Resistance Training for Individuals With Mild Cognitive Impairment

Study Overview
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Brief Summary
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This research project aims to analyze the effects of different resistance training volumes on cognitive function, oxidative stress, immunological response, lipid profile, glycemic status, liver function, muscle function, hemodynamic response, and physical performance in individuals with mild cognitive impairment. First, we will analyze the effects of a single resistance training session (acute effects) with one and three sets on hemodynamic and physical performance in individuals with mild cognitive impairment. After, we will analyze the effects of an 8-week resistance training program with one or three sets on cognitive function, oxidative stress, immunological response, lipid profile, glycemic status, liver function, muscle function, hemodynamic response, and physical performance in individuals with mild cognitive impairment. We hypothesize that a single resistance training session of one or three sets will increase the acute hemodynamic and physical performance stress in individuals with mild cognitive impairment, although with a higher magnitude in the session with three sets. Furthermore, we hypothesize that eight weeks of resistance training with one or three sets will induce similar improvements in cognitive function, oxidative stress, immunological response, lipid profile, glycemic status, liver function, muscle function, hemodynamic response, and physical performance in individuals with mild cognitive impairment.

Detailed Description
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Following specific inclusion and exclusion criteria (see Eligibility Criteria), participants will be recruited from residential care facilities or day centers. For the acute effects study (cross-over study), the participants will randomly perform two resistance training sessions separated by one week of rest: i) one session with one set and ii) another session of three sets. The intensity of the exercises, number of repetitions, type and order of exercises, movement velocity, and rest time between exercises will be the same in both groups. Before, immediately after, and 72 hours after the sessions, a battery of tests will be applied to evaluate the changes in blood pressure, heart rate, tympanic temperature, medicine ball throw distance, five-repetition sit-to-stand time, and handgrip strength. Afterward, the participants will be randomly assigned into a one-set or three-set group to perform an eight-week resistance training intervention. As for the acute effects study, the prescription of the other acute training variables will be the same for both groups. A control group (without any form of physical exercise), recruited at the beginning of the research project, will also be part of the study. Before and after the intervention, a battery of tests will be applied to determine the training program's impact on cognitive function, oxidative stress, immunological response, lipid profile, glycemic status, liver function, muscle function, hemodynamic response, and physical performance in individuals with mild cognitive impairment.

Official Title
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Effects of Different Resistance Training Volumes on Cognitive Function, Oxidative Stress, Immunological Response, Lipid Profile, Glycemic Status, Liver Function, Muscle Function, Hemodynamic Response, and Physical Performance in Individuals With Mild Cognitive Impairment

Conditions
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Mild Cognitive Impairment, Mild Dementia

Intervention / Treatment
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* Other: One Resistance Training Set (Single Session)
* Other: Three Resistance Training Sets (Single Session)
* Other: One Resistance Training Set (8 Weeks)
* Other: Three Resistance Training Sets (8 Weeks)
* Other: Control (8 Weeks)


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: i) Men or women aged ≥ 50 years diagnosed with mild cognitive impairment; ii) SPPB score ≥ 3 points; iii) Willingness to participate in the interventions and collaborate with the research team; iv) Able to provide informed consent (oral or written). Exclusion criteria: i) Severe dementia; ii) Severe comorbidity that negatively influences participation in the intervention; iii) Color blindness; iv) Fractures in the last three months.

Ages Eligible for Study
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Minimum Age: 50 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 |
| --- | --- |
| Experimental: One Resistance Training Set (Single Session)<br>The participants will perform one resistance training session with one set. | Other: One Resistance Training Set (Single Session)<br>* The participants will perform a resistance training session with one set per exercise. The training sequence will be the following: i) 10 minutes of warm-up walking on the treadmill at 50% of maximal walking velocity, ii) 1 set of 10 repetitions at 60% of one-repetition maximum (1RM) in the leg press, iii) 1 set of 10 repetitions at 55% 1RM in the chest press, iv) 1 set of 10 repetitions in the sit-to-stand exercise, v) 1 set of 10 repetitions in the 1-kg medicine ball throw exercise, and vi) 5 minutes walking on the treadmill at 60% of maximal walking velocity.<br>|
| Experimental: Three Resistance Training Sets (Single Session)<br>The participants will perform one resistance training session with three sets. | Other: Three Resistance Training Sets (Single Session)<br>* The participants will perform a resistance training session with three sets per exercise. The training sequence will be the following: i) 10 minutes of warm-up walking on the treadmill at 50% of maximal walking velocity, ii) 3 sets of 10 repetitions at 60% of one-repetition maximum (1RM) in the leg press, iii) 3 sets of 10 repetitions at 55% 1RM in the chest press, iv) 3 sets of 10 repetitions in the sit-to-stand exercise, v) 3 sets of 10 repetitions in the 1-kg medicine ball throw exercise, and vi) 5 minutes walking on the treadmill at 60% of maximal walking velocity.<br>|
| Experimental: One Resistance Training Set (8 Weeks)<br>The participants will perform eight weeks of resistance training (two sessions per week, separated by 72 hours of rest) with one set. | Other: One Resistance Training Set (8 Weeks)<br>* The participants will perform eight weeks of resistance training with one set per exercise. The training sequence will be the following: i) 10 minutes of warm-up walking on the treadmill at 50% of maximal walking velocity, ii) 1 set of 10 repetitions between 50-70% of one-repetition maximum (1RM) in the leg press, iii) 1 set of 10 repetitions between 40-60% 1RM in the chest press, iv) 1 set of 6-12 repetitions in the sit-to-stand exercise, v) 1 set of 6-12 repetitions in the 1-kg medicine ball throw exercise, and vi) 5 minutes walking on the treadmill at 60% of maximal walking velocity.<br>|
| Experimental: Three Resistance Training Sets (8 Weeks)<br>The participants will perform eight weeks of resistance training (two sessions per week, separated by 72 hours of rest) with three sets. | Other: Three Resistance Training Sets (8 Weeks)<br>* The participants will perform eight weeks of resistance training with three sets per exercise. The training sequence will be the following: i) 10 minutes of warm-up walking on the treadmill at 50% of maximal walking velocity, ii) 3 sets of 10 repetitions between 50-70% of one-repetition maximum (1RM) in the leg press, iii) 3 sets of 10 repetitions between 40-60% 1RM in the chest press, iv) 3 sets of 6-12 repetitions in the sit-to-stand exercise, v) 3 sets of 6-12 repetitions in the 1-kg medicine ball throw exercise, and vi) 5 minutes walking on the treadmill at 60% of maximal walking velocity.<br>|
| Experimental: Control (8 Weeks)<br>The participants will not perform any form of physical exercise during the intervention period of eight weeks. | Other: Control (8 Weeks)<br>* The participants in the control group will maintain their regular daily activities without performing any form of physical exercise.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Systolic blood pressure (SBP) | In the cross-over study (acute effects), the SBP will be assessed through a blood pressure device. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Handgrip strength (HGS) | In the cross-over study (acute effects), the HGS will be assessed through an analogic dynamometer. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Dementia Rating Scale-2 (DRS-2) | In the eight-week study, the DRS-2 questionnaire will be applied to analyze the overall level of cognitive function through five subscales: attention, initiation/perseveration, construction, conceptualization, and memory. | Change from baseline to week 8 | 
| Brain-Derived Neurotrophic Factor (BDNF) | In the eight-week study, the BDNF protein levels will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| Short Physical Performance Battery (SPPB) | In the eight-week study, the SPPB will determine the overall level of functional performance through three tests: balance (feet side by side, semi tandem, tandem), 4-meter walking, and 5-repetition sit-to-stand. | Change from baseline until week 8 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diastolic blood pressure (DBP) | In the cross-over study (acute effects), the DBP will be assessed through a blood pressure device. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Heart rate (HR) | In the cross-over study (acute effects), the HR will be assessed through a blood pressure device. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Tympanic temperature (TT) | In the cross-over study (acute effects), the TT will be assessed through a tympanic thermometer. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Five-repetition sit-to-stand (5STS) | In the cross-over study (acute effects), the 5STS time will be recorded through a chronometer. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| 1-kg Medicine Ball Throw (MBT) | In the cross-over study (acute effects), the MBT distance will be recorded with a tape measure. | Change from baseline to 0 minutes and 72 hours after the sessions | 
| Inflammatory markers | In the eight-week study, inflammatory markers (IL-6, TNF-α, and IL-10) will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| Oxidative stress | In the eight-week study, oxidative stress markers (carbonylated proteins) will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| Lipid Profile | In the eight-week study, the lipid profile (LDL, HDL, total cholesterol, triglycerides) will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| HbA1c | In the eight-week study, the HbA1c will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| Muscle Damage | In the eight-week study, the muscle damage (creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase) will be analyzed through specific blood testing kits. | Change from baseline to week 8 | 
| One-repetition maximum (1RM) | In the eight-week study, a progressive loading test until reaching the 1RM will be applied in the horizontal leg press and seated chest press machines. | Change from baseline to week 8 | 
| Load-velocity profiles | In the eight-week study, the load-velocity profiles will be analyzed using the velocity values (recorded with a linear velocity transducer) associated with the absolute loads used during the progressive loading tests in the horizontal leg press and seated chest press machines. | Change from baseline to week 8 | 
| Ten-meters walking | In the eight-week study, the 10-meter walking time will be measured through a chronometer. | Change from baseline to week 8 | 
| 1-kg Medicine Ball Throw (MBT) | In the eight-week study, the MBT distance will be recorded with a tape measure. | Change from baseline to week 8 | 
| Handgrip strength (HGS) | In the eight-week study, the HGS will be assessed through an analogic dynamometer. | Change from baseline to week 8 | 
| 6-Minute Walk Test (6MWT) | In the eight-week study, the 6MWT distance will be assessed by multiplying the number of total laps by the lap distance (e.g., 10 laps x 10 meters). | Change from baseline to week 8 |