Abstract
BackgroundResistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults.MethodsThree hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach.ResultsAfter 12 weeks, lower-extremity muscle strength improved by 11–26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0–12-weeks,90%(SD,13%); 12–24-weeks,89%(SD,17%)] and control [12–24-weeks,90%(SD,19%)] groups.ConclusionCommunity-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks.Trial registrationClinicalTrials.gov, NCT04661618, Registered 10 December 2020 - Retrospectively registered.
Highlights
Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults
The gradual loss in muscle strength and function with age result in adverse health outcomes including frailty, increased risk of falls, lower quality of life, increased dependency, hospitalization and mortality [3, 4]. While multiple factors such as malnutrition, obesity and hormonal changes contribute to the age-associated decline in physical function, low level of physical activity (PA) is a key factor that mediates the reduction in muscle strength and function with age [5]
Our results extended the findings of previous small research studies on muscle strength improvement with pneumatic machine resistance training [24, 25], to a community programme implemented at multiple neighbourhood senior centres
Summary
Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults. The gradual loss in muscle strength and function with age result in adverse health outcomes including frailty, increased risk of falls, lower quality of life, increased dependency, hospitalization and mortality [3, 4]. While multiple factors such as malnutrition, obesity and hormonal changes contribute to the age-associated decline in physical function, low level of physical activity (PA) is a key factor that mediates the reduction in muscle strength and function with age [5]. It is pertinent for PA research to move beyond clinical research trials to evaluate effectiveness of large-scale communitydelivered programmes
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