Clinical trial NCT03079180: Tendon Adaptations to Training - Effect of Ageing
Official title: Effect of Different Strength Training Intensities on Achilles and Patellar Tendon Adaptations With Aging
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Aging
Exercise Training
Connective Tissue
Skeletal Muscle
Keywords: Tendon
Ageing
Training
Achilles tendon
Patella tendon
Skeletal muscle
Adaptation
Triceps Surae
Quadriceps
Lead sponsor: Université de Technologie de Compiegne
Sponsor class: OTHER
Collaborators: name: Centre Hospitalier Compiègne-Noyon
name: University of Copenhagen
First posted: 2017-03-14
Enrollment: 60
Sex: MALE
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Tendons are essential structures for transmitting muscle forces to skeletal structures. A stiffer tendon will transmit muscle force faster, and then allow faster movement. Moreover, tendons are a living tissue and respond to mechanical forces by changing their metabolism as well as their structural and mechanical properties. The aim of the present study is to answer essential questions remaining unanswered that are necessary in order to optimize physical activity with ageing in humans, and thus improve quality of life in elderly. The main questions are: What is the minimal training intensity leading to tendon adaptations? What is the time-course of tendon adaptations? Does the same loading protocol lead to similar tendon adaptations for different tendons (Achilles vs Patellar) and does the same training program lead to identical tendon adaptations with age (25yrs vs 75yrs)? To answer these questions, tendon architecture and mechanical properties will be investigated in humans of different age and applying different training intensities. The kinematic of the tendon adaptations due to these different training characteristics will also be investigated. The training protocol will be applied on plantar flexors and knee extensors. MRI and ultrasound techniques as well as the use of ankle and knee ergometers will allow the quantification of possible modifications in tendon architecture and mechanical properties (tendon stiffness and Young's Modulus). This will be assessed in vivo, using ultrasound images to assess tendon displacement during an incremental maximal contraction.

Detailed description: Given the aging population demographics, and the barriers that exist in this population in terms of exercise participation, determining the level of exercise intensity required and the time-course to induce tendon adaptations is of paramount importance in this population. Therefore the purpose of this study is to:

1. determine whether a low intensity exercise training program (resistance 55% 1RM) affects tendon architecture and mechanical properties with aging,
2. compare these effects to those of a higher intensity exercise training protocol (resistance 80% 1RM) with a match training work with regards to the low intensity exercise training group,
3. evaluate the time course of tendon adaptations (architecture and mechanical properties) for the two training conditions with aging,
4. compare the effect of an identical training protocol applied on two different muscle groups (triceps surae vs quadriceps muscles) on Patellar and Achilles tendon adaptations.

Every subject recruited (Two groups composed of males aged between 65 and 85 years, and one group of young subjects (between 18 and 30 years)) will be asked to take part in a training program applied on the calf and quadriceps muscle groups on both legs. All subjects will be assessed 4 weeks before starting the intervention program (T-4w), at time zero (T0) and every four weeks during 12 weeks (T4w, and T8w). The investigation 4 weeks before starting the training program will allow using each subject as its own control. The intervention will involve a maximum of forty five (45) minutes training sessions 3 times per week. Subjects will be subjected to the same battery of baseline assessments (T-4w, and T0), during the training procedure (T4w, and T8w), and following the 12-weeks intervention period (T12w).

The effect of aging and different loading interventions on Achilles and Patellar tendon will be investigated for the following parameters:

* Tendon mechanical properties (stiffness and Young's Modulus) using US technique to assess Achilles and Patellar tendon displacement during an incremental maximal contraction.
* Tendon architecture using MRI technique to assess Achilles and Patellar tendon cross-sectional area, tendon length and moment arm.
* Maximal voluntary contraction (MVC)
* Muscle architecture using MRI technique.

Thus all these data will allow defining an optimal training intensity for physical activity of elderly persons.

Eligibility criteria: Inclusion Criteria:

* Males
* Age between 18 and 30 years for the young group and between 65 and 85 years for aged group
* Physical and mental health, as assessed by clinical investigation
* Written informed consent
* Willingness to co-operate
* Non-smoker
* Not addicted to alcohol or drugs
* Habitual sedentary/low physical activity levels

Exclusion Criteria:

* BMI \<20 or \>28
* Height \<155cm, \>195cm
* Chronic disease with regular clinical treatment
* Regular drug intake
* Any metabolic or hormonal disorder
* Psychiatric conditions
* Any blood clotting disorder
* Any muscle or bone disease
* Metal implants
* Any inflammatory disease
* Metabolic or hormonal disorder
* Participation in sports at competitive rather than at a recreational level
* Fractures during the past 6 months
* Epilepsy
* Back pain
* Lower extremity trauma during the past 6 months, or currently experiencing related symptoms, or receiving treatment
* Any other condition or history that the investigator considers might increase the risk to the individual or interfere with the evaluation of data

Primary outcomes:
measure: Time-course change of tendon size
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
measure: Time-course change of tendon mechanics (Elastic modulus of the tendon)
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
Secondary outcomes:
measure: Time-course change of plantar flexion muscle strength
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
measure: Time-course change of calf muscle size
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
measure: Time-course change of quadriceps muscle strength
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
measure: Time-course change of quadriceps muscle size
timeFrame: T-4weeks (4 weeks before starting intervention), T0 (before starting intervention), T+4weeks (after 4 weeks of intervention), T+8weeks (after 8 weeks of intervention), T+12weeks (at the end of the 12 weeks of intervention)
Other outcomes:
Locations:
city: Compiegne
country: France
facility: Universite de Technologie de Compiegne
Study officials:
affiliation: Centre Hospitalier Compiegne-Noyon
name: Franck Mabesoone, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Letocart AJ, Mabesoone F, Charleux F, Couppe C, Svensson RB, Marin F, Magnusson SP, Grosset JF. Muscles adaptation to aging and training: architectural changes - a randomised trial. BMC Geriatr. 2021 Jan 13;21(1):48. doi: 10.1186/s12877-020-02000-0.