High-intensity Progressive Resistance Training Research Articles

Circulating CD31+ Angiogenic T cells are reduced in prediabetes and increase with exercise training

AimsTo investigate circulating angiogenic cells in adults with prediabetes and the effect of a structured exercise program. MethodsA cohort of adults with overweight/obesity and either normal glucose (NG) or prediabetes were randomised to receive exercise (Exercise) (as twice weekly supervised combined high intensity aerobic exercise and progressive resistance training, and once weekly home-based aerobic exercise) or an unsupervised stretching intervention (Control) for 12 weeks. Circulating angiogenic T cells, muscle strength, and cardiovascular disease risk factors, including blood lipids, arterial stiffness, central haemodynamic responses, and cardiorespiratory fitness (VO2peak) in those with prediabetes (n = 35, 16 Control, 19 Exercise) and NG (n = 37, 17 Control, 20 Exercise) were analysed at baseline and after the 12-week intervention. ResultsAt baseline, compared with NG those with prediabetes demonstrated reduced VO2peak, angiogenic CD31+CD8+ T cells and VEGFR2+CD4+ T cells, and increased systolic blood pressure. CD31+ T cells were negatively correlated with cardiovascular disease (CVD) risk. Compared with Control, exercise training increased muscle strength, VO2peak, and CD31+CD4+ and CD31+CD8+ T cells in NG and prediabetes. ConclusionsCirculating angiogenic CD31+ T cells are decreased in people with prediabetes and are enhanced with exercise training. Exercise increases CD31+ T cells, and through this mechanism it is proposed that it may reduce CVD risk. Trial registrationAustralian New Zealand Clinical Trials Registry number: ACTRN12617000552381.

"We want more": perspectives of sarcopenic older women on the feasibility of high-intensity progressive resistance exercises and a whey-protein nutrition intervention.

This qualitative study is nested within a 12-week pilot randomized-controlled, two-arm trial involving high-intensity progressive resistance training (PRT) or PRT with a multi-nutrient, whey-protein supplementation (PRT+WP) in sarcopenic older adults (trial registration no: TCTR20230703001). The aim was to investigate sarcopenic participants' perceptions and barriers to this multi-modal intervention strategy that may accelerate "real-world" implementation. Eighteen older adults (one man) with possible sarcopenia were invited to join the study, of whom 16 women were randomized to a thrice-weekly PRT (n = 8) program (80% of 1-repetitive maximum, six resistance band exercises) only or PRT plus daily weekday milk-based WP supplementation (PRT+WP, n = 8). Muscle strength (handgrip and 5-times sit-to-stand), mass (dual-energy X-ray absorptiometry), performance (Short Physical Performance Battery and stair ascent-descent), and nutrition status (Mini Nutritional Assessment) were assessed for changes. We randomly selected eight women for the semi-structured interview. Post-intervention, eight (50%) women were sarcopenia-free, six (38%) remained in possible sarcopenia, one (6%) improved to sarcopenia, and one (6%) deteriorated from possible to severe sarcopenia. There were no significant between-group differences, but significant within-group improvements (p < 0.05) were detected for handgrip strength (PRT+WP 5.0 kg, d = 0.93; PRT 6.1 kg, d = 0.55), 5-times sit-to-stand time (PRT 2.0 s, d = 1.04), nutrition score (PRT+WP 3.44, d = 0.52; PRT 1.80, d = 0.44), and stair ascent time (PRT+WP 0.97 s, d = 0.77; PRT 0.75 s, d = 0.97). Our thematic analyses identified four main themes, namely, (1) perceived benefits, (2) sustaining behavior changes, (3) challenges in participating, and (4) improved wellbeing. Participants expressed how they initially were skeptical and doubted that they could complete the exercises or tolerate the milk-based WP supplements. However, they reported positive experiences and benefits felt from strength gains, increased confidence, and better physical abilities. Participants were surprised by the zero adverse effects of WP supplements. The women wanted more nutritional information and structured, guided exercise programs and suggested a community-based implementation. In conclusion, our findings showed PRT was well received and may support reduced risks of sarcopenia. No added benefits were seen with the addition of WP supplementation, but a larger sample is required to address this question. Overall, older (previously sarcopenic) Malay women indicated that they want more multi-modal programs embedded in their community.

Finding the Optimal Resistance Training Intensity for Your Bones: Protocol for a Randomized Controlled Trial.

The purpose of this trial is to evaluate the effect of twice-weekly, moderate-to-high intensity progressive resistance training (PRT) for 1year on lumbar spine bone mineral density (BMD) in individuals with low BMD, compared to attention control. Secondary analyses will examine if resistance training improves other health outcomes; if high intensity is more effective than moderate intensity resistance training for all outcomes; the cost of intervention versus benefit; the willingness to pay; and harms. For this study, 324 men or postmenopausal women aged ≥50years with a femoral neck, total hip, or lumbar spine BMD T-score of ≤-1, or a Fracture Risk Assessment Tool probability of ≥20% for major osteoporotic fracture or ≥ 3% for hip fracture are being recruited to participate in a randomized controlled trial with 1:1:1 randomization. Participants will be stratified by site (3 centers) to twice-weekly, supervised PRT at moderate intensity (about 10 repetitions maximum), to high intensity PRT (≤6 repetitions maximum), or to a home posture and balance exercise program (attention control) for 1year (resistance training to comparator allocation ratio of 2:1). The primary outcome is lumbar spine BMD via dual-energy X-ray absorptiometry. Secondary outcomes include trabecular bone score, proximal femur and total hip BMD and structure, bone-free and appendicular lean mass, physical functioning, falls, fractures, glucose metabolism, cost per life-year gained, adverse events, and quality of life. Between-group differences will be tested in intention-to-treat and per-protocol analyses using analysis of covariance, chi-square tests, or negative binomial or logistic regression, adjusting for site and baseline values. The Finding the Optimal Resistance Training Intensity For Your Bones trial will support decision making on resistance training for people at risk of fracture.

Benefícios do treinamento com exercícios resistidos progressivos no desempenho motor e na hipertrofia muscular de ratos com doença de Parkinson

ABSTRACT Parkinson’s disease (PD) is a progressive neurodegenerative condition defined by the presence of primary debilitating motor symptoms. This study aims to investigate the benefits of high-intensity progressive resistance training on muscle tissue and motor performance before and after the induction of PD in rats. A total of 80 male Wistar rats (Rattus norvegicus, var. albinus) aged 40 days and weighing between 250 and 450g were used. A total of 40 animals were subjected to PD surgery to induce electrolytic injury and were randomly assigned to the following subgroups: animals trained before PD induction (PA-Exa); animals trained after PD induction (PA-Exd); animals trained before and after PD induction (PA-Exad); and sedentary animals with PD induction (PA-Sed). The other 40 animals (control) were subjected to surgical access but not to PD electrolytic injury (Sham) and distributed in the same subgroups described above. For the PD induction surgery, electrolytic stimulation was used at the following coordinates: anteroposterior (AP) −4.9, mid-lateral (ML) 1.7,and dorsoventral (DV) 8.1. High-intensity progressive resistance training was performed on a vertical ladder five days/week from 30 to 45 minutes for four weeks. For our functional evaluation, the parallel bars and the misstep tests were used at the beginning (after surgery) and at the end of the experiment. After euthanasia, the forelimb biceps and hindlimb flexor hallucis longus muscles were removed. Processing, coloration, and histomorphometry analysis of muscle tissue were performed for all groups. To analyze the data, GraphPad Prism 9.4 was used with one-way analysis of variance (ANOVA) and a p&lt;0.05. Data on muscle fiber count and area in forelimb biceps showed no significant differences, with a 0.853 and 0.4122 p-value, respectively. Flexor hallucis longus muscle fiber count showed a significant difference (p=0.0356), and PA-Exa and PA-Exd averaged the highest means. Hindlimb flexor hallucis longus muscle fiber area also evinced a significant difference (p=0.0306), in which PA-Exd, PA-Exad, and Sham-Exad showed the largest areas. Analysis of hindlegs in the parallel bars test showed that PA-Exad evinced the best functional performance. In the misstep test, we observed an increase in the number of errors animals made for almost all the groups, evincing a significant difference in the number of errors before and after the test only for PA-Exa, PA-Exd, and PA-Sed. We concluded that the animals that underwent high-intensity progressive training showed better performance in their hindlegs than in their fore ones and that animals that exercised before and after surgery benefited more from training.

Promoting independence in Lewy body dementia through exercise: the PRIDE study

BackgroundLewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-intensity exercise are effective in other neurological cohorts but have been scarcely evaluated in LBD.MethodsThe Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomised, non-blinded, crossover pilot trial involving older adults with LBD consisting of a baseline assessment, an 8-week wait-list, and an 8-week exercise intervention. The aims of this study were to evaluate the determinants of the primary outcome functional independence, as measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, and the feasibility and preliminary efficacy of an exercise intervention on this outcome. Additionally, important clinical characteristics were evaluated to explore associations and treatment targets. The exercise intervention was supervised, clinic-based, high-intensity progressive resistance training (PRT), challenging balance, and functional exercises, 3 days/week.ResultsNine participants completed the baseline cross-sectional study, of which five had a diagnosis of Parkinson’s disease dementia (PDD), and four dementia with Lewy Bodies (DLB). Six completed the exercise intervention (three PDD, three DLB). The cohort was diverse, ranging from mild to severe dementia and living in various residential settings. Greater functional independence at baseline was significantly associated with better physical function, balance, cognition, quality of life, muscle mass ratio, walking endurance, faster walking speed and cadence, and lower dementia severity (p < 0.05). Participants declined by clinically meaningful amounts in functional independence, cognition, physical function, muscle mass, and weight over the wait-list period (p < 0.05). Following exercise, participants improved by clinically meaningful amounts in functional independence, cognition, physical function, and strength (p < 0.05). Progressive, high intensity exercise was well-tolerated (> 80% adherence), and only one minor exercise-related adverse event occurred.ConclusionsPRIDE is the first exercise trial conducted specifically within individuals diagnosed with LBD, and provides important insight for the design of larger, randomized trials for further evaluation of progressive, high-intensity exercise as a valuable treatment in LBD.Trial registrationThe PRIDE trial protocol has previously been prospectively registered (08/04/2016, ANZCTR: ACTRN12616000466448).

The Comparison of the effect of High Intensity Interval and Progressive Resistance Training on Activated Transcription Factor 3 myocardial gene expression in male Diabetic Rats

The Comparison of the effect of High Intensity Interval and Progressive Resistance Training on Activated Transcription Factor 3 myocardial gene expression in male Diabetic Rats

High-intensity interval training versus progressive high-intensity circuit resistance training on endothelial function and cardiorespiratory fitness in heart failure: A preliminary randomized controlled trial.

IntroductionExercise training is strongly recommended as a therapeutic approach to treat individuals with heart failure. High-intensity exercise training modalities still controversial in this population. The study aims to preliminary assess the consequences of high-intensity exercise training modalities, aerobic interval training (HIIT) and progressive high circuit-resistance training (CRT), on primarily endothelial function and cardiorespiratory fitness, and secondly on muscle strength and physical performance in heart failure patients.MethodsThis preliminary multicentric randomized controlled trial comprised 23 heart failure patients, aged 56 ± 10 years old, mainly New York Heart Association classification I and II (%), hemodynamically stable, who compromise at least 36 exercise sessions of a randomly assigned intervention (HIIT, CRT or control group). Endothelial function, cardiopulmonary exercise testing, muscle strength and physical performance were completed at baseline and post-intervention.ResultsAlthough no effects on endothelial function; both HIIT and CRT modalities were able to produce a positive effect on peak (HIIT = +2.1±6.5, CRT = +3.0±4.2 and control group = -0.1± 5.3 mL/kg/min, time*group p-value<0,05) and METs (HIIT = +0.6±1.8, CRT = +0.9±1.2 and control group = 0±1.6, time*group p-value<0,05). Only HIIT increased isokinetic torque peak (HIIT = +8.8±55.8, CRT = 0.0±60.7 and control group = 1.6±57.6 Nm) matched p-value<0,05. Regarding the physical performance, the CRT modality reduced chair stand test completion time (HIIT = -0.7±3.1, CRT = -3.3±3.2 and control group = -0.3±2.5 s, matched p-value<0,05 and HIIT improved global physical performance(time*group p<0,05).ConclusionThis preliminary study trends to indicate for the first time that high-intensity interval training promotes a jointly superior effect compared to progressive high intensity circuit-resistance training by improving cardiorespiratory fitness, muscular strength, and physical performance. Further research with larger cohort is necessary.Clinical trial registration numberReBEC RBR-668c8v.

Effects of intradialytic progressive resistance training on muscle strength, physical capacity and quality of life in end-stage renal disease patients

Objective: This study aimed to investigate the effects of moderate- to high-intensity intradialytic progressive resistance training (IPRT) on muscle strength (MS), physical capacity (PC), and quality of life (QoL) in end-stage renal disease patients. Methods: Twenty-seven sedentary hemodialysis patients (55.5±10.6 years) were divided into a resistance training group (RTG, n=15) and a control group (CG, n=12). Patients of RTG were submitted to IPRT, three times per week for 12 weeks. The Borg’s scale was used for exercise prescription. Muscle strength was measured using hand grip dynamometry (MS). The sit-to-stand (STS) test and usual walking speed (UWS) test were performed to measure the physical capacity, and the SF-36 questionnaire to evaluate the quality of life (QoL). All patients were evaluated at baseline and after 12 weeks. Results: Moderate- to high-intensity IPRT significantly increased the MS (p=0.001, effect size (ES)=0.98), the physical capacity evaluated by the STS (p=0.002, ES=0.85) and UWS (p=0.014, ES=1.11), and all domains of SF-36 questionnaire (p&lt;0.05). On the other hand, in the CG these variables did not change significantly. The protocol was well tolerated and was not associated with significant clinical complications. Conclusion: Twelve weeks of moderate- to high-intensity IPRT in HD patients was safe and improved MS, PC, and QoL.

High intensity power training in middle-aged women with Charcot–Marie–Tooth disease: a case series

Background/aims High-intensity power training has been shown to be effective in improving muscular capabilities, functional performance and health-related quality of life in populations with physical impairments. However, the effectiveness of high-intensity power training in people with Charcot–Marie–Tooth disease remains uncertain. This case series investigated the effects of high-intensity power training on muscle performance, function and health-related quality of life in middle-aged women with Charcot-Marie-Tooth disease. Methods Four women (age 51–58 years) with Charcot–Marie–Tooth disease type 1A participated in 8 weeks of supervised high-intensity power training. Results All participants improved strength of the right hip abductors (46.7–109.7%) and left hip abductors (27.3–128.6%), maximal gait speed (2.3–9.1%), static balance (0.7–4.9%), tandem walk (−3.3 to −58.5%), and mental component scores on the Short Form 36 Health Status Survey (0.8–27.6%). Adherence to high-intensity power training was 100% and only one minor adverse event related to the intervention was reported. Conclusions Although promising, larger controlled studies are indicated to confirm the safety and efficacy of high-intensity progressive resistance and power training in this cohort.

233-OR: Circulating Inflammatory Biomarkers Are Not Improved with Combined Low-Volume High-Intensity Interval Training and Progressive Resistance Training in Prediabetes

In prediabetes (PD), circulating inflammatory biomarkers are associated with increased CVD1 risk. Exercise (Ex) has a positive effect on cardiovascular fitness and metabolic outcomes in PD but Ex effects on inflammation markers in PD are not fully known and were investigated in this study. Adults with PD (n=34) and normal fasting glucose (NG) (n=34) were randomised into one of four groups: NG control (NGC, n=16), NG Ex (NGE, n=18), PD control (PC, n=16) and PD Ex (PE, n=18). NGE/PE completed 12 weeks of supervised HIIT and progressive resistance training (PRT) 2 times/week, and NGC/PC unsupervised stretching 3 times/week. Baseline, age and weight were similar in PD and NG. Compared with NG, FPG and HbA1c were higher and VO2peak was significantly lower in PD (29±7 vs. 33±8 mL/kg/min, p=0.03). Comparing NG and PD at baseline, serum IL-1β was higher in NG (11.4±9.0 vs. 7.9±2.8 pg/mL, p=0.04), IL-12p70 and IL-22 were higher in PD (respectively, 5.7±3.6 vs. 4.4±2.2 pg/mL; 164.6±90.3 vs. 122.2±83.2 pg/mL, both p&amp;lt;0.05) and IL-1α, IL-6, IL-8, IL-15, M-CSF and TNFα were similar. At follow-up, HbA1c was reduced by -0.07±0.11% in NGE and -0.09±0.17% in PC (both p&amp;lt;0.05) and not changed in PE or NGC. PE had an increase in VO2peak (5.5±7.5mL/kg/min, p=0.01). Inflammatory biomarkers were unchanged in PE but NGE had reduced IL-12p70 (4.3±1.9 to 3.5±0.8 pg/mL, p=0.05) and M-CSF (124.5±58.2 to 93.8±36.2 pg/mL, p=0.02). Analysis of Ex with &amp;gt;80% adherence revealed that IL-1α, IL-1β, IL-8 and IL-15 were reduced in NGE, however no change was seen in PE despite a reduction in HbA1c of -0.14±0.17% (p=0.02). PD is associated with reduced cardiorespiratory fitness and increased IL-12p70 and IL-22. Ex reduced IL-12p70 and M-CSF in those with NG but not PD, even after stratifying by adherence and despite improvements in clinical markers. This study indicates low volume HIIT with PRT may not be adequate to reduce serum inflammatory biomarkers in prediabetes. Disclosure C. J. Baker: None. D. Min: None. J. Gerofi: None. X. Wang: None. S. L. Hocking: Advisory Panel; Self; Eli Lilly and Company, Inova, Novo Nordisk, Pfizer Inc. S. Colagiuri: None. N. A. Johnson: None. S. M. Twigg: Advisory Panel; Self; Abbott Diabetes, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi-Aventis, Consultant; Self; Aktivo Labs, Sanofi-Aventis, Research Support; Self; Abbott Diabetes, Speaker’s Bureau; Self; Abbott Diabetes, AstraZeneca. Funding National Health and Medical Research Council (APP1113612)

Activité physique chez l’adulte en consultation de l’ostéoporose

Physical activity is a modifiable risk factor for osteoporosis. Studies on physical activity and bone health have mainly targeted postmenopausal women. Observational studies with fracture outcomes of physical activity interventions in adults older than 40 years found 11-40 % reduced risk of any fracture. There is no randomised controlled trials of exercise with fracture as a primary outcome. However, there is evidence that exercise can reduce fall-related fractures, particularly exercise that includes functional strength and balance training. Exercise recommendations to optimize bone health emphasize moderate-intensity or high-intensity progressive resistance training (PRT), and impact (weight-bearing activities) and balance training in order to reduce falls and improve bone mineral density. Indeed, multicomponent programmes that combine impact exercise with sufficiently dosed, moderate-intensity or high-intensity PRT and that are progressive in nature are the most effective. Professionals should avoid restricting physical activity and exercise unnecessarily according to age. People with osteoporosis should be encouraged to do more rather than less. Important themes for osteoporosis are: strong, steady and straight!

Exercise Interventions as the Primary Treatment for Depression: Evidence from a Narrative Review.

There is an increasing evidence supporting the efficacy of exercise interventions in the treatment of depression, which is a growing global health concern. However, data on the efficacy of exercise as the primary treatment for depression are scarce. This narrative review explored the efficacy of exercise interventions as the primary treatment for depressive disorders. A comprehensive search for English-language literature published between January 1965 and November 2019 was conducted via PubMed, Google Scholar, Scopus, Web of Science, PsycINFO, EMBASE, Cochrane database and Medline. Thirteen randomised control trials (RCTs) were included in the final analysis. Their results indicated that supervised aerobic exercise and high-intensity progressive resistance training (PRT) were effective in ameliorating depressive symptoms as the primary treatment compared with control groups, but they were not superior to other active treatments, such as antidepressants and cognitive behavioural therapy. Aerobic exercise and high-intensity PRT may be a promising primary treatment for depression as they may induce biopsychosocial effects (effects on neurotrophic factor, pro-inflammatory cytokines, monoamine, the hypothalamic-pituitary-adrenal axis, self-efficacy, mastery experience, adaptive coping and social interaction), which may ameliorate the severity of depressive symptoms. However, future RCTs with more comprehensive and well-designed methodologies are warranted to confirm our findings.

Exploring thoracic kyphosis and incident fracture from vertebral morphology with high-intensity exercise in middle-aged and older men with osteopenia and osteoporosis: a secondary analysis of the LIFTMOR-M trial

The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial examined efficacy and safety of an eight-month, supervised, high-intensity progressive resistance and impact training (HiRIT) program compared with machine-based isometric axial compression (IAC) training in middle-aged and older men with low areal bone mineral density (aBMD). The primary purpose of the current work was to explore change in thoracic kyphosis and incident fracture from vertebral morphology following eight-months of HiRIT or IAC training. The secondary purpose was to explore change in clinical kyphosis measures for HiRIT, IAC and a non-randomized, matched control group. Men (≥ 45yrs), with low aBMD, were recruited and randomized to HiRIT or IAC, or designated control. Clinical measures of thoracic kyphosis with inclinometry were determined. Cobb angle of kyphosis and vertebral fracture assessment using the Genant semi-quantitative method were determined from lateral thoracolumbar DXA (Medix DR, Medilink, France). Per-protocol (n = 40) and intention-to-treat (n = 93) analyses were conducted. Forty participants (HiRIT n = 20, IAC n = 20; 66.1 ± 7.8yrs.; lumbar spine T-score - 0.1 ± 0.8; femoral neck T-score - 1.5 ± 0.5) underwent clinical kyphosis measures and thoracolumbar DXA at baseline and follow-up. No between-group differences were detected in kyphosis change, however, within-group improvements in neutral (HiRIT - 2.3 ± 0.8°; IAC - 2.5 ± 0.8°) and 'standing tall' (HiRIT - 2.4 ± 0.8°; IAC - 2.0 ± 0.8°) postures were observed (p < 0.05). HiRIT improved Cobb angle (- 3.5 ± 1.5°, p = 0.027) from baseline. Over the 8months, no incident vertebral fractures nor progression of prevalent vertebral fractures occurred for HiRIT participants. Five incident fractures of thoracic vertebrae occurred for IAC and one wedge fracture progressed. Ninety-three participants underwent clinical kyphosis measures at both time-points (HiRIT n = 34, IAC n = 33, control n = 26). HiRIT exhibited a reduction in 'standing tall' kyphosis compared to control (- 2.3 ± 0.6° versus 1.4 ± 0.7°, p < 0.05), but no other between-group differences were detected. Although there was no difference in change between intervention groups, thoracic kyphosis appeared to improve in both HiRIT and IAC with exercise exposure. HiRIT improved 'standing tall' posture in comparison to usual activities. HiRIT was not associated with vertebral fracture progression or incident vertebral fracture, but for some IAC participants there was evidence of progression of vertebral fracture severity and incident vertebral fractures, in our small sample. Larger trials are required to confirm the observations of the current work, which was exploratory in nature.

Postmenopausal Women With Low Bone Mass Enjoy Bone-targeted, High-intensity Resistance Training: LIFTMOR Trial Observations

PURPOSE: The LIFTMOR trial improved bone and function with high-intensity progressive resistance and impact training (HiRIT) in postmenopausal women with low to very low bone mass. While efficacious in a research setting, a comprehensive evaluation of participant perception of HiRIT was required to inform implementation in the ‘real world’. Therefore, the aim of the current work was to examine physical activity enjoyment, quality of life (QOL), and participant perception of the HiRIT program undertaken in the LIFTMOR trial. METHODS: Postmenopausal women with low bone mass were randomized to either 8 months of 30-minute, twice-weekly supervised HiRIT (n=49) or unsupervised, low-intensity, home-based exercise (CON; n=52). At baseline and follow-up, all participants completed physical activity enjoyment (PACES-8) and QOL (WHOQOL-BREF) questionnaires (Kruskal-Wallis and Friedman’s test). At follow-up, 17 HiRIT and 15 CON participants completed an exit survey relating to their experiences, scored using a 5-point Likert scale. Of those, 14 participants from the HiRIT program underwent semi-structured interviews to facilitate qualitative analysis (Leximancer v4.50) of their experiences undertaking the HiRIT program. RESULTS: Participants who undertook the HiRIT program reported improvements in PACES-8 (3.3±1.0 vs -1.6±0.9, p<0.001), and on the exit survey, HiRIT were happier with their group allocation (4.8±0.6 vs 4.0±1.2, p=0.03), more enthusiastic about undertaking training sessions (4.4±0.5 vs 3.7±1.1, p=0.03) and more likely to participate in the LIFTMOR trial again given the chance (3.8±0.9 vs 2.9±1.3, p=0.028), than CON (p<0.05). Qualitative analysis revealed current bone health status as the most common motivator for enrolling in the LIFTMOR trial, time was an important barrier to previous physical activity participation and supervised group exercise sessions were perceived as positive. All HiRIT participants would recommend the program to a friend. No differences in QOL were observed (p>0.05). CONCLUSIONS: Supervised HiRIT was more enjoyable than a low-intensity home exercise program. The combination of high acceptability and the osteogenic nature of the LIFTMOR program suggests supervised HiRIT is an effective and appealing therapy for postmenopausal women at risk of fracture.

Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-component exercise program in older men: secondary analysis of an 18-month randomized controlled trial

In older men, we previously reported that a multi-component exercise program improved lumbar spine (LS) trabecular volumetric BMD (Tb.vBMD) compared with no exercise. This study aimed to investigate the following: (1) the effect of the exercise program on paraspinal and psoas (back) muscle CSA and VAT, and 2) if any exercise-related changes in muscle CSA and/or VAT were associated with changes in spinal BMD. Men (n = 180) aged 50-79 years were randomized to an exercise or no-exercise group. Exercise involved high-intensity progressive resistance training (60-85% max) with weight-bearing impact exercise (3 days/week) for 18 months. Quantitative computed tomography was used to assess L1-L3 Tb.vBMD, paraspinal, and psoas muscle CSA and VAT. Exercise resulted in a 2.6% ((95% CI, 1.1, 4.1), P < 0.01) net gain in back muscle CSA, but no effect on VAT (-1.6% (95% CI, -7.3, 4.2)) relative to no exercise. Robust regression indicated that percentage changes in Tb.vBMD were positively associated with changes (expressed as z-scores) in back muscle CSA in both the exercise (beta (β)-coefficient = 1.9, 95% CI 0.5, 3.2, P = 0.007) and no-exercise (β = 2.6, 95% CI, 1.1, 4.1, P = 0.001) group, and negatively with the changes in VAT (β = -2.0, 95% CI -3.3, -0.7, P = 0.003) in the exercise only group. There were no group differences in the slopes for the muscle-bone or VAT-bone relationships. Regression analysis (pooled data) revealed that back muscle CSA and VAT were independent predictors of the change in Tb.vBMD, explaining 14% of the variance. A multi-component exercise program in middle-aged and older men improved spinal BMD and back muscle size but not visceral fat. However, changes in back muscle size and VAT were associated with the changes in spinal BMD, independent of exercise. ACTRN 12617001224314, 22/08/2017 retrospectively registered.

Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial.

Few data exist on the effects of bone-targeted exercise on geometric and biomechanical indices of bone strength in men. The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial was designed to compare the efficacy and safety of two novel, supervised, twice-weekly, high-intensity exercise programs in middle-aged and older men with osteopenia and osteoporosis on musculoskeletal health and risk factors related to falls and fractures. The current report includes secondary outcomes of the LIFTMOR-M exercise intervention trial. Our goal was to determine the effects of two supervised, twice-weekly, high-intensity exercise programs on bone geometry and strength of the proximal femur, and distal and proximal sites of the tibia and radius in middle-aged and older men with osteopenia and osteoporosis. Generally-healthy men (≥45years), with low lumbar spine (LS) and/or proximal femur areal bone mineral density (aBMD), were recruited from the community. Eligible participants were randomised to either eight months of twice-weekly supervised high-intensity progressive resistance and impact training (HiRIT) or supervised machine-based isometric axial compression (IAC) exercise training. Intervention group outcomes were compared at baseline and eight months with a matched but non-randomised control group (CON) who self-selected to usual activities. DXA scans (Medix DR, Medilink, France) of the skeletally non-dominant proximal femur were analysed using 3D hip software (DMS Group, France) to derive femoral neck (FN) and total hip (TH) bone mineral content (BMC), volume, and volumetric bone mineral density (vBMD) for total, trabecular and cortical bone compartments. Total FN cortical thickness was determined as well as anterior, posterior, lateral and medial subregions. pQCT scans (XCT-3000, Stratec, Germany) of the 4 and 38% sites of the tibia, and 4 and 66% sites of the radius were conducted to determine a range of geometric and bone structural strength indices. Intervention effects were examined using univariate ANCOVA of percent change, and repeated measures ANCOVA of raw baseline and follow-up data, controlling for initial values, using intention-to-treat and per-protocol approaches. Ninety-three men (67.1±7.5yrs, 175.2±6.7cm, 82.1±11.6kg, 26.7±3.5kg/m2) with lower than average aBMD (LS T-score -0.06±1.04, FN T-score -1.58±0.58, TH T-score -1.00±0.58) were recruited, and designated CON (n=26) or randomised to HiRIT (n=34) or IAC (n=33). Compliance to the supervised exercise programs did not differ (HiRIT 77.8±16.6% versus IAC 78.5±14.8%, p=0.872). HiRIT improved medial FN cortical thickness compared with CON (5.6±1.7% versus -0.1±1.9%, p=0.028) and IAC (5.6±1.7% versus 0.7±1.7%, p=0.044). Distal tibia total BMC, vBMD, area and bone strength index, and trabecular BMC and bone strength index all declined for CON compared with maintenance for both HiRIT and IAC (all p<0.05). HiRIT maintained distal tibia trabecular area compared with a loss in CON (0.2±0.5% versus -1.6±0.5%, p=0.013). HiRIT and IAC maintained distal radius total BMC compared with loss in CON (-0.1±0.7% versus -3.7±0.8%, p=0.001; 1.3±0.7% versus -3.7±0.8%, p<0.001, respectively). HiRIT and IAC maintained distal radius total bone strength index compared with loss in CON (1.4±1.4% versus -6.0±1.6%, p=0.001; 0.2±1.3% versus -6.0±1.6%, p=0.004, respectively). HiRIT reduced proximal radius cortical area compared with CON (-3.1±1.0% versus 1.1±1.2%, p=0.011) and IAC (-3.1±1.0% versus -0.2±1.0%, p=0.042). No between-group differences were detected in any pQCT-derived bone outcome at the diaphyseal tibia 38% site. Findings indicate that supervised HiRIT provides a positive stimulus to cortical bone at the medial FN compared with supervised IAC exercise, and both HiRIT and IAC preserve bone strength at the distal tibia and distal radius. These effects may translate into a reduced risk of lower and upper extremity fracture in middle-aged and older men with low bone mass.

A Comparison of Bone-Targeted Exercise Strategies to Reduce Fracture Risk in Middle-Aged and Older Men with Osteopenia and Osteoporosis: LIFTMOR-M Semi-Randomized Controlled Trial.

The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial examined efficacy and safety of two novel exercise programs in older men with low BMD. Men with low hip and/or LS BMD were randomized to high-intensity progressive resistance and impact training (HiRIT) or machine-based isometric axial compression (IAC) and compared to a nonrandomized matched control (CON). Outcomes included: hip and LS BMD; calcaneal ultrasound parameters; anthropometry; body composition; function (timed up-and-go [TUG], five-times sit-to-stand [FTSTS]); back extensor strength (BES); leg extensor strength (LES); compliance and adverse events. Ninety-three men (67.1 ± 7.5 years; 82.1 ± 11.6 kg; 175.2 ± 6.7 cm; FN T-score -1.6 ± 0.6) were randomized to HiRIT (n = 34) or IAC (n = 33), or allocated to CON (n = 26). HiRIT improved trochanteric BMD (2.8 ± 0.8%; -0.1 ± 0.9%, p = .024), LS BMD (4.1 ± 0.7%; 0.9 ± 0.8%, p = .003), BUA (2.2 ± 0.7%; -0.8 ± 0.9%, p = .009), stiffness index (1.6 ± 0.9%; -2.0 ± 1.1%, p = .011), lean mass (1.5 ± 0.8%; -2.4 ± 0.9%, p = .002), TUG, FTSTS, BES, and LES (p < .05) compared with CON. IAC improved lean mass (0.8 ± 0.8%; -2.4 ± 0.9%, p = .013) and FTSTS (-4.5 ± 1.6%; 7.5 ± 2.0%, p < .001) compared with CON. HiRIT improved LS BMD (4.1 ± 0.7%; 2.0 ± 0.7%, p = .039), stiffness index (1.6 ± 0.9%; -1.3 ± 0.9%, p = .025), and FTSTS (-10.7 ± 1.6%; -4.5 ± 1.7%, p = .010) compared with IAC. Exercise compliance was high (HiRIT 77.8 ± 16.6%; IAC 78.5 ± 14.8%, p = .872). There were five minor adverse events (HiRIT, 2; IAC, 3). HiRIT was well-tolerated and improved bone, function and fracture risk more than CON or IAC. © 2020 American Society for Bone and Mineral Research.

Progressive resistance training and High Intensity Interval Training increases the expression of TRAF6 gene and reduces serum levels of TNF-α in male Wistar diabetic rats

Background: The most common causes of mortality in diabetic patients are cardiovascular disorders, one of the reasons being inflammatory factors. Given that physical activity can reduce inflammation, the present study was to investigate the effects of two types of high intensity Interval and progressive resistance training on the expression of TRAF6 and serum levels of TNF-α in male diabetic rats. Methods: In this experimental study, 72 male rats were divided into 6 groups of 12 (diabetic rats, control, diabetic high intensity Interval training, high intensity Interval training, diabetic progressive resistance training and progressive resistance training). Progressive resistance training was performed in a 6-weekly 3-session, climbing the vertical ladder, with 50%, 75%, 90% and 100% the body weight of the animal. After successful completion, 30 grams were added to the weights, to the extent that the samples can not carry the ladder. High intensity Interval training were also performed at 6-weekly 3-session, with an intensity of 50 to 110% of the maximum oxygen consumption. TRAF6 gene expression was measured by Real Time PCR. Results: TRAF6 levels increased significantly in both types of training, in diabetic group, which was higher in the interval group. TNF-α decreased significantly after both types of training, which was more prominent in the interval group. Conclusion: Both types of training reduced the TNF-α inflammatory factor and increased the expression of TRAF6 gene expression. These effects were more frequent in the interval group.

The effect of combined functional anaerobic and strength training on treadmill gait kinematics and kinetics in ambulatory young adults with cerebral palsy

BackgroundLeg muscle weakness is a major impairment for individuals with cerebral palsy (CP) and is related to reduced functional capacity. Evidence is limited regarding the translation of strength improvements following conventional resistance training to improved gait outcomes. Research QuestionDoes a combined functional anaerobic and lower limb strength training intervention improve gait kinematics and kinetics in individuals with CP aged 15–30 years? 17 young adults (21 ± 4 years, 9 males, GMFCS I = 11, II = 6) were randomized to 12 weeks, 3 sessions per week, of high intensity functional anaerobic and progressive resistance training of the lower limbs (n = 8), or a waitlist control group (n = 9). Pre- and post-training outcomes included maximum ankle dorsiflexion angle at foot contact and during stance, gait profile score, ankle and hip power generation during late stance, and the ratio of ankle to hip power generation. ResultsThere were no between-group differences after the intervention for any kinematic or kinetic gait outcome variable. Within-group analysis revealed an increase in peak ankle power during late stance (0.31 ± 0.28 W·kg−1, p = 0.043) and ankle to hip power ratio (0.43 ± 0.37, p = 0.034) following training in the intervention group. SignificanceWe have previously reported increased overground walking capacity, agility and sprint power, in the training group compared to the control group at 12-weeks. These changes in overground measures of functional capacity occurred in the absence of changes in treadmill gait kinematics and kinetics reported here. ANZCTR: 12614001217695.

The impact on glycemic control through progressive resistance training with bioDensityTM in Chinese elderly patients with type 2 diabetes: The PReTTy2 (Progressive Resistance Training in Type 2 Diabetes) Trial

AimsTo evaluate the effects of a novel, low-volume, high-intensity Progressive Resistance Training (PRT) technique on blood glucose control in elderly Chinese patients with Type 2 Diabetes. Materials and methodsThe PReTTy2 trial enrolled 300 male and female patients with Type 2 Diabetes in a randomized resistance training program with the bioDensity™ technique. 100 were control patients with no training intervention and 200 had resistance training. Anthropometry, biochemical parameters, HbA1c and fasting plasma glucose (FPG) were measured at baseline, 3-month and 6-month intervals. Results265 patients completed the study with no adverse events. There were no statistically significant differences in HbA1c for all patients, control and PRT groups, at baseline (p = 0.60), 3 months (p = 0.42) and 6-months (p = 0.45). Subgroup analysis with baseline HbA1c > 7.5% (58 mmol/mol), showed statistically significant differences in HbA1c and FPG between groups at 6 months (p < 0.05). All PRT group patients had statistically significant differences from baseline at 6 months for HDL (1.25 + 0.32 vs. 1.17 + 0.26 mmol/L, p < 0.001), LDL (3.23 ± 0.89 vs. 2.93 ± 0.80 mmol/L, p < 0.001) and total cholesterol (4.97 ± 1.22 vs. 4.58 ± 1.03 mmol/L, p < 0.001). ConclusionsPRT improves glycemic indices in elderly patients with Type 2 Diabetes with poor glucose control as an adjunct to diet and medication. Progressive Resistance Training with bioDensity™ is feasible, safe and effective in elderly patients with Type 2 Diabetes.