Abstract
BackgroundAlthough resistance exercise interventions have been shown to be beneficial in prefrail or frail older adults it remains unclear whether there are residual effects when the training is followed by a period of detraining. The aim of this study was to establish the sustainability of a muscle power or muscle strength training effect in prefrail older adults following training and detraining.Methods69 prefrail community-dwelling older adults, aged 65–94 years were randomly assigned into three groups: muscle strength training (ST), muscle power training (PT) or controls. The exercise interventions were performed for 60 minutes, twice a week over 12 weeks. Physical function (Short Physical Performance Battery=SPPB), muscle power (sit-to-stand transfer=STS), self-reported function (SF-LLFDI) and appendicular lean mass (aLM) were measured at baseline and at 12, 24 and 36 weeks after the start of the intervention.ResultsFor the SPPB, significant intervention effects were found at 12 weeks in both exercise groups (ST: p = 0.0047; PT: p = 0.0043). There were no statistically significant effects at 24 and 36 weeks. In the ST group, the SPPB declined continuously after stop of exercising whereas the PT group and controls remained unchanged. No effects were found for muscle power, SF-LLFDI and aLM.ConclusionsThe results showed that both intervention types are equally effective at 12 weeks but did not result in statistically significant residual effects when the training is followed by a period of detraining. The unchanged SPPB score at 24 and 36 weeks in the PT group indicates that muscle power training might be more beneficial than muscle strength training. However, more research is needed on the residual effects of both interventions. Taken the drop-out rates (PT: 33%, ST: 21%) into account, muscle power training should also be used more carefully in prefrail older adults.Trial registrationThis trial has been registered with clinicaltrials.gov (NCT00783159)
Highlights
Resistance exercise interventions have been shown to be beneficial in prefrail or frail older adults it remains unclear whether there are residual effects when the training is followed by a period of detraining
Greater benefits were shown for high-intensity or muscle power training programs when they were compared with moderate-intensity or traditional muscle strength training programs
Before the start of the intervention program, participants were stratified by sex and frailty score and were randomly allocated into a muscle strength training (ST, n = 23), muscle power training (PT, n = 24) or control group (C, n = 22) by a researcher not involved in this study
Summary
Resistance exercise interventions have been shown to be beneficial in prefrail or frail older adults it remains unclear whether there are residual effects when the training is followed by a period of detraining. Mobility impairments have been shown to be associated with the occurrence of disability and are a strong predictor of mortality and nursing home admission [1] This concerns especially the frail and prefrail cohort in the older community [2]. Prefrailty is defined as the transitional stage between the non-frail and frail state [5] Considering these facts, exercise interventions aiming at enhancement in mobility and function in frail or prefrail older adults have gained increasing attention and promotion as well as scientific support. In prefrail older adults muscle strength and muscle power interventions have been shown to be beneficial for increasing physical function [10]. This implies that prefrail older adults may respond differently to muscle strength or muscle power training modalities than nonfrail older adults and exercise interventions would have to be adjusted
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