Abstract
Prehabilitation might attenuate common surgery-induced losses in muscle mass and physical performance. Beneficial effects of physical exercise with protein supplementation have been reported in older adults, but typically after an intervention of at least 12weeks. The time-window for pre-surgery training is often limited to around 30days, and it is not known if it is possible to achieve comparable results in such a short time window. The aim of this study was to pilot-test the effectiveness of a controlled four-week combined exercise and protein supplementation program on skeletal muscle-related outcomes in a Dutch older adult population. This study was a one-armed pilot trial. Seventeen older men and women, aged 55-75y, not scheduled for surgery. A 4-week intervention program consisting of a twice-weekly supervised resistance and high-intensity aerobic exercise training of 75min, combined with daily protein supplementation (2 doses of 15.5g/day at breakfast and lunch). After two and four weeks, isometric quadriceps maximal voluntary contraction (MVC) was assessed via Biodex and quadriceps cross-sectional area (CSA) via magnetic resonance imaging. Other outcome measures were handgrip strength, chair rise time and maximal aerobic capacity (VO2-max), as assessed from a submaximal exercise test. Compliance to the supervised training sessions (99.3%) and the protein supplementation (97%) was very high. The 4-week exercise and protein program led to an increase in quadriceps CSA of 2.3±0.7cm2 (P=0.008) in the dominant leg and 3.2±0.7cm2 (P<0.001) in the non-dominant leg. Isometric quadriceps MVC increased in the dominant leg (Δ14±4Nm, P=0.001) and in the non-dominant leg (Δ17±5Nm, P=0.003). Chair rise test time improved with -3.8±0.5s (P<0.0001), and VO2-max improved with 3.3±1.1ml/min/kg (P=0.014). We observed no changes in body weight and handgrip strength. A 4-week exercise and protein intervention led to improvements in muscle-related outcomes in older adults with low levels of physical activity.
Highlights
Surgery largely impacts the physical status of patients (Dronkers et al, 2016)
The present study aims to assess the effects of an intense four-week combined exercise and protein supplementation program on muscle strength, muscle mass, and aerobic capacity in older adults
Potential participants were recruited from a volunteer database from Wageningen University and Research, and eligibility was assessed via five questionnaires: (Dronkers et al, 2016) a screening questionnaire regarding the inclusion and exclusion criteria, (Giannoudis et al, 2006) a screening questionnaire regarding the demographics of the participants, (Desborough, 2000) the Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) (Wendel-Vos et al, 2003) to assess current activity level, (Gillis and Carli, 2015) the Physical Activity Readiness Questionnaire (PARQ) and (Weimann et al, 2017) a Magnetic Resonance Imaging (MRI) screening questionnaire
Summary
Surgery largely impacts the physical status of patients (Dronkers et al, 2016). A surgical procedure induces a stress response, which alters the functioning of different organs and physiological systems (Giannoudis et al, 2006). Beneficial effects of physical exercise with protein supplementation have been reported in older adults, but typically after an intervention of at least 12 weeks. Objectives: The aim of this study was to pilot-test the effectiveness of a controlled four-week combined exercise and protein supplementation program on skeletal muscle-related outcomes in a Dutch older adult population. Intervention: A 4-week intervention program consisting of a twice-weekly supervised resistance and high-intensity aerobic exercise training of 75 min, combined with daily protein supplementation (2 doses of 15.5 g/day at breakfast and lunch). Other outcome measures were handgrip strength, chair rise time and maximal aerobic capacity (VO2-max), as assessed from a submaximal exercise test. Conclusion: A 4-week exercise and protein intervention led to improvements in muscle-related outcomes in older adults with low levels of physical activity
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