Effects of Resistance Training With High vs. Light-moderate Loads on Muscle-tendon Function in the Elderly

Study Overview
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Brief Summary
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There are no unbiased studies that have analyzed the effects of resistance training with traditional, heavy versus light-moderate loads on muscle, tendon and bone in elderly people. The purpose of the present study is to assess the effects on muscle mass and function, tendon and bone of two different training intensities, light-moderate vs. heavy load, in people older than 65 years old. The study will be carried out with a randomized controlled design. Participants will perform single training sessions and a 12-wk dynamic resistance training program on the knee extensors with different training intensities on each leg. One leg will train with heavy loads and the other one will train with light-moderate loads, but matching the load x repetitions performed by the contralateral side.

Detailed Description
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The decline in muscle function provoked by the aging process and frailty are directly related to decreases in mobility and the ability to perform the so called daily life activities. Resistance training is especially useful at this stage, given that it is an effective and widely applicable intervention to control and revert sarcopenia, and the deterioration of tendon and bone function. Despite of the effectiveness of heavy load resistance training, a controversy has arisen in the last years about the effects of lower load resistance training programs to achieve similar adaptations. This is because most of the studies that have compared light-moderate versus heavy load programs did not control the differences in total training load, measured as the overall mechanical work performed during the training program. Therefore, there are no unbiased studies that have analyzed the effects of resistance training with traditional, heavy versus light-moderate loads on muscle, tendon and bone in elderly people. The purpose of the present study is to assess the effects on muscle mass and function, tendon and bone of two different training intensities, light-moderate vs. heavy load, in people older than 65 years old. The studies will be carried out with a crossover (acute training sessions) and randomized controlled design (longitudinal training intervention). Participants will perform single training sessions with each resistance training intensity and a 12-wk dynamic resistance training program on the knee extensors with different training intensities on each leg. One leg will train with heavy loads and the other one will train with light-moderate loads, but matching the load x repetitions performed by the contralateral side. Muscle adaptations (EMG, muscle size and architecture), tendon mechanical properties, bone mineral density, blood parameters and life quality will be analyzed before and after the cessation of the training program.

Official Title
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Effects of Resistance Training With High vs. Light-moderate Loads on Muscle-tendon Function in the Elderly

Conditions
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Aging, Sarcopenia, Frail Elderly Syndrome

Intervention / Treatment
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* Behavioral: High Intensity resistance training (12 weeks)
* Behavioral: Light-moderate intensity resistance training (12 weeks)
* Behavioral: Control (12 weeks)
* Behavioral: One High Intensity resistance training session
* Behavioral: One Light-moderate intensity resistance training session


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 years and older, non-institutionalized passed physical examination including physical function assessment (no frailty status; SPPB >7 points) Exclusion Criteria: Neurological, musculoskeletal, or other disorder that would preclude completing resistance training and all performance tests Uncontrolled hypertension, unstable or exercise-induced angina pectoris or myocardial ischemia or any other medical condition that would interfere with testing or increase one's risk of complications during exercise. History of regular resistance exercise during the previous 3 years Knee prosthesis

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: High intensity vs Control (12 weeks)<br>8 weeks of baseline period plus an exercise program where one leg undergoes High Intensity resistance training (12 weeks) and the other leg is established as control. | Behavioral: High Intensity resistance training (12 weeks)<br>* High intensity resistance training (80% of 1 repetition maximum), 2 d/wk (Longitudinal)<br>* Other names: HIT;Behavioral: Control (12 weeks)<br>* No resistance training during the intervention period.<br>* Other names: CON;|
| Active Comparator: Light intensity vs Control (12 weeks)<br>8 weeks of baseline period plus an exercise program where one leg undergoes light-moderate intensity resistance training (12 weeks) and the other leg is established as control. | Behavioral: Light-moderate intensity resistance training (12 weeks)<br>* Light-moderate intensity resistance training (40% of 1 repetition maximum), 2 d/wk (Longitudinal)<br>* Other names: LIT;Behavioral: Control (12 weeks)<br>* No resistance training during the intervention period.<br>* Other names: CON;|
| Experimental: High vs Light intensity (12 weeks)<br>8 weeks of baseline period plus an exercise program where one leg undergoes High Intensity resistance training (12 weeks) and the other leg undergoes light-moderate intensity resistance training. | Behavioral: High Intensity resistance training (12 weeks)<br>* High intensity resistance training (80% of 1 repetition maximum), 2 d/wk (Longitudinal)<br>* Other names: HIT;Behavioral: Light-moderate intensity resistance training (12 weeks)<br>* Light-moderate intensity resistance training (40% of 1 repetition maximum), 2 d/wk (Longitudinal)<br>* Other names: LIT;|
| Experimental: High intensity (Acute)<br>Analysis of the effects of one High Intensity resistance training session, with a crossover design. | Behavioral: One High Intensity resistance training session<br>* High intensity resistance training, 1 training session<br>* Other names: HIT (Acute);|
| Experimental: Light intensity (Acute)<br>Analysis of the effects of one Light-moderate Intensity resistance training session, with a crossover design. | Behavioral: One Light-moderate intensity resistance training session<br>* Light-moderate intensity resistance training, 1 training session<br>* Other names: LIT (Acute);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute change in muscle size (cross sectional area, cm2) | Ultrasound-based determination quadriceps muscle size and architecture. | Change from baseline at 5 minutes after a training session | 
| Change in muscle size (cross sectional area, cm2) | Ultrasound-based determination quadriceps muscle size and architecture. | Change from baseline to week 12 | 
| Acute change in muscle function (N) | Force-velocity profile of the single-leg press exercise | Change from baseline at 5 minutes after a training session | 
| Change in muscle function (N) | Force-velocity profile of the single-leg press exercise | Change from baseline to week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in patellar tendon stiffness (N/mm) | Ultrasound and force-based measures of tendon mechanical properties. | Change from baseline to week 12 | 
| Acute change in patellar tendon stiffness (N/mm) | Ultrasound and force-based measures of tendon mechanical properties. | Change from baseline at 5 minutes after a training session | 
| Change in muscle mass (kg) | Lean mass determined by Dual energy X-ray absorptiometry | Change from baseline to week 12 | 
| Change in bone mass (g) | Bone mineral content determined by Dual energy X-ray absorptiometry | Change from baseline to week 12 | 
| Acute change in muscle excitation (mV) | Electromyographic activity of the knee extensor and flexor muscles during strength assessment and training | Change from baseline at 5 minutes after a training session | 
| Change in muscle excitation (mV) | Electromyographic activity of the knee extensor and flexor muscles during strength assessment and training | Change from baseline to week 12 | 
| Change in physical function | Short Physical Performance Battery | Change from baseline to week 12 | 
| Blood analysis: Acute change in oxidative stress | Carbonyl proteins (plasma concentration) | Change from baseline at 5 minutes after a training session | 
| Blood analysis: Change in oxidative stress | Carbonyl proteins (plasma concentration) | Change from baseline to week 12 | 
| Blood analysis: Acute change in Inflammation | Interleukin 6, Tumoral necrosis factor Alpha, C reactive protein (plasma concentration) | Change from baseline at 5 minutes after a training session (Acute) | 
| Blood analysis: Change in inflammation | Interleukin 6, Tumoral necrosis factor Alpha, C reactive protein (plasma concentration) | Change from baseline to week 12 | 
| Blood analysis: Acute change in anabolic processes | Testosterone, growth hormone, Insulin growth factor-1 (plasma concentration) | Change from baseline at 5 minutes after a training session | 
| Blood analysis: Change in anabolic processes | Testosterone, growth hormone, Insulin growth factor-1 (plasma concentration) | Change from baseline to week 12 | 
| Blood analysis: Acute change in catabolic processes | Cortisol, Creatin kinase (plasma concentration) | Change from baseline at 5 minutes after a training session | 
| Blood analysis: Change in catabolic processes | Cortisol, Creatin kinase (plasma concentration) | Change from baseline to week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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resistance training, sarcopenia, hypertrophy, tendon, frailty, ageing