Effectiveness of a community-delivered pneumatic machine resistance training programme (Gym Tonic) for older adults at neighbourhood senior centres – a randomized controlled trial

Abstract Background Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults. Methods Three hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach. Results After 12 weeks, lower-extremity muscle strength improved by 11–26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0–12-weeks,90%(SD,13%); 12–24-weeks,89%(SD,17%)] and control [12–24-weeks,90%(SD,19%)] groups. Conclusion Community-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks. Trial registration ClinicalTrials.gov, NCT04661618, Registered 10 December 2020 - Retrospectively registered.

Download Full-text

Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00260-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Chisato Hayashi ◽

Soshiro Ogata ◽

Tadashi Okano ◽

Hiromitsu Toyoda ◽

Sonoe Mashino

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Exercise ◽

Lower Extremity ◽

Physical Function ◽

Community Dwelling ◽

Group Exercise ◽

Community Based ◽

Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

Download Full-text

Lower Extremity Muscle Function after Strength or Power Training in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.17.4.416 ◽

2009 ◽

Vol 17 (4) ◽

pp. 416-443 ◽

Cited By ~ 78

Author(s):

Anthony P. Marsh ◽

Michael E. Miller ◽

W. Jack Rejeski ◽

Stacy L. Hutton ◽

Stephen B. Kritchevsky

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Lower Extremity ◽

Knee Extension ◽

Control Group ◽

Power Training ◽

Wait List Control ◽

Treatment Groups ◽

Leg Press ◽

Lower Extremity Muscle

It is unclear whether strength training (ST) or power training (PT) is the more effective intervention at improving muscle strength and power and physical function in older adults. The authors compared the effects of lower extremity PT with those of ST on muscle strength and power in 45 older adults (74.8 ± 5.7 yr) with self-reported difficulty in common daily activities. Participants were randomized to 1 of 3 treatment groups: PT, ST, or wait-list control. PT and ST trained 3 times/wk for 12 wk using knee-extension (KE) and leg-press (LP) machines at ~70% of 1-repetition maximum (1RM). For PT, the concentric phase of the KE and LP was completed “as fast as possible,” whereas for ST the concentric phase was 2–3 s. Both PT and ST paused briefly at the midpoint of the movement and completed the eccentric phase of the movement in 2–3 s. PT and ST groups showed significant improvements in KE and LP 1RM compared with the control group. Maximum KE and LP power increased approximately twofold in PT compared with ST. At 12 wk, compared with control, maximum KE and LP power were significantly increased for the PT group but not for the ST group. In older adults with compromised function, PT leads to similar increases in strength and larger increases in power than ST.

Download Full-text

Motor and Physical Function Impairments in Middle-Aged and Older Adults in the Baltimore Longitudinal Study of Aging

Innovation in Aging ◽

10.1093/geroni/igaa057.748 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 232-232

Author(s):

Yurun Cai ◽

Qu Tian ◽

Yuri Agrawal ◽

Eleanor Simonsick ◽

Jennifer Schrack

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Function ◽

Gait Speed ◽

Standing Balance ◽

Finger Tapping ◽

Equation Modeling ◽

Latent Factors ◽

Lower Extremity Muscle ◽

Mobility Difficulty

Abstract Older adults experience motor function decline early in the disablement process, impacting daily activities and contributing to adverse health outcomes. Few studies have comprehensively examined the interrelationships among motor and functional impairments and investigated whether their contributions to mobility difficulty vary in well-functioning older adults. We examined direct and indirect associations of motor and physical function impairments with slow gait speed (<1.0m/s) and mobility difficulty using structural equation modeling (SEM) among 858 participants aged ≥50 years in the BLSA (mean age=74.1±10.6, 55% women). Motor and physical function tests included grip strength, knee extension strength, proprioception, finger tapping, standing balance (semi-, full-tandem, single-leg), repeated chair stands, and usual gait speed. Mobility difficulty was defined as self-reported difficulty in walking ¼ mile or climbing stairs. Motor and physical function impairments increased linearly with age, with 27.6% of participants having slow gait speed and 10.4% having mobility difficulty. Age-adjusted SEMs identified chair stands pace as the strongest predictor of slow gait speed, followed by latent factors of upper and lower extremity muscle strength and standing balance. Chair stands pace was the strongest predictor of mobility difficulty, followed by gait speed. Latent factors of muscle strength, proprioception, finger tapping, and standing balance were indirectly associated with mobility difficulty via gait speed. All models showed good model fit (RMSEA<0.05, CFI>0.95). These findings suggest components of strength and balance are among the most important contributors to poorer functional performance in mid-to-late life. Future longitudinal studies gauging the effect of change in these factors are warranted.

Download Full-text

The effect of a multicomponent exercise protocol (VIVIFRAIL©) on inflammatory profile and physical performance of older adults with different frailty status: study protocol for a randomized controlled trial

BMC Geriatrics ◽

10.1186/s12877-021-02030-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marina Petrella ◽

Ivan Aprahamian ◽

Ronei Luciano Mamoni ◽

Carla Fernanda de Vasconcellos Romanini ◽

Natália Almeida Lima ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Inflammatory Mediators ◽

Gait Speed ◽

Exercise Intervention ◽

Intervention Group ◽

Control Group ◽

Frailty Status ◽

Anti Inflammatory ◽

Inflammatory Profile

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.

Download Full-text

Relationship between Age-related Postural Hyperkyphosis and Sarcopenia

Current Aging Science ◽

10.2174/1874609814666210322114500 ◽

2021 ◽

Vol 14 ◽

Author(s):

Gülçimen Soylu ◽

Güzin Çakmak ◽

Yusuf Yalvaç ◽

Funda Datlı Yakaryılmaz ◽

Zeynel Abidin Öztürk

Keyword(s):

Lower Extremity ◽

Significant Relationship ◽

Gait Speed ◽

Vertebral Compression Fractures ◽

Control Group ◽

Neutral Position ◽

Old Patients ◽

Speed Test ◽

Lower Extremity Muscle ◽

Age Related

Background: Hyperkyphosis is one of the commonly seen disabling problems in the elderly. Loss of muscle mass and function is supposed to be related to age-related hyperkyphosis. We aimed to explain the relationship between sarcopenia and hyperkyphosis in old patients in this study. Methods: 142 patients who were applied to polyclinic of geriatrics of Gaziantep University Hospital were enrolled in this cross-sectional study. Hyperkyphotic patients were included in the study group, and non-hyperkyphotic patients were included in the control group by experienced staff. Their mean age was 72±6.9. Thirty-six of them were male, and 106 of them were female. The EWGSOP 2 criteria were used for the diagnosis of sarcopenia[1]. SARC-F (sluggishness, assistance in walking, rise from a chair, climb stairs, falls) test were done to all patients. The handgrip test was applied to patients that had a score ≥4 from SARC-F. We did bioimpedance analysis to the probable sarcopenic patients who diagnosed with handgrip assessment. Four-meter gait speed test, Timed Up and Go Test (TUG) and Tinetti Test was applied to all patients to evaluate gait speed. Hyperkyphosis was evaluated with the bloc method in the Rancho Bernardo Study[2]. Numbers of the blocks used for keeping patients in neutral position were recorded. We defined hyperkyphosis as the state that one or more blocks needed to maintain the patient's neutral position on the radiology table. Results: Hyperkyphosis was positively related to lower extremity dysfunction which was assessed by 4-m-gait speed test (p=0.018) and TUG (p=0.042). A significant relationship between gait speed and hyperkyphosis was revealed when evaluated with one-way MANOVA (F [5,92] =2.588, p=0.031, Wilk's Λ=0.877, partial η2=0.123). We found a significant relationship between TUG and the number of blocks needed to restore neutral position by linear regression analyses (r2 =0.059, p=0.044). We found a cut-off value of gait speed as 0.65 m/s for presence of hyperkyphosis (sensitivity:60%, specificity:70%, CI=95%, p<0.001, AUC=0.710). Tinetti balance, gait and total test scores were also negatively related to hyperkyphosis (p=0.006; 0,027; 0.031). Conclusions: In previous studies, vertebral compression fractures, degenerative disc disease, weakness of back extensor muscles and genetic predisposition were suggested as predisposing factors for age related kyperkyphosis[3]. Different from these in our study, lower extremity muscle function was found to be related to age-related hyperkyphosis. More studies on this subject could be helpful. Hyperkifosis prognosis in severe sarcopenic groups might be a new research topic.

Download Full-text