Effects of short-term multicomponent exercise intervention on muscle power in hospitalized older patients: A secondary analysis of a randomized clinical trial.

BACKGROUND: Bed rest during hospitalization can negatively impact functional independence and clinical status of older individuals. Strategies focused on maintaining and improving muscle function may help reverse these losses. This study investigated the effects of a short-term multicomponent exercise intervention on maximal strength and muscle power in hospitalized older patients. METHODS: This secondary analysis of a randomized clinical trial was conducted in an acute care unit in a tertiary public hospital. Ninety (39 women) older patients (mean age 87.7 ± 4.8 years) undergoing acute-care hospitalization [median (IQR) duration 8 (1.75) and 8 (3) days for intervention and control groups, respectively]) were randomly assigned to an exercise intervention group (n = 44) or a control group (n = 46). The control group received standard care hospital including physical rehabilitation as needed. The multicomponent exercise intervention was performed for 3 consecutive days during the hospitalization, consisting of individualized power training, balance, and walking exercises. Outcomes assessed at baseline and discharge were maximal strength through 1 repetition maximum test (1RM) in the leg press and bench press exercises, and muscle power output at different loads (≤30% of 1RM and between 45% and 55% of 1RM) in the leg press exercise. Mean peak power during 10 repetitions was assessed at loads between 45% and 55% of 1RM. RESULTS: At discharge, intervention group increased 19.2 kg (Mean Δ% = 40.4%) in leg press 1RM [95% confidence interval (CI): 12.1, 26.2 kg; P < 0.001] and 2.9 kg (Mean Δ% = 19.7%) in bench press 1RM (95% CI: 0.6, 5.2 kg; P < 0.001). The intervention group also increased peak power by 18.8 W (Mean Δ% = 69.2%) (95% CI: 8.4, 29.1 W; P < 0.001) and mean propulsive power by 9.3 (Mean Δ% = 26.8%) W (95% CI: 2.5, 16.1 W; P = 0.002) at loads ≤30% of 1RM. The intervention group also increased peak power by 39.1 W (Mean Δ% = 60.0%) (95% CI: 19.2, 59.0 W; P < 0.001) and mean propulsive power by 22.9 W (Mean Δ% = 64.1%) (95% CI: 11.7, 34.1 W; P < 0.001) at loads between 45% and 55% of 1RM. Mean peak power during the 10 repetitions improved by 20.8 W (Mean Δ% = 36.4%) (95% CI: 3.0, 38.6 W; P = 0.011). No significant changes were observed in the control group for any endpoint. CONCLUSIONS: An individualized multicomponent exercise program including progressive power training performed over 3 days markedly improved muscle strength and power in acutely hospitalized older patients.

Similar body composition, muscle size, and strength adaptations to resistance training in lacto-ovo-vegetarians and non-vegetarians.

There is a popular belief that meat consumption is necessary to optimize adaptations to strength training (ST), but evidence to support this hypothesis is scarce. Therefore, this study aimed to compare ST adaptations in lacto-ovo-vegetarians (LOV) and non-vegetarians (NV) with adjusted protein intake per meal. Sixty-four LOV and NV performed 12 weeks of ST and were instructed to ingest at least 20 g of protein in each main meal during the experimental period. Quadriceps femoris muscle thickness (QFMT), knee extension one-repetition maximum (1RM), and isometric peak torque (PT), as well as participants' body composition were assessed before and after the intervention. Dietary intake was assessed throughout the study. After 12 weeks, similar increases in QFMT (LOV: 9.2 ± 5.4; NV: 5.5 ± 8.1 mm), knee extension 1RM (LOV: 24.7 ± 11.1; NV: 21.6 ± 9.8 kg), and PT (LOV: 29.8 ± 33.4; NV: 17.5 ± 19.4 N m) and lean body mass (LOV: 1.3 ± 0.9; NV: 1.4 ± 1.4 kg), alongside a decrease in body fat mass (LOV: -0.5 ± 1.6; NV -0.8 ± 1.6 kg) were observed in both groups at the end of the training period (p < 0.05). LOV had lower protein consumption than NV throughout the study (p < 0.05), but participants reached intake of at least 1.2 g of protein/kg/day during the experimental period. In conclusion, LOV and NV displayed similar improvements in muscle mass, strength, and in body composition after 12 weeks of ST, suggesting that meat consumption and higher protein intake in NV did not bring about further benefits to early adaptations to ST. This study was registered in Clinical Trials (NCT03785002) on 24 December 2018.

Association Between Physical Exercise Interventions Participation and Functional Capacity in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Controlled Trials.

BACKGROUND: The prevalence of type 2 diabetes mellitus increases with age, and people with type 2 diabetes are more affected by reductions in functional performance. Although exercise interventions are recommended for people with diabetes, it is relevant to assess the effects of different training modes on the available functional outcomes. Therefore, our purpose was to systematically assess the effect of different physical exercise modalities in patients with type 2 diabetes with an average age of 45 years or older on outcomes used to measure functional capacity. METHODS: A systematic review and meta-analysis of controlled trials was conducted. Seven databases were searched from January 1987 to December 2021 (PubMed, Physiotherapy Evidence Database, Cochrane Library, SPORTDiscus, and in grey literature: Open Grey and Google Scholar). Eligible studies should last 8 weeks or longer, comparing structured exercise training and non-exercise control for one out of six pre-specified functional capacity outcomes (Timed Up and Go test, chair stands, walking performance, upper-limb muscle strength, lower-limb muscle strength, physical fitness parameter), in patients with type 2 diabetes, aged ≥ 45 years. The risk of bias was assessed with the Downs & Black checklist. Pooled mean differences were calculated using a random-effects model, followed by sensitivity and meta-regression analyses. RESULTS: Of 18,112 references retrieved, 29 trials (1557 patients) were included. Among these, 13 studies used aerobic training, 6 studies used combined training, 4 studies used resistance training, 3 studies had multiple intervention arms and 3 studies used other types of training. Exercise training was associated with an increase in functional capacity outcomes, as reflected by changes in 6-min walk test (n = 8) [51.6 m; 95% CI 7.6% to 95.6%; I2 92%], one-repetition maximum leg-press (n = 3) [18.0 kg; 95% CI 4.0% to 31.9%; I2 0%], and maximum oxygen consumption (VO2max) (n = 20) [2.41 mL/kg·min; 95% CI 1.89% to 2.92%; I2 100%] compared with control groups. In sensitivity and subgroup analyses using VO2max as outcome and stratified by type of study (randomized and non-randomized controlled clinical trials), duration of diabetes diagnosis, and sex, we observed overlapping confidence intervals. Meta-regression showed no association between glycated hemoglobin (HbA1C) levels and VO2max [p = 0.34; I2 99.6%; R2 = 2.6%]. In addition, the quality of the included studies was mostly low. CONCLUSION: The results indicate that structured physical exercise programs might improve functional capacity in patients with type 2 diabetes, except for the upper-limb muscle strength. However, we could not identify potential effect predictors associated with directional summary estimates. Trial registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42020162467); date of registration: 12/15/2019. The review protocol is hosted at the Open Science Framework (OSF) (Preprint https://doi.org/10.31219/osf.io/kpg2m ).

Cardiometabolic health profile of young girls with aesthetic professions.

BACKGROUND: In the literature, professions that impose body standards for daily performance are designated as non-conventional professions (i.e. models, athletes, ballet dancers), with great emphasis on the female population. More than a job, it becomes a lifestyle to those inserted in this environment, thus, thousands of children and adolescents seek inclusion and success in these professions due to financial and media gains. Such professions are associated with several health-related risk factors. The purpose of this study was to identify and compare among physical fitness levels, cardiometabolic health markers, mental health and dietary habits in non-conventional professions. METHODS: The sample consisted of 41 female individuals aged between 14 and 24 years, allocated into four groups, control group composed by university students (UG = 11), models (MG = 11), ballet dancers (BG = 11), and athletes' group (AG = 8). Physical fitness outcomes (cardiorespiratory fitness, flexibility, maximal dynamic strength, muscular endurance and body composition); biochemical outcomes (high-density lipoprotein [HDL], low-density lipoprotein [LDL], total cholesterol [TC], fasting glucose [FG], fasting insulin [FI], C-reactive protein [CRP]), diet quality and mental health were evaluated. RESULTS: No impairments were observed in the health markers evaluated among groups, both for health-related physical fitness and biochemical outcomes. However, low levels of bone mineral density (BMD) were observed. Even with statistically significant differences between the groups for chronological age (p = 0.002), menarche (p = 0.004), career length (p = 0.001), height (p = 0.001), body mass index (p = 0.018), waist-to-height ratio (p < 0.001), %Fat (p = 0.020), VO2peak (p = 0.020), maximal dynamic strength of knee extensors (p = 0.031) and elbow flexors (p = 0,001) and flexibility (p < 0.001), all these values are within the normal range for health. CONCLUSION: The professions analyzed do not seem to interfere in the physical fitness and cardiometabolic health of the girls assessed. However, we identified that exposure to these profession can impair mental health (depressive symptoms in 100% of participants) and body composition (BMD 63% of participants).

Chronic aerobic exercise prevents high-fructose diet-induced impairment in blood pressure in healthy young adults: a double-blind, randomised clinical trial.

The purpose of the study was to verify the effect of 4 weeks of a high-fructose diet (HFD) associated with aerobic training on the risk factors for cardiometabolic diseases. Twenty-one young adults were randomised into three groups: HFD (HFD: 1 g/kg body weight of fructose/day), high-glucose diet (HGD: 1 g/kg body weight of glucose/day) and high-fructose diet and exercise (HFDE: 1 g/kg body weight of fructose/day + 3 weekly 60-minute sessions of aerobic exercise). Before and after the 4 weeks of the intervention, blood samples were taken and flow-mediated dilatation, insulin resistance index, pancreatic beta cell functional capacity index, insulin sensitivity index and 24-h blood pressure were evaluated. HFD showed an increase in uric acid concentrations (P = 0·040), and HGD and HFDE groups showed no changes in this outcome between pre- and post-intervention; however, the HFDE group showed increased uric acid concentrations from the middle to the end of the intervention (P = 0·013). In addition, the HFD group showed increases in nocturnal systolic blood pressure (SBP) (P = 0·022) and nocturnal diastolic blood pressure (DBP) (P = 0·009). The HGD group exhibited decreases in nocturnal SBP (P = 0·028) and nocturnal DBP (P = 0·031), and the HFDE group showed a decrease in 24-h SBP (P = 0·018). The consumption of 1 g/kg of fructose per day may increase uric acid concentrations and blood pressure in adults. Additionally, aerobic exercises along with fructose consumption attenuate changes in uric acid concentrations and prevent impairment in nocturnal blood pressure.

Effects of high-intensity interval training combined with traditional strength or power training on functionality and physical fitness in healthy older men: A randomized controlled trial.

Concurrent training (CT) is an efficient strategy to improve neuromuscular function and cardiorespiratory fitness in older adults, which are factors of pivotal importance for the maintenance of functional capacity with aging. However, there is a lack of evidence about the effectiveness of power training (PT) as an alternative to traditional strength training (TST) during CT. Thus, the aim of the present study was to examine the effect of 16 weeks (twice weekly) TST combined with high intensity interval training (TST + HIIT) vs. PT combined with HIIT (PT + HIIT) on functional performance, cardiorespiratory fitness and body composition in older men. Thirty five older men (65.8 ± 3.9 years) were randomly allocated into two training groups: TST + HIIT (n = 18), and PT + HIIT (n = 17). TST + HIIT performed resistance training at intensities ranging from 65% to 80% 1RM at slow controlled speed (≅ 2 s for each concentric phase), whereas PT + HIIT trained at intensities ranging from 40% to 60% of 1RM at maximal intentional speed. Both groups performed HIIT at intensities ranging from 75 to 90% of VO2peak. Participants performed functional tests (sit-to-stand, timed-up-and-go, stair climbing); cardiopulmonary exercise testing (maximal cycling power output: Wmax, peak oxygen uptake: VO2peak, cycling economy), as well as body composition assessment (DXA) before, post 8 and post 16 weeks of training. The groups improved similarly (P < 0.05) with training in all functional capacity outcomes, Wmax, cycling economy, VO2peak and body composition (P < 0.05). These findings suggest that HIIT based CT programs involving TST vs. PT are equally effective in improving functionality, cardiorespiratory fitness and body composition in healthy older men.

Adaptations in mechanical muscle function, muscle morphology, and aerobic power to high-intensity endurance training combined with either traditional or power strength training in older adults: a randomized clinical trial.

PURPOSE: There is a lack of information on the effects of power training (PT) as an alternative to traditional strength training (TST) during concurrent training (CT) in older individuals. This study aimed to verify the neuromuscular adaptations that occurred following 16-week interventions with two CT models in older men: high-intensity interval training (HIIT) combined with either TST or PT. METHODS: Thirty-five older men (65.8 ± 3.9 years) were randomly assigned into one of two training groups CTS: TST + HIIT (n = 18) or CTP: PT + HIIT (n = 17). CTS performed resistance training at intensities ranging from 65 to 80% of 1 RM at slow controlled speed, whereas CTP trained at intensities ranging from 40 to 60% of 1 RM at maximal intentional speed. Lower body one-repetition maximum (1 RM), isometric rate of force development (RFD), countermovement jump (CMJ) muscle power output, quadriceps femoris muscles thickness (QF MT), and peak oxygen uptake (VO2peak) were assessed before training and after 8 and 16 weeks of CT. RESULTS: Groups improved similarly in all primary outcomes (P < 0.05), with mean increases ranging: 1 RM (from 39.4 to 75.8%); RFD (from 9.9 to 64.8%); and CMJ muscle power (from 1.8 to 5.2%). Significant increases (P < 0.05) were observed in all secondary outcomes (QF MT, specific tension and VO2peak) with no differences between groups. CONCLUSION: CT models were effective for improving maximal and explosive force (1 RM, RFD, and CMJ power), QF MT, and VO2peak. Moreover, despite that using lower loading intensities, PT induced similar adaptations to those of TST.

Functional and physiological adaptations following concurrent training using sets with and without concentric failure in elderly men: A randomized clinical trial.

This study compared the functional and physiological adaptations induced by concurrent training (CT) performed with repetitions to concentric failure and not to failure in elderly men. Fifty-two individuals (66.2 ±â€¯5.2 years) completed the pre- and post-measurements and were divided into three groups: repetitions to failure (RFG, n = 17); repetitions not to failure (NFG, n = 20); and repetitions not to failure with total volume equalized to that in the RFG (ENFG, n = 15). The participants' sit-to-stand ability, timed-up-and-go (TUG), muscle power output in squat jump (SJ) and countermovement jump (CMJ), peak oxygen uptake (VO2peak), blood lipids and glucose, as well as blood pressure levels were assessed. A subsample of our participants (n = 22) also underwent assessment of body composition by dual X-ray absorptiometry (DXA). CT was performed twice weekly for over 12 weeks. In addition to the specific strength training (ST) programme, each group also underwent endurance training (ET) in the same session (i.e., ST immediately followed by ET). After training, all groups improved similarly and significantly in their sit-to-stand ability (P < 0.01), muscle power output relative to body mass in SJ and CMJ (P < 0.001), VO2peak (P < 0.01) and HDL cholesterol levels (P < 0.001). There were reductions in the total, leg and trunk percent fat mass as well as increases in the total, leg and trunk percent lean mass (P values ranging from P < 0.05 to P < 0.01). Independent of performing repetitions until concentric failure and greater ST volumes, all CT groups exhibited improved sit-to-stand ability, muscle power output, VO2peak and HDL cholesterol levels. In addition, our preliminary data suggest that there are no differences in the effects of the assessed CT approaches on body composition outcomes. We therefore highlight the need for additional well-powered studies to assess whether repetitions to failure could underlie distinct effects on body composition.

Repetitions to failure versus not to failure during concurrent training in healthy elderly men: A randomized clinical trial.

This randomized clinical trial compared the neuromuscular adaptations induced by concurrent training (CT) performed with repetitions to concentric failure and not to failure in elderly men. Fifty-two individuals (66.2 ±â€¯5.2 years) completed the pre- and post-measurements and were divided into three groups: repetitions to failure (RFG, n = 17); repetitions not to failure (NFG, n = 20); and repetitions not to failure with total volume equalized to RFG (ENFG, n = 15). Participants were assessed in isometric knee extension peak torque (PTiso), maximal strength (1RM) in the leg press (LP) and knee extension (KE) exercises, quadriceps femoris muscle thickness (QF MT), specific tension, rate of torque development (RTD) at 50, 100 and 250 ms, countermovement jump (CMJ) and squat jump (SJ) performance, as well as maximal neuromuscular activity (EMGmax) of the vastus lateralis (VL) and rectus femoris (RF) muscles. CT was performed over 12 weeks, twice weekly. Along with each specific strength training program, each group also underwent an endurance training in the same session. After training, all groups improved similarly and significantly in LP and KE 1RM, PTiso, CMJ and SJ performance, RTD variables, specific tension, and VL EMGmax, (P < 0.05-0.001). QF MT improved only in RFG and ENFG (P < 0.01). These results suggest that repetitions until concentric failure does not provide further neuromuscular performance gains and muscle hypertrophy, and that even a low number of repetitions relative to the maximal possible (i.e., 50%) optimizes neuromuscular performance in elderly men. Moreover, training volume appears to be more important for muscle hypertrophy than training using maximal repetitions.