Short-Term Resistance Training in Older Adults
Condition: Sarcopenia; Muscle Quality
MeSH terms: Sarcopenia
Study type: Interventional

Summary: 
      The purpose of this study will be to evaluate whether dumbbell resistance training (DBRT) or
      elastic band resistance training (EBRT) is beneficial in older adults whom may be classified
      as sarcopenic based on the collective operational definition and older adults that do not
      meet the criteria to be considered sarcopenic compared to non-exercise controls of these
      populations after sarcopenia criteria have been established. As well as identify if
      resistance exercise will improve muscle quality in older adults, considering how muscle
      quality relates to sarcopenia status. Specific Aim 1 will determine if short-term resistance
      training will alter muscle quality or sarcopenia status in older adults compared to
      non-exercise controls. The study team will instruct and supervise adults aged 55-85 in
      structured, periodized EBRT or DBRT for 6 weeks. After the training, muscle quality and
      sarcopenia status will be re-evaluated. It is hypothesized that both types of training (EBRT
      and DBRT) will improve the sarcopenia status of older adults engaging in resistance training
      and if sarcopenic, their classification may change to non-sarcopenic. A secondary hypothesis
      is that EBRT will be more beneficial than DBRT, resulting in greater changes in body
      composition, strength, and functional movements. It is also hypothesized that muscle quality,
      as an index of relative strength, will improve after 6 weeks of resistance training with
      either dumbbells or elastic bands and that there is a strong negative linear relationship
      between severity of sarcopenia and muscle quality. Specific Aim 2 will evaluate the
      prevalence of sarcopenia in older adults using previously-identified equations and cut-off
      values and to subsequently generate a new index to include functional muscle mass and
      performance to identify sarcopenic individuals. This will be completed using muscle mass
      estimations from dual-energy x-ray absorptiometry (DEXA), bioelectrical impedance analysis
      (BIA), functional performance measures, and structural composition. It is hypothesized that
      DEXA and BIA will provide accurate estimates of appendicular lean mass (ALM), and functional
      performance (handgrip strength and gait speed) will be significant contributors to a
      predictive equation of a muscle quality index for men and women.
    

Detailed description: 
      It is well known that as adults age, a proportion of lean body mass is reduced if not lost,
      specifically fast twitch (FT or Type II) fibers, and subsequently, strength and power is
      diminished. The age-related loss of muscle mass and function is referred to as sarcopenia.
      Reduction of muscle mass plays a direct role in the loss of function, and potentially, the
      ability to complete activities of daily living. It is also highly related to an increase in
      incidence of falls and onset of many other comorbidities resulting in changes in quality of
      life (QOL). Copeland et al. recently reported that strength training will benefit all adults,
      regardless of their functional level, based on a self-report survey of nearly 10,000 adults
      aged 60 years and older. Aside from diagnosing sarcopenia in individuals using pre-identified
      criteria (and doing so accurately), it is of the utmost importance to implement resistance
      exercise programs in populations of older adults that can directly combat the decline in type
      II fiber size, maintain aerobic fitness, aid in maintaining or reducing total body fat,
      minimize the prevalence of sarcopenia, and ultimately improve QOL. Targeted interventions
      that include dumbbell and elastic band resistance training (both considered free-movement)
      and progressive programming schemes have been reported to enhance muscle size, strength, and
      quality, functional mobility, and confidence in older adults, in turn, reducing percent body
      fat, risk of falls, and incidence of comorbidities that are often coupled with senescence.
      Recently, Calatayud et al. reported similar improvements in strength and muscle activation
      (electromyographic [EMG] amplitude) between free weight (bench press) and resistance band
      (band push-up) exercises, suggesting either mode of resistance exercise would be beneficial.
      Furthermore, use of resistance bands for chest flys and reverse flys were validated to be
      comparable with conventional free weights. There are several exercises that can be duplicated
      using either modality. However, the challenge is the vertical plane for free weights, as free
      weights only provide resistance against gravity and exercise movements, more specifically,
      body position, need to be modified in order to perform the resisted movement. Some older
      adults tend to have balance impairments and thus adjusting their body position to perform
      (dumbbell) resisted exercise may not be ideal, specifically if they may have a greater risk
      for falls as suggested by sarcopenia status (i.e. reduced muscle mass and gait speed or
      strength). Therefore the purpose of this study will be to evaluate whether dumbbell
      resistance training (DBRT) or elastic band resistance training (EBRT) is beneficial in older
      adults whom may be classified as sarcopenic based on the collective operational definition
      and older adults that do not meet the criteria to be considered sarcopenic compared to
      non-exercise controls of these populations after sarcopenia criteria have been established.
      As well as identify if resistance exercise will improve muscle quality in older adults,
      considering how muscle quality relates to sarcopenia status.
    

Intervention name(s): Resistance exercise program
Intervention type(s): Behavioral
Intervention description(s): Exercise sessions with exercise science professional. Target hypertrophy repetition range and progressive resistance exercise.
Other intervention name(s): control-no exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: muscular strength; functional capacity; resistance exercise