurance), psychologiques (anxiété, dépression, estime de soi, motivation) et éducative (connaissance de la maladie, de ses traitements, acquisition de la capacité de l’auto-soin).Nous proposons d’analyser la réponse des patients BPCO à la RR afin de déterminer des phénotypes de patients avec des clusters selon leurs réponses à la RR, et d’identifier les prédicateurs de la réponse à la RR, pour à terme pouvoir proposer une optimisation de la RR selon ces phénotypes.
Article
Objective This study aimed to determine the comparative effectiveness of interventions in treatment of sarcopenia. The primary outcome was the measure of treatment effect on muscle mass, and secondary outcomes were the treatment effect on muscle strength and physical performance. Design Systematic review and network meta-analysis (NMA). Setting and Participants Participants with sarcopenia receiving interventions targeting sarcopenia in any setting. Methods Data sources: Relevant RCTs were identified by a systematic search of several electronic databases, including CINAHL, Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials (CENTRAL) from January 1995 to July 2019. Duplicate title and abstract and full-text screening, data extraction, and risk of bias assessment were performed. Data extraction: All RCTs examining sarcopenia interventions [mixed exercise (combined aerobic and resistance exercise), aerobic exercise, resistance exercise, balance exercise, physical activity and protein or nutrition supplementation, acupuncture, whole-body vibration, protein supplement or interventions to increase protein intake, any nutritional intervention other than protein, and pharmacotherapy] were included. Comparators were standard care, placebo, or another intervention. Data synthesis: We performed Bayesian NMA; continuous outcome data were pooled using the standardized mean difference effect size. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. Results A total of 59 RCTs were included after screening of 4315 citations and 313 full-text articles. Network meta-analysis of muscle mass outcome (including 46 RCTs, 3649 participants, 11 interventions) suggested that mixed exercise were the most effective intervention (SUCRA = 93.94%) to increase muscle mass. Physical activity and protein or nutrition supplementation, and aerobic exercise were the most effective interventions to improve muscle strength and physical performance, respectively. Overall, mixed exercise is the most effective intervention in increasing muscle mass and was one of the 3 most effective interventions in increasing muscle strength and physical performance. Conclusions and Implications Mixed exercise and physical activity with nutritional supplementation are the most effective sarcopenia interventions. Most of the included studies have a high risk of bias. More robust RCTs are needed to increase the confidence of our NMA results and the quality of evidence.
Article
Background We aimed to examine the combined association of dietary acid load and obesity with muscle strength. Methods This cross-sectional study was conducted on 270 adults (118 men and 152 women), aged 18-70 y. Dietary data were collected using a validated 168-item semi-quantitative food frequency questionnaire. Potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) were calculated. General obesity was defined as a body mass index (BMI) ≥30 kg/m² and abdominal obesity was defined as a waist circumference (WC) ≥102 cm for men and ≥88 cm for women. Muscle strength was measured by a digital handgrip dynamometer. Results The mean of muscle strength was higher in participants classified as high-PRAL/BMI≥30 (P = 0.01), high-PRAL/WC < 102 (men) or 88 (women) (P = 0.002), high-NEAP/BMI≥30 (P = 0.002), high-NEAP/WC < 102 (men) or 88 (women) (P < 0.001) and also high-DAL/BMI≥30 (P = 0.01) and high-DAL/WC < 102 (men) or 88 (women) (P = 0.001) compare to other classifications in the crude model. Both for obese and non-obese people PRAL, NEAP, and DAL were associated with higher muscle strength, which is opposite to the acid hypothesis. These associations were not significant after adjustment for confounders. Also, the mean of skeletal muscle mass was higher in participants that were classified as high-PRAL/BMI≥30 and high-PRAL/WC < 102 (men)-or-88 (women), high-NEAP/BMI≥30, and high-NEAP/WC < 102 (men)-or-88 (women), high-DAL/BMI≥30 and high-DAL/WC < 102 (men)-or-88 (women) (Ptrend<0.001 for all). These significant associations remained significant after controlling for confounders. Conclusions We found that the interaction of dietary acid load and general and central obesity could be associated with skeletal muscle mass but not muscle strength. All findings of association indicated higher muscle strength and skeletal muscle mass with higher acid diet measures, contrary to the acid hypothesis.
Article
Sarcopenia is a geriatric disease characterized by a marked loss of muscle mass and strength. This has led to it being recognized for the role it plays in elderly morbidity and mortality. It is a multifactorial disease with many mechanisms to how it comes about. So far, increasing physical activity has proven to be the best therapeutic agent. Exercise is capable of increasing flow of nutrition to muscle, reversing mitochondrial damage, increasing muscle mass, and strength. Furthermore, resistance training has been shown to be superior to aerobic training when it comes to increasing muscle mass and strength. Additionally, exercise plays a role in both prevention and treatment of sarcopenia, especially in a background of adequate nutrition. With increasing age, the effect of exercise is also subjected to issues such as anabolic resistance that can make increasing muscle mass and strength more challenging. However, physical activity and exercise remain the most important components of improving muscular strength.
Article
Objectives : To conduct a comprehensive evidence synthesis to verify the available literature on the effects of exercise intervention on muscle mass, muscle strength, and physical function in older adults with muscle wasting. Methods Systematic literature searches of the PubMed/Medline, CINAHL, EMBASE, Cochrane Library, and Airiti Library databases were performed for exercise-related randomized controlled trials among adults aged 60 years and above with muscle wasting disease, published from 2010 to April 30, 2021. The search included the keywords and synonyms: “older,” “sarcopenia,” “cachexia,” “muscle wasting,” “exercise’. Results The systematic review included 34 studies: 25 on patients with sarcopenia and 9 on patients with cachexia. Sarcopenia and cachexia were analyzed as separate subgroups. The effects of exercise in the sarcopenia group showed significant improvement in the following parameters: body composition (appendicular skeletal muscle [ASM] [standardized mean difference, SMD 0.38, P = 0.05] and ASM/height² [SMD 0.14, P = 0.02]), muscle strength (grip strength [SMD 1.73, P < 0.0001]), and physical performance (gait speed [SMD 0.14, P < 0.00001] and the timed up and go test [SMD -1.20, P < 0.00001]). Similarly, in the cachexia group, exercise intervention showed improvement in the body composition (ASM [SMD 3.38, P = 0.001]) and physical performance (400 m walk [SMD -36.00, P = 0.02]). Conclusions Exercise intervention has significant benefits in older adults with muscle wasting diseases. More well-designed large-sample-sized studies with long-term follow-ups are warranted to verify the benefits of exercise intervention in this population.
Article
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Objective We conducted a meta-analysis to analyze the effects of resistance training on measures of body composition, muscle strength, and muscle performance in older people with sarcopenia. Methods All randomized controlled trials on the effects of resistance training on outcome variables in older people with sarcopenia were searched on Pubmed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Data from January 2010 to October 2020 were reviewed. Two researchers extracted data and evaluated the quality of the studies that met the inclusion criteria independently. Meta-analysis for pre-post changes were calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). Results Fourteen studies meeting inclusion criteria included 561 healthy older adults (age 65.8 to 82.8) with sarcopenia. Compared with the control group, resistance training had positive effects on body fat mass (SMD = -0.53, 95% CI − 0.81 to − 0.25, p = 0.0002, I 2 = 0%), handgrip strength (SMD = 0.81, 95%CI 0.35 to 1.27, p = 0.0005, I 2 = 81%), knee extension strength (SMD = 1.26, 95% CI 0.72 to 1.80, p < 0.0001, I 2 = 67%), gait speed (SMD = 1.28, 95%CI 0.36 to 2.19, p = 0.006, I 2 = 89%), and the timed up and go test (SMD = -0.93, 95% CI − 1.30 to − 0.56, p < 0.0001, I 2 = 23%). Resistance training had no effects on appendicular skeletal muscle mass (SMD = 0.25, 95% CI − 0.27 to 0.78, p = 0.35, I 2 = 68%), skeletal muscle mass (SMD = 0.27, 95% CI − 0.02 to 0.56, p = 0.07, I 2 = 0%) and leg lean mass (SMD = 0.12, 95% CI − 0.25 to 0.50, p = 0.52, I 2 = 0%). Old people with sarcopenia of different ages, genders or diagnostic criteria and weights have different gains in muscle mass, handgrip strength, knee extension strength and muscle performance after different intervention duration, frequencies, mode and intensity resistance training. Conclusion Resistance training is an effective treatment to improve body fat mass, muscle strength, and muscle performance in healthy older people with sarcopenia.
Article
From the third decade of life and due to multiple causes, muscle mass and strength are gradually lost, which affects the function of the musculoskeletal system. This combined loss of muscle mass and strength with aging is called sarcopenia, and is associated with greater morbidity and mortality in the elderly. Early treatment is therefore essential, and physical exercise is the therapeutic approach that has given the best results. This literature review intended to analyze the effect of physical exercise, excluding the role that other treatments proposed, including the nutritional approach, could play in the treatment of sarcopenia, refers to 12 articles. In studies including high intensity strength exercises in isolation, either alone or combined with aerobic exercise, improvements were seen in muscle mass, muscle strength, and functional test times. There is also a significant increase in fat-free mass in individuals who exercised more frequently (more than two sessions per week). Current evidence shows that strength-resistance training and its combination in multimodal programs with aerobic exercise show significantly beneficial effects on anthropometric and muscle function parameters. Programs of prescribed exercises including strength exercises adequate to the characteristics should therefore be adapted to the characteristics of each individual and replace the usual practice of prescribing aerobic exercises (walking) only.
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Resumen A partir de la tercera década de la vida, y por causas multifactoriales, se pierde masa y fuerza muscular de forma progresiva, afectando a la funcionalidad del aparato locomotor. A esta pérdida combinada de masa y fuerza muscular que aparece con el envejecimiento se le denomina sarcopenia, la cual se asocia a una mayor morbimortalidad en el sujeto anciano, por lo que el tratamiento precoz es fundamental, siendo el ejercicio físico la estrategia terapéutica que mejores resultados ha demostrado. En esta revisión bibliográfica realizada para analizar el efecto individual del ejercicio físico, excluyendo el papel que podría representar en el tratamiento de la sarcopenia otras propuestas desde el enfoque nutricional, se incluyen 12 artículos. En aquellos estudios que incluían ejercicios de fuerza de alta intensidad de forma aislada, exclusivamente o combinado con ejercicio aeróbico, se observa mejoría de la masa muscular, fuerza muscular y tiempos en pruebas funcionales. Existe asimismo un incremento significativo de masa libre de grasa en individuos que realizaban ejercicio con mayor frecuencia (más de 2 sesiones a la semana). La evidencia actual demuestra que los entrenamientos basados en fuerza-resistencia y la combinación en programas multimodales con ejercicio aeróbico muestran efectos significativamente beneficiosos sobre parámetros antropométricos y de funcionalidad muscular, debiendo por tanto adecuarse los programas de ejercicios pautados, incluyendo ejercicios de fuerza adaptados a las características de cada individuo, y sustituir a la práctica habitual de prescribir en exclusiva ejercicios de tipo aeróbico (caminar).
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PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, p =.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, p =.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, p =.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, p =.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, p =.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, p =.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.
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PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, p =.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, p =.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, p =.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, p =.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, p =.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, p =.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.
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We determined muscle fiber type–specific hypertrophy and changes in satellite cell (SC) content following a 12-week resistance training program in 13 healthy, elderly men (72 ± 2 years). Leg strength and body composition (dual-energy X-ray absorptiometry and computed tomography) were assessed, and muscle biopsy samples were collected. Leg strength increased 25%–30% after training (p < .001). Leg lean mass and quadriceps cross-sectional area increased 6%–9% (p < .001). At baseline, mean fiber area and SC content were smaller in the Type II versus Type I muscle fibers (p < .01). Following training, Type II muscle fiber area increased from 5,438 ± 319 to 6,982 ± 503 μm2 (p < .01). Type II muscle fiber SC content increased from 0.048 ± 0.003 to 0.084 ± 0.008 SCs per fiber (p < .001). No changes were observed in the Type I muscle fibers. In older adults, skeletal muscle tissue is still capable of inducing SC proliferation and differentiation, resulting in Type II muscle fiber hypertrophy.
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Loss of muscle power due to normal aging has greater functional impact than loss of strength alone. The present study compared two resistance training programs, one aimed at enhancing muscle power and one at increasing muscle strength, on muscle function and functional performance in older adults. Sixty-seven healthy, independent older adults (65-84 years) were randomized to a high-velocity varied resistance (HV), constant resistance (ST), or nontraining control (CO) group. Participants trained twice weekly for 24 weeks using six exercises. Dynamic and isometric muscle strength, muscle power, movement velocity, muscle endurance, and a battery of functional performance tasks were assessed. Secondary outcomes included body composition, quality of life, and balance confidence. Muscle strength increased significantly (p <.001) and similarly in the training groups compared to controls (HV, 51.0 +/- 9.0%; ST, 48.3 +/- 6.8%; CO, 1.2 +/- 5.1%). Peak muscle power also increased with training (p <.05), with no difference between training groups. The change in peak power was 50.5 +/- 4.1%, 33.8 +/- 3.8%, and -2.5 +/- 3.9% in the HV, ST, and CO groups, respectively. Training also improved selected functional performance tasks in the HV and ST groups compared to controls (p <.05), and the HV group reported improved quality of life (p =.018). Muscle power and muscle strength improved similarly using either resistance training protocol, and these changes were accompanied by improvements in several functional performance tasks. However, improvements in the HV group occurred with less total work performed per training session.