Progressive Resistance Training Program Research Articles

Adapting a dyadic exercise program to be culturally relevant for Hispanic men with prostate cancer using community engagement studio: a brief report.

Cancer disparities exist for Hispanic men with prostate cancer and their caregivers that could be reduced through exercise. Exercising Together© is a six-month, evidence-based dyadic resistance training program that promotes teamwork between prostate cancer survivors and their spouses to improve physical, mental, and relational health outcomes. The purpose of this study was to elicit feedback and recommendations from stakeholders on the Exercising Together© intervention to inform the cultural adaptation of this program for Hispanic men with prostate cancer. We conducted a virtual Community Engagement Studio (V-CES) with community expert stakeholders representing the Hispanic and cancer care communities in Southern Arizona. The V-CES process included orientation, presentation of the research, guided discussion, and evaluation. The V-CES was audio recorded, transcribed, and rapidly analyzed to identify actionable feedback and contextual adaptations. Nine stakeholders (6/9 male; 5/9 Hispanic) completed all V-CES activities. Through stakeholder engagement and feedback from the V-CES, adaptations to the original Exercising Together© intervention included: (1) inclusion of the cancer survivor's identified caregiver, who may not be a spouse; (2) availability in English and Spanish; (3) shortening the intervention to 3 months; (4) remote delivery of the intervention; and (5) incorporation of low burden procedures. Findings from our V-CES informed the adaptation of a culturally relevant dyadic progressive resistance training program for Hispanic men with prostate cancer and their caregivers.

Resistance training effects on pubertal children with a risk of developing pediatric dynapenia.

Many modern-day children are at risk of pediatric dynapenia (muscle weakness). We examined the effects of a 12-week resistance training (RT) program on neuromuscular function and body composition parameters in pubertal children with a risk of dynapenia. Twelve children (13.4 ± 0.9 y) with dynapenia performed a progressive RT program consisting of knee extension and flexion, bench press, abdominal crunch, back extension, lateral pull-down, elbow flexion, and upright row (1-2 sets of 10-15 repetitions/exercise) twice/week for 12weeks. Outcome measures included one-repetition maximum (1-RM) strength, maximal voluntary isometric contraction (MVIC) torque, rate of torque development (RTD), electromyographic (EMG) activity, muscle thickness (MT), muscle quality (MQ) assessed by echo intensity (MQEI) of the knee extensors and specific tension of MVIC torque to thigh fat-free mass (MQST), and total and regional body and bone composition assessed by dual-energy X-ray absorptiometry. Changes in the measures before and after the 12-week RT and associations among the measures were analyzed by linear mixed models. Significant (p < 0.05) increases in 1-RM (63.9 ± 4.5%), MVIC torque (16.3 ± 17.8%), MT (18.8 ± 5.5%) and MQ (MQEI: -25.9 ± 15.2%; MQST: 15.1 ± 18.8%;) were evident from pre- to post-training. Total fat-free mass (FFM) increased by 2.3 ± 3.2% from baseline (p = 0.01), but no changes (p > 0.05) in the other measures were observed. Significant (p < 0.05) associations between the changes in 1-RM and/or MVIC torque and the changes in quadriceps MT, MQEI, MQST and total body FFM were evident. The 12-week RT was effective for improving neuromuscular and body composition parameters, and thereby reversed the risk of pediatric dynapenia.

Multimodal and conventional resistance training interventions improve muscle function in older adults: Findings from the Training IMCT study

Age-associated remodeling processes affect the intramuscular connective tissue (IMCT) network, which may significantly impair muscle function. Thus, we aimed to test whether including exercises shown to efficiently target the IMCT to a conventional resistance exercise intervention (CONV) would result in greater functional gains as compared to CONV alone. Fifty-three men and women (66.2 ± 3.3 years) were assigned to either CONV (n = 15), multimodal training (MULTI; n = 17) or a control (CTRL; n = 21) group. All subjects were tested at baseline, and those assigned to CONV or MULTI underwent a 16-week training intervention. The CONV group followed a progressive resistance training program, in which the number of weekly training sessions gradually increased from 1 to 3. In the MULTI group, one of these sessions was replaced with plyometric training, followed by self-myofascial release. Testing included maximal strength and power, imaging-based muscle volume, architecture, and functional performance. The intervention effects were analyzed using two- or three-way repeated measures ANOVA models (α = 0.05). Briefly, the maximal knee extension isometric contraction, one-repetition maximum, and isokinetic peak torque increased in all groups (p < 0.05), albeit to a lesser extent in CTRL. On the other hand, quadriceps femoris muscle volume (p = 0.019) and vastus lateralis pennation angle (p < 0.001) increased only in the MULTI group. Handgrip strength did not change in response to the intervention (p = 0.312), whereas Sit-to-Stand performance improved in all groups after the first 8-wks, but only in MULTI and CONV after 16-wks (all p < 0.001). In conclusion, we found that a resistance training intervention in which one weekly training session is replaced by plyometric training is feasible and as effective as a program consisting solely of conventional strength training sessions for inducing gains in muscle strength and function in older adults. Muscle size and architecture improved only in the MULTI group. German Clinical Trials: DRKS00015750.

Twelve Weeks of Progressive Resistance Training Positively Improves Physical Fitness and Golf Swing Performance in Talented Youth Golfers.

Shaw, J, Gould, ZI, Oliver, JL, and Lloyd, RS. Twelve weeks of progressive resistance training positively improves physical fitness and golf swing performance in talented youth golfers. J Strength Cond Res 38(6): 1103-1110, 2024-This aim of this study was to investigate the effects of a 12-week resistance training program in talented junior golfers. Eighteen talented youth golfers were pair matched by maturity status and handicap, and subsequently allocated to an experimental (EXP) or control group. During the 12-week intervention, both groups continued with their normal golf practice while the EXP group also completed a progressive twice-weekly resistance training program. At baseline, subjects performed multiple trials of an isometric midthigh pull (IMTP), countermovement jump (CMJ), standing long jump, golf movement screen (GMS), and isometric plank hold. Club head speed (CHS) and carry distance for a 6-iron and driver were also measured using a commercial launch monitor. When controlled for maturity offset, there were significant ( p < 0.05) interaction effects in favor of the EXP group for absolute ( g = 1.29) and relative ( g = 2.06) peak force for the IMTP, CMJ absolute ( g = 0.73) and relative ( g = 0.66) peak power, jump height ( g = 1.05), modified reactive strength index ( g = 1.30), lateral ( g = 0.48-0.88) and horizontal jump distance ( g = 1.20), and GMS total score ( g = 1.07). Significant interaction effects were also reported in 6-iron and driver CHS and carry distance in favor of the EXP group ( p < 0.05; g = 0.41-1.64). These findings indicate that twice-weekly resistance training in combination with regular golf practice can stimulate increases in measures of strength, power, and movement competency in youth golfers, which should contribute to enhanced golf swing performance.

The Effectiveness of Toe Flexor Strengthening on Balance and Risk of Fall in Patients with Diabetic Polyneuropathy- A Pilot Study

Background:Diabetic polyneuropathy (DPN) is relatively common complication of long-term diabetes and isthought to be progressive and irreversible. The loss of sensations associated with Diabetic polyneuropathy isthought to contribute to impaired balance and increased risk of falling. Reduced toe flexor strength is an independentpredictor of falls. However, it is unknown whether strengthening programs can restore toe flexorstrength in patients with DPN.The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot &amp; toe flexor muscles, could improve toe flexor strength in patients with DPN.Methods: A total of 20 patients were allocated into two groups of 10 each. Group A receive 12 sessions of (Conventional physiotherapy &amp; Modified toe training programme) and Group B (Conventional physiotherapy &amp; General toe exercise). Berg balance score (BBS), Fall efficacy scale international (FES-I) &amp; Time up and go test (TUG) were measured on first day (Week 1) and last day (Week 4) of intervention. Pre-test and post-test scores were compared and results were tabulated.Result: Both groups showed significant improvement in balance performance. The Group A showed statistically significant improvement in static &amp; functional balance when compared to Group B.Conclusion: The study demonstrated a significant improvement in balance and functional mobility was seenamong Group A.

Can exercise benefit cerebral white matter myelin? Findings from a 12‐month randomized controlled trial in older adults with vascular cognitive impairment

AbstractBackgroundCerebral small vessel disease is a major underlying cause of subcortical ischemic vascular cognitive impairment (SIVCI). Myelin loss is a feature of cerebral small vessel disease, which may underly cognitive and functional decline in older adults living with SIVCI. Resistance training (RT) is a form of exercise associated with slower progression of white matter lesions, a cerebral small vessel disease marker. However, it remains to be determined whether RT can counteract myelin loss in individuals living with SIVCI. Thus, we examined the impact of a 12‐month, twice‐weekly progressive RT program on myelin content in those with SIVCI.MethodThis was a sub‐study of a 12‐month single‐blinded, randomized controlled trial. Participants (n = 91) were randomized to RT or an active control group (balance and tone exercises [BAT]). Study eligibility included: 1) age 55 years and older; 2) magnetic resonance imaging (MRI) evidence of cerebral small vessel disease; 3) mild cognitive impairment; and 4) the absence of dementia. Myelin was measured using a multi‐echo gradient and spin echo T2 relaxation MRI sequence, indexed as myelin water fraction (MWF). Differences between groups at 12 months were assessed via analysis of covariance adjusting for baseline MWF and estimated intracranial volume. MWF data from fifteen white matter tracts were analyzed. Post‐hoc regressions were conducted to determine if changes in MWF were associated with changes in mobility measured with the Short Physical Performance Battery (SPPB).ResultSeventy‐three participants (RT = 36) aged 74.1 (SD = 5.7), 64% females with high‐quality MRI data were included in the analyses. At 12 months, RT showed lower MWF levels compared with BAT in the genu of the corpus callosum (estimated mean difference [RT – BAT]: ‐0.610, 95% CI: ‐1.041 to ‐0.178, p = 0.006), fornix (‐0.883, 95% CI: ‐1.570 to ‐0.197, p = 0.012), and combined white matter tracts (‐0.326, 95% CI: ‐0.643 to ‐0.009, p = 0.044). Changes in MWF in the combined white matter tracs were positively associated with changes in SPPB (Unstandardized B = 0.124, SE = 0.061, p = 0.047).ConclusionContrary to our expectations, 12 months of balance and tone exercises, but not RT, showed positive changes in myelin. These improvements may result in better mobility in older adults with SIVCI.

Reshaping the path of vascular cognitive impairment with progressive resistance training: A 12‐Month Randomized Trial

AbstractBackgroundSubcortical ischaemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment, due to its modifiable risk factors such as hypertension and diabetes mellitus. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities, research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, we examined the efficacy of a 12‐month, twice‐weekly progressive resistance training (RT) program on cognitive function in older adults with SIVCI.MethodWe conducted a 12‐month single‐blinded, randomized controlled trial with 91 adults with SIVCI who were randomly allocated to: 1) progressive RT; or 2) balance and tone exercises (BAT; control). Study eligibility included: 1) age 55 years and older; 2) neuroimaging evidence of cerebral small vessel disease at study entry; 3) mild cognitive impairment, as indicated by Montreal Cognitive Assessment scores &lt; 26/30; and 4) the absence of dementia. Measurements occurred at baseline, 6 months, and 12 months. The primary outcome for cognitive function was the Alzheimer’s Disease Assessment Scale‐Cognitive‐Plus (ADAS‐Cog 13 with additional cognitive tests). Gait speed over 4 meters was also assessed as impaired mobility is common among those with SIVCI.ResultForty‐five participants were randomized to the RT group and 46 to the BAT group. Mean baseline age was 74.6 years (SD = 5.7 years), 66% of participants were female, and the median Fazekas score was 1. After adjusting for baseline, participants in the RT group had significantly better ADAS‐Cog Plus performance at 12 months vs. BAT (estimated mean difference [RT – BAT]:‐0.20; 95% CI:[‐0.39, ‐0.01]; p = 0.039). In addition, participants in RT had significantly faster gait speed at 12 months vs. BAT (estimated mean difference: ‐0.08 m/s; 95% CI: [‐0.16, 0.00]; p = 0.047).ConclusionThe prevalence and burden of SIVCI will only increase due to the world’s aging population. Our results suggest progressive resistance training should be considered in the management and treatment of individuals with SIVCI.

59 The effectiveness of a progressive resistance exercise class for Sarcopenic hospitalised older adults

Abstract Background Sarcopenia is common in the older inpatient population with an estimated prevalence of 22.6%. A Progressive Resistance Training (PRT) program addressing sarcopenia is recommended to counteract its adverse effects of increased falls and mortality. The delivery of exercise in the acute setting can pose a challenge for health care professionals. Therefore, this study aimed to examine the effectiveness of a PRT exercise class for older adults in an acute setting. Methods This was an observational study using a convenience sample of older adults undergoing physiotherapy within the hospital. All participants deemed medically suitable were referred by their primary physiotherapist. Participants underwent PRT including upper and lower body exercises, twice a week. These patients also undertook regular physiotherapy outside of the class. The primary outcome measures were the five times Sit-to-Stand (5STS) and bilateral hand-grip recorded by their primary physiotherapist pre-class attendance and on their last class. Results A total of 10 participants engaged in the PRT class. 70% were male and 30% were female with and average age of 77.5 years. The average number of classes attended was 3.1. Participants demonstrated an improvement in sarcopenic measure of 5STS, median change of 7.9 seconds (interquartile range [IQR] 4.88–11.75 seconds), and grip strength, median improvement in left 0.96 kgs (IQR -3.85-5.18) and right 0.1kgs (IQR -1.55-1.68). Conclusion This PRT exercise class demonstrated an improvement in sarcopenic measures in hospitalised older adults. These results are not exclusively due to PRT class attendance however this programme is an example of an effective way to address the negative effects of sarcopenia and the identified research gap in providing exercise in the acute setting. Further research is required to examine the effect of combining nutritional education with PRT training as an intervention for older adults with sarcopenia.

"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.

Investigating the Levels of Liver Lipogenic and Lipolytic Enzymes in Rat with High-Fat Diet and Sucrose Solution Underwent Progressive Resistance Training

Objective: Consuming too much fat or carbohydrates stimulates lipogenesis and excess fat is stored in non-fat tissues, including the liver, and manifests as obesity and fatty liver disease. This study aimed to investigate the effect of eight weeks of progressive resistance training (PRT) on the liver levels of some enzymes affecting lipid metabolism in rats fed a high-fat diet and sucrose solution.&#x0D; Materials and Methods: Twenty-four male wistar rats with 5 weeks of age were randomly divided into two groups: standard diet (SD) (n=8) and high-fat diet and sucrose solution (HFDS) (n=16). Twelve weeks later, HFDS group was divided into two groups: sedentary (HS) and PRT (HPRT). The PRT program was implemented 3 days a week for 8 weeks. Gene expression of AMPKα1, SCD-1, ATGL and FASN enzymes affecting lipid metabolism in liver tissue and its fat content were investigated.&#x0D; Results: HFDS significantly increased the body weight (P: 0.001) and significantly decreased the liver expression of ATGL and FASN (P: 0.001, P: 0.011). Eight weeks of PRT did not show a significant difference in the expression of AMPKα1, SCD-1, ATGL and FASN genes. Rats fed HFDS had considerably higher levels of triglyceride (TG) and total cholesterol (TC) in their liver tissue (P: 0.004, P: 0.001) and PRT did not affect them (P: 0.959, P: 0.809 respectively).&#x0D; Conclusion: It seems that eight weeks of PRT will not change liver lipid metabolism enzymes. Therefore, modifying the diet and changing it, will probably show different results after PRT.

Acceptability of a progressive resistance training programme for ambulatory adolescents with spastic cerebral palsy in England: a qualitative study

Purpose The aim of this study was to explore the acceptability of a 10-week progressive resistance training programme from the perspective of ambulatory adolescents with CP and physiotherapists. Material and Methods Semi-structured interviews were conducted with 32 adolescents with spastic CP, aged 10–19 years in Gross Motor Function Classification System (GMFCS) levels I–III, and 13 physiotherapists. Adolescents had completed a 10-week progressive resistance training programme and physiotherapists had delivered the programme. The Framework Method was used to analyse data. Results The analysis identified four themes. “It’s do-able” described the acceptability of the programme structure, including the frequency of sessions and the duration of the programme. “They were difficult but I did it” described the acceptability of the exercises. “It is completely different,” explored the experience of using equipment to progress the programme and “I wish I could do it on a permanent basis” discussed continuing to participate in resistance training. Conclusions Findings suggest that resistance training is largely acceptable to adolescents and physiotherapists. Acceptability was enhanced by having a weekly supervised session and being able to adapt and progress the exercises to meet the individual’s ability. However, there are challenges to implementing progressive resistance training as part of routine practice.Clinical trial registration number: ISRCTN90378161

Supervised, Heavy Resistance Training Is Tolerated and Potentially Beneficial in Women with Knee Pain and Knee Joint Hypermobility: A Case Series.

Adults with generalised joint hypermobility including knee joint hypermobility (GJHk) report more knee joint symptoms when compared to adults without GJHk. There is no consensus on best practice for symptom management. For instance, controversy exists regarding the appropriateness and safety of heavy resistance training as an intervention for this specific group. This case series aims to describe a supervised, progressive heavy resistance training program in adults with GJHk and knee pain, the tolerability of the intervention, and the outcomes of knee pain, knee-related quality of life, muscle strength, proprioception, and patellar tendon stiffness through a 12-week period. Adults with GJHk and knee pain were recruited to perform supervised, progressive heavy resistance training twice a week for 12 weeks. The main outcome was the tolerability of the intervention. Secondary outcomes were knee pain during a self-nominated activity (VASNA); Knee injury and Osteoarthritis Outcome Score (KOOS); Tampa Scale of Kinesiophobia (TSK); maximal quadriceps voluntary isometric contraction and rate of torque development; 5 repetition maximum strength in five different leg exercises; single leg hop for distance; knee proprioception and patellar tendon stiffness. In total, 16 women (24.2 years, SD 2.5) completed at least 21/24 training sessions. No major adverse events were observed. On average, VASNA decreased by 32.5 mm (95% CI 21.4-43.6), in addition to improvements in KOOS and TSK scores. These improvements were supported by an increase in all measures of lower extremity muscle strength, knee proprioception, and patellar tendon stiffness. Supervised heavy resistance training seems to be well tolerated and potentially beneficial in young women with GJHk and knee pain.

The effects of home-based progressive resistance training in chronic kidney disease patients

IntroductionFaced with lockdowns, it was mandatory the development of supervised home-based RT protocols to keep patients with chronic kidney disease engaged in programs. Nonetheless, there is a lack of scientific literature regarding its effects on patients. PurposeTo investigate the effects of a supervised home-based progressive resistance training program on functional performance, bone mineral density, renal function, endothelial health, inflammation, glycemic homeostasis, metabolism, redox balance, and the modulation of exerkines in patients with CKD in stage 2. MethodsPatients (n = 31) were randomized and allocated into the control group (CTL; n = 15; 58.07 ± 5.22 yrs) or resistance training group (RT; n = 16; 57.94 ± 2.74 yrs). RT group performed 22 weeks of supervised progressive home-based resistance exercises. Bone mineral density, anthropometric measurements, and functional performance were assessed. Venous blood samples were collected at baseline and after the intervention for the analysis of markers of renal function, endothelial health, inflammation, glycemic homeostasis, metabolism, and redox balance. ResultsTwenty-two weeks of home-based RT were effective in improving (P < 0.05) functional performance, bone mineral density, uremic profile, ADMA, inflammatory markers, the Klotho-FGF23 axis, glycemic homeostasis markers, and exerkines. These improvements were accompanied by higher concentrations of exerkines and anti-inflammatory cytokines. RT group displayed a decrease in cases of osteopenia after the intervention (RT: 50 % vs. CTL: 86.7 %; X2 = 4.763; P = 0.029). ConclusionResults provide new evidence that supervised home-based progressive RT may be a relevant intervention to attenuate the progression of CKD and improve functional capacity, bone mineral density, and the immunometabolic profile. These improvements are associated with positive modulation of several exerkines.

60 POWER-AGERS: IMPLEMENTING PROGRESSIVE RESISTANCE TRAINING TO MANAGE SARCOPENIA AMONG COMMUNITY DWELLING OLDER ADULTS

Abstract Background The prevalence of sarcopenia among community dwelling older adults is between 10-40%. Progressive Resistance Training (PRT) improves sarcopenia and functional performance among older-adults. A PRT programme was introduced to a Day Hospital service as part of a sarcopenia management quality improvement initiative. Methods The PRT programme was implemented on a phased basis. Phase 1 evaluated the feasibility, safety and participant satisfaction. Phase 2 then collected pre and post outcome measures (gait-speed, grip strength and 5-Times-Sit-to-Stand [5TSTS]), and a patient perception questionnaire. The intervention consisted of a physiotherapist-lead PRT programme (weekly in phase 1 and biweekly in phase 2). Recent community dwelling Day Hospital attendees were recruited by the physiotherapist to participate. The class consisted of a circuit of 4-6 exercises targeting upper and lower limbs, along with an educational component. Exercises were progressively overloaded on an individual basis. Results Ten participants attended the PRT programmes (phase 1 [n=5], phase 2 [n=5]). Most were female (n=6), mean age was 84 years. None had prior formal experience of PRT. The phase 1 PRT group was deemed feasible and safe in an outpatient setting. All phase 1 participants (n=5) felt it was beneficial and rated it 5/5. All phase 2 participants had improvements in sarcopenia markers (grip strength [range=1kg-9kg], gait-speed [range=0.04m/s-0.19m/s], and 5TSTS [range=5.1sec-11sec]). All participants reported that the programmes improved their confidence in PRT and that they were interested in continuing PRT in the future. Conclusion This supports that PRT a clinical setting with community dwelling older adults is safe, feasible and effective in improving sarcopenia markers. Furthermore, the high rate of satisfaction supports its use with this population. Further research is required to examine the impact of combined nutritional education with strength training as an intervention for older adults with sarcopenia.

Progressive resistance training for children with cerebral palsy: A randomized controlled trial evaluating the effects on muscle strength and morphology.

Children with spastic cerebral palsy often present with muscle weakness, resulting from neural impairments and muscular alterations. While progressive resistance training (PRT) improves muscle weakness, the effects on muscle morphology remain inconclusive. This investigation evaluated the effects of a PRT program on lower limb muscle strength, morphology and gross motor function. Forty-nine children with spastic cerebral palsy were randomized by minimization. The intervention group (nparticipants = 26, age: 8.3 ± 2.0 years, Gross Motor Function Classification System [GMFCS] level I/II/III: 17/5/4, nlegs = 41) received a 12-week PRT program, consisting of 3-4 sessions per week, with exercises performed in 3 sets of 10 repetitions, aiming at 60%–80% of the 1-repetition maximum. Training sessions were performed under supervision with the physiotherapist and at home. The control group (nparticipants = 22, age: 8.5 ± 2.1 year, GMFCS level I/II/III: 14/5/3, nlegs = 36) continued usual care including regular physiotherapy and use of orthotics. We assessed pre- and post-training knee extension, knee flexion and plantar flexion isometric strength, rectus femoris, semitendinosus and medial gastrocnemius muscle morphology, as well as functional strength, gross motor function and walking capacity. Data processing was performed blinded. Linear mixed models were applied to evaluate the difference in evolution over time between the control and intervention group (interaction-effect) and within each group (time-effect). The α-level was set at p = 0.01. Knee flexion strength and unilateral heel raises showed a significant interaction-effect (p ≤ 0.008), with improvements in the intervention group (p ≤ 0.001). Moreover, significant time-effects were seen for knee extension and plantar flexion isometric strength, rectus femoris and medial gastrocnemius MV, sit-to-stand and lateral step-up in the intervention group (p ≤ 0.004). Echo-intensity, muscle lengths and gross motor function showed limited to no changes. PRT improved strength and MV in the intervention group, whereby strength parameters significantly or close to significantly differed from the control group. Although, relative improvements in strength were larger than improvements in MV, important effects were seen on the maintenance of muscle size relative to skeletal growth. In conclusion, this study proved the effectiveness of a home-based, physiotherapy supervised, PRT program to improve isometric and functional muscle strength in children with SCP without negative effects on muscle properties or any serious adverse events. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT03863197.

Exercícios resistidos modificam a massa muscular e a classificação de fragilidade em idosas sarcopênicas: estudo quase-experimental

ABSTRACT Frailty and sarcopenia are geriatric syndromes highly prevalent, complex, and hard to diagnose and treat. The literature still lacks a consensus on which resistance training program is better for older people, especially when considering frailty status and sarcopenia. We aimed to evaluate the effectiveness of a progressive resistance training program on muscle mass and frailty status in older sarcopenic women. This study included 18 community-dwelling sarcopenic women aged 65 or older enrolled in the progressive resistance training program. The intervention was based on 75% of each subject’s maximum repetition test (3 times/week, for 12 weeks). Before the intervention, 16.7% were frail, and 61.1% were pre-frail; after the intervention, 5.6% were frail, and 50% were pre-frail. The result shows that the intervention reduced frailty status and increased muscle mass (p=0.01). Hence, after the intervention, we observed both a decrease in frailty and a positive change in function, since the percentage of robust women increased twice (p=0.01). We conclude that the progressive resistance training program might be the best strategy to prevent frailty and sarcopenia. Therefore, we suggest using weight resistance training in daily clinical practice to improve muscle mass and decrease frailty status in sarcopenic women.

Preventing the adverse cardiovascular consequences of allogeneic stem cell transplantation with a multi-faceted exercise intervention: the ALLO-Active trial protocol

BackgroundAllogeneic stem cell transplantation (allo-SCT) is a potentially lifesaving treatment for high-risk hematological malignancy, but survivors experience markedly elevated rates of cardiovascular disease and associated functional impairment. Mounting evidence suggests regular exercise, combined with a reduction in sedentary time through replacement with light exercise may be a useful therapeutic strategy for the prevention of cardiovascular comorbidities. However, this type of intervention has yet to be evaluated in patients undergoing allo-SCT. The ALLO-Active study will evaluate the efficacy of a ~ 4 month multi-faceted exercise intervention, commenced upon admission for allo-SCT, to preserve peak oxygen uptake (VO2peak) and peak cardiac output, compared with usual care. The study will also evaluate the effect of the intervention on functional independence, quality of life, and symptoms of fatigue.MethodsSixty adults with hematological malignancy scheduled for allo-SCT will be randomly assigned to usual care (n = 30) or the exercise and sedentary behaviour intervention (n = 30). Participants assigned to the intervention will complete a thrice weekly aerobic and progressive resistance training program and concomitantly aim to reduce daily sedentary time by 30 min with short, frequent, light-intensity exercise bouts. Participants will undergo testing prior to, immediately after inpatient discharge, and 12 weeks after discharge. To address aim 1, VO2peak and peak cardiac output (multiple primary outcomes, p < 0.025) will be assessed via cardiopulmonary exercise testing and exercise cardiac magnetic resonance imaging, respectively. Secondary outcomes include functional independence (defined as VO2peak ≥ 18.mL.kg−1.min−1), quality of life, and fatigue (assessed via validated questionnaire). Exploratory outcomes will include indices of resting cardiac, vascular, and skeletal muscle structure and function, cardiovascular biomarkers, anxiety and depression, transplant outcomes (e.g., engraftment, graft-versus-host disease), and habitual physical activity, sedentary time, and sleep.DiscussionMulti-faceted exercise programs are a promising approach for ameliorating the cardiovascular consequences of allo-SCT. If this intervention proves to be effective, it will contribute to the development of evidence-based exercise guidelines for patients undergoing allo-SCT and assist with optimising the balance between acute cancer management and long-term health.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ID: 12619000741189. Registered 17 May 2019.

Effect of 4 Weeks of Progressive Resistance Training on Plasma Levels of Omentin-1 and Metabolic Factors in Diabetic Male Rats

Background and Objectives Omentin-1 is a new adipokine with a potential to increase insulin sensitivity, and is associated with lipid profile. There are limited studies on the effect of exercise on the serum level of Omentin-1. The present study aims to investigate the effect of progressive resistance training (PRT) on plasma level of omentin-1 and glycemic control in diabetic male rats. Subjects and Methods In this study, 24 male Wistar rats were randomly divided into three groups: Control, diabetic, and diabetic+PRT. The training group performed a PRT program using a ladder (three days a week, for 4 weeks). Body weight, glucose level, amentin-1 level, insulin level, and lipid profile were measured. Results The PRT significantly increased plasma levels of omentin-1 and triglycerides in the diabetic + PRT group compared to the diabetic group (P=0.017). There was no significant difference in high-density lipoprotein (F=0.318, P&gt;0.05), low-density lipoprotein (F=0.612, P&gt;0.05) and cholesterol (F=0.049, P&gt;0.05) levels between the study groups. Conclusion The PRT improves omentin-1 and insulin resistance in diabetic rats.

Changes Resulting From Resistance Training in the Ratio of Interferon-gamma to Insulin-like Growth Factor 1 and Lipid Profile in Diabetic Rats

Background and Objectives Diabetes is associated with an increase in inflammatory markers and development of atrophy and cardiovascular diseases. Studies have shown that resistance training at appropriate intensity can reduce inflammation generally. This study aims to investigate the effect of a progressive resistance training (PRT) program on serum concentrations of interferon gamma (IFN-γ), and insulin-like growth factor 1 (IGF-1) and lipid profile in rats with type 1 diabetes. Subjects and Methods In this experimental study, 32 male Wistar rats aged 40 days and weighing 250±30 g were divided into four groups of healthy control, healthy trained, diabetic control, diabetic trained. Streptozotocin (55 μg/kg per body weight) was injected intraperitoneally to induce diabetes. A 6-week PRT protocol was performed, including climbing a ladder with weights at three sessions per week (one hour per day), where the load increased by 5% increase each week. Data were analyzed by ANOVA followed by Tukey’s post hoc test. The significance level was set at 0.05. Results There was no significant difference in IFN-γ level between the diabetic trained group and other groups (P&gt;0.05). The IGF-1 level in diabetic trained group was significantly lower than in the healthy control and trained control groups (P=0.002). The ratio of IGF-1/IFN-γ in diabetic trained group was significantly lower than in the trained control (P=0.003) and healthy control (P=0.008) groups. In assessing the lipid profile, the cholesterol level was higher in the diabetic trained group compared to the healthy control group (P=0.028). Moreover, triglyceride level was significantly higher in the diabetic trained group compared to the diabetic control (P=0.033), trained control (P=0.003) and healthy control (P=0.002) groups. Conclusion Six weeks of PRT cannot lead to desired efficacy in diabetic rats compared to non-trained diabetic rats. However, the small changes such as increased IGF-1 and HDL levels and decreased serum glucose level, can help with the clinical improvement of patients with type 1 diabetes.

Progressive Resistance Training Program Characteristics in Rehabilitation Programs Following Hip Fracture: A Meta-Analysis and Meta-Regression.

Introduction: Older adults often experience incomplete recovery after a hip fracture. Rehabilitation programs with progressive resistance training are associated with improved functional recovery. This systematic review and meta-analysis with meta-regression a) evaluated resistance training characteristics reported in hip fracture rehabilitation programs, b) performed meta-analysis of resistance training impact on strength (primary outcome), gait and physical activity (secondary outcomes), and c) explored resistance training program characteristics associated with improved outcomes using meta-regression. Materials and Methods: Medline, EMBASE, CINAHLPLUS, and Web of Science Core Collection databases were searched (January2000–February2021). Randomized controlled trials including progressive resistance training rehabilitation programs after hip fracture surgery in adults ≥50 years old were included. Meta-analyses and exploratory meta-regression were performed. Results: Meta-analysis showed significant increases in strength (10 trials-728 participants; Standardized Mean Difference (SMD) [95%CI]; .40 [.02, .78]) immediately following program completion in intervention relative to control participants. Meta-analysis on 5 trials (n = 384) with extended follow up found no significant group differences (SMD = .47 [-.28, 1.23]) in strength. Center-based relative to home-based programs were associated with significantly greater improvements in strength (P < .05) as were programs where resistance training intensity was prescribed using one-repetition maximum relative to other exercise prescription methods (P < .05). In gait meta-analysis (n = 10 trials-704 participants), gait speed in intervention participants immediately after the program was significantly higher than control (SMD = .42 [.08, .76]) but this finding was not maintained in extended follow-up (n = 5 trials-240 participants; SMD = .6 [-.26, .38]). Higher resistance training intensity was associated with significant improvements in gait speed (P < .05). No meta-analysis was performed for the 3 heterogeneous studies reporting physical activity. Discussion: Progressive resistance training improved muscle strength and gait speed after hip fracture surgery in adults ≥50years old immediately after the program ended, but the longer-term impact may be more limited. Conclusions: Higher resistance training intensity and center-based programs may be associated with more improvement, but require further research.