Remote delivery of a resistance exercise and protein intervention to improve muscle parameters in 40-65-year-olds: a feasibility study. The REMEND trial

ABSTRACT

Sarcopenia is the reduction of muscle mass and strength associated with ageing(1). Resistance exercise alone and in combination with protein is thought to lead to increased muscle protein synthesis and may help combat sarcopenia(2). Resistance exercise is traditionally undertaken in a gym setting, using fixed-machines and free weights, however, this environment can be unappealing to middle-older age adults. Access to gyms was also prohibited during COVID-19 UK lockdowns leading us to explore alternative approaches to delivering nutrition and exercise intervention trials. The aim of this study was to evaluate the feasibility of remote delivery of a homebased resistance exercise and protein intervention. This was a six week, 3-arm parallel intervention trial. Participants aged between 40-65 years were recruited via a social media advertising campaign and randomised to one of 3 treatment arms i) resistance exercise, ii) resistance exercise and 15 g of protein/day (taken alongside lunch) or iii) resistance exercise and 30 g of protein/day (15 g taken alongside breakfast and 15 g taken alongside lunch.) The home-based resistance exercise intervention was conducted using resistance bands and consisted of 50-minute exercise sessions delivered live via videoconferencing. Participants were asked to participate in two exercise sessions per week. Protein was consumed as a gel supplement (Pro-source Plus) supplied by Nutrinovo (www.nutrinovo.com). Participants were asked to record their engagement and experience in a trial logbook and took part in semi-structured interviews at the end of the intervention period. In-person assessments of muscle strength and function, physical activity and diet were made at baseline and end of the intervention. Thirty-two individuals responded to the recruitment campaign within a three-week timeframe and a final total of eleven volunteers were eligible to participate and gave informed consent (all female, age range 40-61). No participants dropped out of the trial;however, one participant engaged in only 3 out of the 12 exercise classes and the same participant consumed only 14% of the protein supplement supplied. The remaining 10 participants had good compliance with both the exercise and protein intervention, and overall, there was 87% adherence to exercise sessions (2 or more classes a week) and adherence of 68% and 88% to the protein supplement in the 15 g and 30 g protein intervention arms respectively. Acceptability and adherence were in line with the study requirements for most participants. These findings are encouraging and support the feasibility of a remote exercise and protein intervention trial. Qualitative analysis of the semi-structured interviews will provide further information to inform the design of a larger intervention trial.