Impact of resistance training on sarcopenia in nursing care facilities: A pilot study.

The impact of progressive resistance training on sarcopenia among very old institutionalized adults was investigated. Residents of Nursing Care Facilities were included in a controlled trial of twice weekly resistance and balance exercise program for six months (Age: 85.9 ± 7.5 years, Time in care: 707.1 ± 707.5 days, N = 21 per group). Sarcopenia was measured based on the European Working Group on Sarcopenia in Older People criteria. Of the recruited 42 participants, 35.7% had sarcopenia at baseline, with prevalence increasing in the control group post-intervention (42.9%-52.4%). Following training, the exercise group experienced a significant increase in grip strength when compared to controls (p = .02), and a within-group decrease in body mass index and increase in grip strength (p ≤ .007). Resistance and balance exercise has positive benefits for older adults residing in a nursing care facilities which may transfer to reduce disability and sarcopenia transition, but more work is needed to ensure improved program uptake among residents.

Prevalence and risk factors of sarcopenia among adults living in nursing homes.

OBJECTIVES: Sarcopenia is a progressive loss of skeletal muscle and muscle function, with significant health and disability consequences for older adults. We aimed to evaluate the prevalence and risk factors of sarcopenia among older residential aged care adults using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. STUDY DESIGN: A cross-sectional study design that assessed older people (n=102, mean age 84.5±8.2 years) residing in 11 long-term nursing homes in Australia. MAIN OUTCOME MEASUREMENTS: Sarcopenia was diagnosed from assessments of skeletal mass index by bioelectrical impedance analysis, muscle strength by handheld dynamometer, and physical performance by the 2.4m habitual walking speed test. Secondary variables where collected to inform a risk factor analysis. RESULTS: Forty one (40.2%) participants were diagnosed as sarcopenic, 38 (95%) of whom were categorized as having severe sarcopenia. Univariate logistic regression found that body mass index (BMI) (Odds ratio (OR)=0.86; 95% confidence interval (CI) 0.78-0.94), low physical performance (OR=0.83; 95% CI 0.69-1.00), nutritional status (OR=0.19; 95% CI 0.05-0.68) and sitting time (OR=1.18; 95% CI 1.00-1.39) were predictive of sarcopenia. With multivariate logistic regression, only low BMI (OR=0.80; 95% CI 0.65-0.97) remained predictive. CONCLUSIONS: The prevalence of sarcopenia among older residential aged care adults is very high. In addition, low BMI is a predictive of sarcopenia.

Alterations in muscle attenuation following detraining and retraining in resistance-trained older adults.

BACKGROUND: Aging skeletal muscle is characterized not only by a reduction in size (sarcopenia) and strength but also by an increase in fatty infiltration (myosteatosis). An effective countermeasure to sarcopenia is resistance exercise; however, its effect on fatty infiltration is less clear. OBJECTIVE: To examine in resistance-trained older persons whether muscle attenuation, a noninvasive measure of muscle density reflecting intramuscular lipid content, is altered with training status. METHODS: Thirteen healthy community-dwelling men and women aged 65-83 years (body mass index 27.0+/-1.2, mean+/-SE) had computed-tomography scans of the mid-thigh performed following 24 weeks of training, 24 weeks of detraining, and 12 weeks of retraining. Training and retraining were undertaken twice weekly for several upper- and lower-body muscle groups. Skeletal muscle attenuation in Hounsfield units (HU) as well as mid-thigh muscle volume was obtained for the quadriceps and hamstrings. Muscle strength was assessed by 1-repetition maximum and physical function by a battery of tests. RESULTS: The average change in muscle strength following training, detraining and retraining was 48.8+/-2.9%, -17.6+/-1.3%, and 19.8+/-2.0%, respectively. Strength changes were accompanied by significant alterations in muscle density (p<0.001), with the quadriceps HU decreasing by 7.7+/-1.0% following detraining and increasing by 5.4+/-0.5% with retraining. For the hamstrings HU measure, detraining and retraining resulted in an 11.9+/-1.4% loss and a 5.5+/-1.8% gain, respectively. There was no significant change in muscle volume. CONCLUSION: Cessation of resistance exercise in trained older persons increases the fatty infiltration of muscle, while resumption of exercise decreases it. Monitoring changes in both muscle size and fat infiltration may enable a more comprehensive assessment of exercise in combating age-related muscular changes.

Detraining and retraining in older adults following long-term muscle power or muscle strength specific training.

BACKGROUND: Training cessation among older adults is associated with the loss of functional ability. However, exercise programs undertaken prior to activity cessation may offer functional protection. In the present study, the residual effects of muscle power or muscle strength training were investigated following extended detraining and subsequent retraining. METHODS: Thirty-eight healthy independent older adults (65-84 years) entered a 24-week detraining period subsequent to 24 weeks of training. Following detraining, participants recommenced training using either the high-velocity muscle power (HV) or muscle strength (ST) protocol, as undertaken during the initial training period, twice weekly for 12 weeks. Isometric and dynamic muscle strength, muscle power, movement velocity, muscle endurance, electromyographic activity, and the results of a battery of functional performance tasks were assessed. RESULTS: Muscle function and functional performance increased following initial training, however, no group differences were observed. Detraining resulted in similar declines in muscle power and muscle strength for both groups (p <.05) (power, HV 17.8 +/- 1.8%, ST 15.5 +/- 2.2%; and strength, HV 17.1 +/- 2.2%, ST 16.5 +/- 1.8%), with comparable accrual following retraining. No significant changes in functional ability were observed following detraining (average change; HV 3.1 +/- 3.5% and ST 2.1 +/- 3.5%) or retraining. No group differences emerged in this study. CONCLUSION: Cessation of training resulted in only a modest loss of muscle power and strength that was recouped following 12 weeks of retraining. Importantly, training-induced gains in functional performance were preserved during detraining. The residual effects of power or strength training appear comparable, and both may be suitable exercise modes prior to a period of activity cessation to promote physical independence.

Strength versus muscle power-specific resistance training in community-dwelling older adults.

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Measuring the impact of increased exercise on quality of life in older adults: the UQQoL, a new instrument.

The University of Queensland Quality of Life instrument (UQQoL) was developed to provide a quantitative measure sensitive to the impact of increased exercise on the quality of life (QoL) of older individuals. This paper describes the development and testing of the UQQoL including an exploratory study of focus group interviews with 18 participants aged 65 and over, item development and selection, and instrument piloting with groups of older adults undergoing high-intensity training. The SF-36, another established QoL tool, was also administered at the same time points for comparative purposes. The UQQoL displayed good convergent validity with selected SF-36 domains. A significant change in QoL following training was found, complementing functional improvements. This change was not detected by the SF-36. While broader testing is required, the UQQoL appears to be a reliable instrument sensitive to the change in QoL experienced by healthy community-dwelling older adults following resistance exercise.

Short-term resistance training and the older adult: the effect of varied programmes for the enhancement of muscle strength and functional performance.

Although it is well recognized that resistance training is an efficient strategy to enhance physical performance in older adults, less is known about the most effective type of resistive exercise or the role of functional training. This study compared the effectiveness of three varied short-term (8 weeks) training protocols on muscle strength and functional performance in older men and women aged 65-84 years. Participants underwent twice-weekly high-velocity varied-resistance training (HV), twice weekly slow to moderate-velocity constant-resistance training (CT), combined once weekly high-velocity varied-resistance and once weekly gymnasium-based functional training (CB) or no training (CO). Dynamic muscle strength (1RM) of six muscle groups was assessed using isotonic equipment and functional performance by a battery of tests. Following 8 weeks of training, whole-body muscle strength increased (P<0.001) by 22.0 +/- 12.5% (mean +/- SD), 21.7 +/- 11.0% and 26.1 +/-14.4% in HV, CT and CB, respectively, compared to CO (-1.8 +/- 7.2%). In between group comparisons, only the HV group displayed greater chair rise ability (P =0.010) than the CO group, while differences among groups approached significance for the fast 6-m walk and the stair climb test (P = 0.017 and 0.041 respectively). Within groups, the HV group significantly improved in stair-climbing and chair rise ability (P

Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training.

BACKGROUND: The age-related loss of muscle power in older adults is greater than that of muscle strength and is associated with a decline in physical performance. OBJECTIVE: To investigate the effects of a short-term high-velocity varied resistance training programme on physical performance in healthy community-dwelling adults aged 60-80 years. METHODS: Subjects undertook exercise (EX; n=15) or maintained customary activity (controls, CON; n=10) for 8 weeks. The EX group trained 2 days/week using machine weights for three sets of eight repetitions at 35, 55, and 75% of their one-repetition maximum (the maximal weight that an individual can lift once with acceptable form) for seven upper- and lower-body exercises using explosive concentric movements. RESULTS: Fourteen EX and 10 CON subjects completed the study. Dynamic muscle strength significantly increased (p=0.001) in the EX group for all exercises (from 21.4 +/- 9.6 to 82.0 +/- 59.2%, mean +/- SD) following training, as did knee extension power (p <0.01). Significant improvement occurred for the EX group in the floor rise to standing (10.4 +/- 11.5%, p=0.004), usual 6-metre walk (6.6 +/- 8.2%, p=0.010), repeated chair rise (10.4 +/- 15.6%, p=0.013), and lift and reach (25.6 +/- 12.1%, p=0.002) performance tasks but not in the CON group. CONCLUSIONS: Progressive resistance training that incorporates rapid rate-of-force development movements may be safely undertaken in healthy older adults and results in significant gains in muscle strength, muscle power, and physical performance. Such improvements could prolong functional independence and improve the quality of life.