Resistance Exercise Intervention Research Articles

Feasibility and acceptability of a milk and resistance exercise intervention to improve muscle function in community-dwelling older adults (MIlkMAN): Pilot study.

BackgroundDietary protein supplementation combined with resistance exercise (RE) may counteract declines in muscle strength, mass, and function (sarcopenia), but the role of whole foods rich in protein, such as milk, is less well understood. In the MIlkMAN study, we aimed to examine the feasibility and acceptability of milk+RE as an intervention for muscle function in community-dwelling older adults, and provide exploratory pilot data for future substantive research in population at risk of sarcopenia.MethodsIn a parallel groups design, 30 older adults (71.7±3.6 years; 12 women) were randomised into three groups: WM (whole milk 3.6% fat)+RE, SM (skimmed milk 0.3% fat)+RE, and C (isocaloric carbohydrate drink)+RE. RE was performed twice-weekly over 6 weeks in a community gym, followed by the consumption of 500 ml of milk (~20 g protein) or carbohydrate drink immediately after exercise and a further 500 ml at home within the following 4–5 hours. The feasibility and acceptability of the study was determined by calculating recruitment and attendance rates, compliance with the intervention, rating participants’ experiences, and recording adverse health events.ResultsThe response rate was 49% (out of 400 invitations sent), and the recruitment rate was 73.2% (30 participants recruited out of 41 screened for eligibility). Twenty-nine participants completed the intervention—an attendance rate of 97.1%; 89.7% rated their experience as ‘excellent’/very good’. Compliance with taking the drinks was 97.1% (WM), 98.3% (SM), and 95.0% (C); 93.1% rated their drink intake as ‘easy’/’very easy’ with no adverse effects. Collection of exploratory pilot data to inform future trials was successful. Mean change in grip strength, 5-chair rises, and gait speed were 0.9±3.4 kg, 1.8±2.2 s, 0.1±0.1 m/s, respectively with no differences between the groups.ConclusionsThis community-based milk+RE intervention was feasible and acceptable to older adults. The study successfully collected pilot data for future substantive research.

Progressive resistance exercise for improving pain and disability in chronic neck pain: A case series.

Chronic neck pain is known to be associated with neck muscle weakness. However, many strengthening programs do not target multi-directional weakness in a functional position. Specialised assessment and treatment technology that is able to strengthen the neck muscles in an upright position may be used to achieve this. There is little research available on the efficacy of neck-specific progressive resistance exercise interventions in patients with chronic neck pain; therefore, this study aimed to determine whether this style of program led to a change in pain and disability, and to investigate the relationship between neck strength, pain and disability. Secondary analysis of participants with chronic neck pain who completed a minimum of nine sessions of a neck-specific progressive resistance program at a physiotherapy clinic between the years of 2002 and 2018. Outcomes were the Neck Disability Index (NDI), Numerical Rating Scale of Pain (NRS) and multi-directional neck strength (flexion, extension and lateral flexion - pounds). Data were analysed through paired samples t-tests and backwards stepwise multiple linear regression models. A total of 127 participants were eligible for inclusion. All neck strength measures, NDI scores and NRS scores showed significant improvements after the nine sessions (all p < .0001). Significant predictors of NDI were symptom duration (β = -0.023, p = .009) and NRS score (β = 4.879, p < .000). Significant predictors of NRS were symptom duration (β = 0.004, p = .005), NDI score (β = 0.105, p < .000), extension strength (β = -0.950, p = .012) and gender (β = 0.777 [male =1, female = 0], p = .029). This study showed that a neck-specific progressive resistance exercise intervention led to significant improvement in neck strength, pain and disability in a clinical population. However, caution should be taken when interpreting results due to a lack of comparison group and the variation in treatment given and, therefore, further higher-quality research should be undertaken to confirm these findings.

Association Between Systemic Inflammation And Skeletal Muscle Mass Following Exercise In Breast Cancer Survivors

INTRODUCTION: Reductions in skeletal muscle mass contribute to reduced physical function and poorer prognosis among breast cancer survivors (BCS). Elevated pro-inflammatory markers stimulate catabolic pathways in skeletal muscle, and have been associated with muscle loss in overweight individuals and older adults. This evidence suggests that elevated pro-inflammatory markers such as IL-6, TNF-alpha , and C-reactive protein (CRP) may explain subsequent muscle loss in BCS. While we previously found exercise reduces inflammation and increases skeletal muscle mass in overweight or obese BCS, an associative investigation is warranted. PURPOSE: The purpose of this secondary analysis was to determine whether associations between post-exercise inflammatory markers and skeletal muscle mass exist among overweight/obese BCS. METHODS: Sedentary, overweight/obese BCS (BMI ≥ 25 kg/m2; Stages I-III) were randomized to exercise (EX; n=50) and control (CON; n=50) groups. EX participated in a supervised 16-week moderate-vigorous intensity aerobic and resistance exercise intervention. CON was asked to maintain current levels of activity. Appendicular Skeletal Muscle Index (ASMI), calculated as ∑extremity lean mass (kg)/ height (m2), was obtained from a whole-body scan using Dual Energy X-Ray Absorptiometry. CRP, IL-6, and TNF-∝ were measured using enzyme-linked immunosorbent assays from fasting blood samples. Pearson’s correlations assessed associations between post-exercise ASMI and inflammatory biomarkers. RESULTS: On average, BCS were 53.5±10.4 years old, postmenopausal (60%), and Hispanic (55%) with a BMI of 33.5±5.5 kg/m2. Post-intervention, EX experienced an increase in ASMI (8.3%; p=0.001), and reductions in CRP (-47.8%; p=0.001) IL-6 (-73.6%; p=0.001) and TNF-∝ (-25.1%; p=0.001). No significant changes were seen in CON (p>0.01). There were significant correlations between ASMI and IL-6 (r=-0.78; p=0.02), CRP (r=-0.91; p=0.01), and TNF-alpha (r=-0.82; p=0.03). CONCLUSIONS: This secondary analysis provides preliminarily evidence to support the relation between changes in skeletal muscle mass and inflammation among BCS, and supports the implementation of exercise to maintain muscle mass during survivorship.

Impacts of resistance exercises intervention on thyroid hormone and thyroid stimulating hormone serum concentration level in school children with intellectual disabilities

The effect of resistance exercise on muscular strength with the influence of growth hormone is well known. However, there is little information about its underlying effect on thyroid hormones (T3 &amp;amp; T4) and thyroid-stimulating hormones. Specifically, no research has been done on the effect of a resistance exercise intervention on thyroid hormone and thyroid-stimulating hormone serum concentration level among school children with intellectual disability in Ethiopian. The objective of this study was to investigate the effect of sixteen-week of a resistance exercise intervention on serum concentration level of thyroid hormones (T3 &amp;amp; T4) and thyroid-stimulating hormone (TSH) in school children with intellectual disabilities. In this study, eighteen school children with intellectual disabilities participated. The participants’ serum concentration level of triiodothyronine (T3), thyroxin (T4) and TSH were measured before and after a sixteen-week resistance exercise intervention and determined using quantitative determination of T3, T4, and TSH respectively. Paired t-test was used to analyze the pre-test and post-test data of thyroid hormones (T3 and T4) and TSH of the study. Aftersixteen weekof resistance exercise intervention, a significant mean score change was observed in the serum concentration level of thyroid hormones (p &amp;lt; 0.05) in T3 (p= 0.038), T4 (p = 0. 017) and TSH (p = 0.018). Our finding revealed that resistance exercise affects the serum concentration level of thyroid hormones and thyroid-stimulating hormones in school children with intellectual disabilities.

Prehabilitative Exercise for the Enhancement of Physical, Psychosocial, and Biological Outcomes Among Patients Diagnosed with Cancer.

This review summarizes the effects of prehabilitative exercise interventions on the physical, psychosocial, and biological outcomes among patients with cancer. Current gaps and future directions in prehabilitative exercise research will be addressed. Prehabilitative exercise mitigates the detrimental impact of cancer surgery on physical fitness, noted by increases in maximal oxygen consumption and 6-min walk distance. Beneficial effects on psychosocial and biological outcomes remain inconclusive. Aerobic exercise interventions were often prescribed and included low-, moderate-, or high-intensity exercise. Resistance exercise interventions were often performed in conjunction with aerobic exercise. Prehabilitative exercise elicits robust improvements in physical fitness; however, effect on psychosocial and biological outcomes remains inconclusive. Exercise prescription parameters varied greatly by frequency, intensity, time, and type across multiple cancer diagnoses. Future investigations are needed to systematically dose exercise for a wider variety of outcome measures, with an overall goal to set forth pre-operative exercise guidelines.

Abstract C123: Ethnocentric differences in sarcopenic obesity and body composition in response to an aerobic and resistance exercise intervention for breast cancer survivors

Abstract Background and Purpose: Hispanic breast cancer survivors (HBCS) have a 1.1-1.5 greater risk of breast cancer mortality when compared to non-Hispanic breast cancer survivors (NHBCS). This disparity may result from modifiable lifestyle factors, as Hispanic women are more apt to be obese and sedentary than matched non-Hispanic counterparts, placing them at risk for obesity-related comorbidities. Also, gains in fat mass with declines in lean mass, known as sarcopenic obesity (SOb), often occur as a side effect of cancer treatment. Thus, participation in physical activity is paramount, as exercise is strongly associated with lowering the risk of cancer recurrence and premature mortality. The purpose of this analysis was to examine ethnicity as a moderator of the effects of a 16-week supervised aerobic and resistance exercise intervention on SOb and body composition (BCM) in overweight/obese breast cancer survivors. Experimental Design: Sedentary, overweight or obese (BMI&amp;gt;25.0 kg/m2) breast cancer survivors (Stage I-III; n=100) were randomized to exercise (n=50) or usual care (n=50). The exercise intervention promoted supervised, progressive moderate-vigorous (65-85% maximum heart rate [MHR]) aerobic and resistance exercise thrice weekly for 16 weeks. Markers of SOB and BCM, including appendicular skeletal muscle index (ASMI), BMI, % body fat and truncal fat were measured at baseline and post-intervention (4 months). Differences in mean changes for outcomes by ethnicity were evaluated using linear mixed-models to assess effect modification. Summary of Results: The study enrolled 57 HBCS and 43 NHBCS with an average age of 53.5±10.4 years and BMI of 33.5±5.5 kg/m2. HBCS were diagnosed with more advanced cancers, were significantly more obese and less physically active compared to NHBCS (p&amp;lt;0.001); 96% of the HBCS and 92% of the NHBCS presented with SOb. Post-intervention, SOb and BCM indices were significantly improved in the exercise arm (both HBCS and NHBCS) as compared to baseline (p 0.01) and usual care (p&amp;lt;0.001). However, HBCS exhibited more favorable improvements compared to NHBCS, including an increase in ASMI (mean difference, -2.1; 95% confidence interval (95% CI), 0.4 to 5.1; p&amp;lt;0.001) and truncal fat (-4.4; 95% CI, -9.1 to -0.8; p&amp;lt;0.001). Ethnicity was found to moderate the effect of the exercise intervention on fat mass (P for interaction=0.09) and % body fat (P for interaction=0.09). Conclusions: HBCS may achieve better outcomes with exercise in attenuating disparities related to SOb and BCM. To our knowledge, this is the first study to investigate ethnocentric differences between HBCS and NHBCS as they pertain to participation in physical activity and high-risk comorbidities related to poorer cancer prognosis and mortality. Exercise presents as a useful lifestyle modifiable intervention to attenuate ethnic health disparities in breast cancer survivors; future studies should aim to enroll diverse populations. Citation Format: Frank C. Sweeney, Wendy Demark-Wahnefried, Kerry S. Courneya, Debu Tripathy, Nathalie Sami, Kyuwan Lee, Thomas A. Buchanan, Darcy Spicer, Leslie Bernstein, Joanne E. Mortimer, Christina M. Dieli-Conwright. Ethnocentric differences in sarcopenic obesity and body composition in response to an aerobic and resistance exercise intervention for breast cancer survivors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C123.

Effects of Resistance Exercise on Muscle Mass, Strength, and Physical Performances in Elderly with Diagnosed Sarcopenia: A Systematic Review and Meta-Analysis

PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, &lt;i&gt;p&lt;/i&gt;=.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, &lt;i&gt;p&lt;/i&gt;=.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, &lt;i&gt;p&lt;/i&gt;=.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, &lt;i&gt;p&lt;/i&gt;=.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, &lt;i&gt;p&lt;/i&gt;=.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, &lt;i&gt;p&lt;/i&gt;=.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.

Effects of Resistance Exercise on Muscle Mass, Strength, and Physical Performances in Elderly with Diagnosed Sarcopenia: A Systematic Review and Meta-Analysis

PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, &lt;i&gt;p&lt;/i&gt;=.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, &lt;i&gt;p&lt;/i&gt;=.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, &lt;i&gt;p&lt;/i&gt;=.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, &lt;i&gt;p&lt;/i&gt;=.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, &lt;i&gt;p&lt;/i&gt;=.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, &lt;i&gt;p&lt;/i&gt;=.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.

Effect of a tailored exercise intervention during or after chemotherapy on cardiovascular morbidity in cancer patients.

12018 Background: Cancer treatment outcome may be impaired due to treatment-related adverse effects like decreased cardiorespiratory fitness. Evidence on exercise during or after chemotherapy shows positive effects on cardiorespiratory fitness, fatigue and quality of life (QoL) in cancer patients. However, optimal timing of starting exercise is unknown. This study aimed to investigate if an exercise intervention that starts during chemotherapy (early group) is superior to a program starting after completion of chemotherapy (late group) to reduce cardiovascular morbidity. Methods: In this multicenter randomized controlled trial, 266 patients (testicular-, (n = 95), breast-, (n = 139), and colon cancer (n = 30) or non-Hodgkin lymphoma (NHL) (n = 2)), treated with curative chemotherapy were randomized to a 24 week aerobic and resistance exercise intervention starting either early, i.e. during chemotherapy (n = 131) or late, i.e. at completion of chemotherapy (n = 135) (NCT01642680). Effect on VO2 peak was evaluated with intention-to-treat linear mixed-effect models, adjusted for baseline values (T0) and diagnosis at post-chemotherapy (T1), post-exercise intervention (T2) and 1-year post-exercise intervention (T3, i.e., primary endpoint). Here we report T0, T1 and T2 data. Secondary endpoints were QoL (EORTC-QLQ-C30) and fatigue (MFI-20), with higher scores indicating more fatigue. Results: Median age was 33 yrs for testicular-, 52 yrs for breast- and 64 yrs for colon cancer and NHL patients. Patients in the early group declined significantly less in VO2 peak and QoL at T1 compared to the late group (adjusted between-group differences were 3.2 ml/min/kg (95% confidence interval CI 2.3 to 4.1, P &lt; 0.0001) and 5.8 (95% CI 0.6 to 10.9, P = 0.028). Patients in the early group experienced reduced general and physical fatigue at T1 (adjusted between-group differences were -2.0 (95% CI -3.3 to -0.8, P = 0.002) and -2.9 (95% CI -4.3 to -1.5, P &lt; 0.0001). At T2, VO2 peak, QoL, general and physical fatigue were comparable and regained baseline levels (adjusted between-group differences - 0.08 ml/min/kg (P = 0.9), -1.4 (P = 0.7), 0.7 (P = 0.3) and 0.2 (P = 0.7), respectively. Conclusions: A supervised exercise program for patients with testicular-, breast- and colon cancer that is initiated at start of curative chemotherapy effectively reduces a decline in VO2 peak and QoL and reduces fatigue. After completion of the exercise intervention, initiated both during and after chemotherapy, patients regained their baseline VO2 peak, levels of fatigue and QoL. Clinical trial information: NCT01642680 .

Exercise: A Protective Measure or an "Open Window" for COVID-19? A Mini Review.

The coronavirus disease 2019 (COVID-19) has spread to at least 115 countries and caused an alarming number of deaths. The current outbreak has lead authorities from many countries to adopt several protective measures, including lockdown and social distancing. Although being a reasonable measure to counteract the COVID-19 contamination, the restrictive measures have limited individual's ability to perform exercise outdoors or in gyms and similar facilities, thus raising the risks for chronic health conditions related to a sedentary lifestyle. The recent exercise recommendations to counteract the potential deleterious effects of COVID-19-related lockdown have not fully addressed resistance exercise interventions as potential home-based exercise strategies. Additionally, the following questions have been constantly raised: (1) Is training status capable of protecting an individual from COVID-19 infection?; and (2) Can a single endurance or resistance exercise session acutely increase the risks for COVID-19 infection? Therefore, the current mini review aimed to focus on these two concerns, as well as to discuss the potential use of practical blood flow restriction and no load resistance training as possible resistance exercise strategies that could be performed during the current COVID-19 pandemic.

Pilot study of combined aerobic and resistance exercise on fatigue for patients with head and neck cancer: Inflammatory and epigenetic changes

This pilot study examined whether a combined aerobic resistance exercise program reduced fatigue and the potential inflammatory and epigenetic mechanisms in patients with head and neck cancer (HNC) receiving intensity-modulated radiotherapy. The exercise group (N = 12) received a 3-month supervised aerobic resistance exercise intervention that was initiated before a 6-week radiotherapy regimen; the control group (N = 14) received standard care. Fatigue was measured using Multidimensional Fatigue Inventory-20; physical function measures included a 6-minute walk distance (6MWD), chair stands, bicep curls, and hand grip strength. Inflammatory markers and DNA methylation data were acquired using standardized protocol. Patients were mostly white (93%) and male (81%) with a mean age of 57 years. At the end of the intervention, the exercise group had a marginal decrease in fatigue compared with the control (−5.0 vs. 4.9; P = 0.10). The exercise group had a significantly greater improvement in 6MWD (29.8 vs. −55.5 m; P = 0.04), and a marginally smaller decline in hand grip (−0.3 vs. −5.8 lbs; P = 0.05) at the end of the intervention than the control. No significant difference in inflammatory markers was observed between groups. Lower plasma interleukin (IL) 6, IL1 receptor antagonist, tumor necrosis factor α (TNFα), soluble TNF receptor II and C-reactive protein were significantly associated with increased 6MWD, chair stand, and bicep curl at the end of the intervention (p < 0.05). Among the 1152 differentially methylated sites (DMS) after intervention (p < 0.001), 163 DMS were located in gene promoter regions. Enrichment analysis suggested that the top 10 upstream regulators were associated with tumor (HNF4A, RPP38, HOXA9, SAHM1, CDK7, NDN, RPS15) and inflammation (IRF7, CRKL, ONECUT1). The top 5 diseases or functions annotations of the 62 hypermethylated DMS indicated anti-tumor and anti-inflammatory effects that might be linked to exercise. These findings suggest that exercise may improve physical performance and reduce fatigue, which could be further linked to decreased inflammation, during active radiotherapy for HNC patients. Larger studies are warranted.

Effects of diet versus diet plus aerobic and resistance exercise on metabolic syndrome in obese young men

BackgroundDiet and physical activity are the most commonly recommended strategies for preventing and treating metabolic syndrome (MetS). This randomized trial aims to examine the effectiveness of a weight reduction intervention based on caloric restriction, low-impact aerobics (LIA), and a resistance-training program in improving body composition, metabolic parameters and cardiovascular disease (CVD) risk factors among obese students diagnosed with MetS. MethodsIn all, 23 male participants, aged 19–24 years, were randomly introduced to a dieting program (the diet group, or DG = 09) or to dieting associated with a supervised physical training program (the diet plus training group, or DTG = 14). Before and after the intervention, the participants’ anthropometric measures and cardiovascular disease risk factors were assessed. ResultsFollowing the diet-based intervention, significant improvements were noted in BMI (p = 0.39), PBF (p = 0.022) and LDL-c (p = 0.024). However, in response to the diet plus aerobic and resistance exercise intervention, obese participants had significant reductions in body weight (p = 0.018), WC (p = 0.042), BMI (p = 0.001), BFP (p < 0.001), DBP (p = 0.013), SBP (p = 0.016), TG level (p = 0.026), TC (p = 0.016), LDL-c (p = 0.001) and VLDL-c (p = 0.026). Notable differences were also observed between groups in terms of changes in WC (p = 0.003), BFP (p = 0.05), WHR (p = 0.029), FBG level (p = 0.022), TG level (p = 0.001), TC (p = 0.006), LDL-c (p = 0.014) and VLDL-c (p < 0.001). ConclusionDiet-based intervention could be an effective tool in reducing body composition and some MetS components. However, adding three weekly aerobic and resistance-training sessions to the dieting program may deliver better outcomes, particularly in terms of reducing WC, BFP, WHR, FBG level, TG level, TC, LDL-c, and VLDL-c.

The effect of resistance exercise on strength and safety outcome for people with haemophilia: A systematic review.

IntroductionHaemophilia is a congenital bleeding disorder with severe musculoskeletal complications. Resistance exercise is important to increase joint stability and to improve physical performance.AimThis review aimed to investigate the safety and efficacy of resistance exercise interventions on people with haemophilia (PwH) and evaluate whether the American College of Sports Medicine resistance exercise criteria for healthy adults are valid for this population.MethodsA systematic search in literature was conducted, using the databases PubMed, MEDLiNE, CINAHL, SCOPUS, PEDro and Cochrane Library. Out of 2.440 studies published between 1960 and November 2019, 14 studies (9 randomized controlled trials, 1 controlled trial, 4 single‐group prospective studies) applying resistance exercise in juvenile and adult PwH corresponded to the inclusion criteria.ResultsStudies performed dynamic, isokinetic or a combination of isometric and dynamic resistance training. Most interventions were carried out in the context of a multimodal training. Resistance was provided using fixed and free weights, body weight, resistance bands and water resistance. Study protocols included clinical and home‐based settings. Several studies suggest that training intensities lower than those known to increase the strength of healthy people are effective in increasing the strength of PwH. Resistance exercise seems to be a safe intervention if it is adequately monitored, individually adapted and applied with sufficient factor therapy. Due to the heterogeneity of study designs, training interventions and outcome measures a meta‐analysis could not be performed.ConclusionsFurther studies of higher methodological quality are needed to determine the optimal types of exercise, optimal dosage and timing.

Abstract P1-11-01: Effect of aerobic and resistance exercise on Reynolds risk score in overweight or obese breast cancer survivors

Abstract Background Breast cancer survivors have approximately double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score is a validated algorithm for the assessment of cardiovascular disease, which incorporates high sensitivity C-Reactive Protein (hsCRP), hemoglobin A1c (HbA1c), and parental history of myocardial infarction with traditional biomarkers including cholesterol, systolic blood pressure (SBP), and presence of diabetes. We previously demonstrated that exercise improves Framingham risk score (12.0±2.0 to 2.0±1.5), calculated by traditional risk factors of cardiovascular disease, SBP (132.9±13.0 to 120.7±9.5 mmHg), high-density lipoprotein cholesterol (HDL-C; 43.1±6.6 to 64.7±7.8 mg/dL), and total cholesterol (TC; 196.5 ± 53.4 to 157.5 ± 37.1 mg/dL), in breast cancer survivors. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on Reynolds risk score in breast cancer survivors. Methods One hundred overweight or obese (BMI&amp;gt;25kg/m2) sedentary breast cancer survivors (stage I-III) who completed cancer treatment within 6 months prior to enrollment were randomized to the Exercise group (EX; n=50) or the Control (CON; n=50). The EX underwent supervised moderate-to-vigorous intensity aerobic and resistance exercise sessions 3 times/week for 16 weeks. The CON was asked to maintain their current level of activity. Reynolds risk score was calculated for each participant by assigning values for each of the following eight categories: age, SBP, TC, HDL-C, presence of diabetes; HbA1c, smoking status, hsCRP; and parental history of myocardial infarction. Within-group and between-group differences in mean change for individual outcomes measured at 16 weeks were evaluated using general linear models repeated-measures analyses of variance and mixed model repeated-measures analysis, respectively. Results Following the 16-week study period, Reynolds risk score was significantly reduced (8.3% to 0.9%), with improvements in hsCRP (3.4±0.6 to 2.3±0.3 mg/L), presence of diabetes (40 to 20%), and HbA1c (7.5±0.9 to 2.9±0.2%) in EX compared to CON (P&amp;lt;0.01). There were no significant changes in TC (194.4±48.9 to 210.4±52.2), HDL-C (41.0±4.3to 39.9±4.0), SBP (133.7±9.7to 135.9±9.8), hsCRP (3.7±0.3 to 4.2±0.4), presence of diabetes (22 to 24%), HbA1c (7.5±0.8 to 7.9±0.8) and Reynolds risk score in CON (P&amp;gt;0.05). Conclusion A 16-week supervised aerobic and resistance exercise intervention is an effective approach to reduce the risk of developing cardiovascular disease by reducing hsCRP, cholesterol, diabetes status, and SBP in breast cancer survivors. Participation in supervised exercise training during cancer survivorship should be considered to reduce the risk for cardiovascular disease mortality in breast cancer survivors. Citation Format: Kyuwan Lee, Debu Tripathy, Wendy Demark-Wahnefried, Kerry Courneya, Joanne Mortimer, Christina Dieli-Conwright. Effect of aerobic and resistance exercise on Reynolds risk score in overweight or obese breast cancer survivors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-11-01.

Effectiveness of a Diet and Resistance Exercise Intervention on Muscle Health in Older Adults: ProMuscle in Practice

ObjectivesClinical studies show that resistance exercise and a protein-rich diet can counteract the age-related decline of muscle mass, strength, and physical performance. The aim of the ProMuscle in Practice study was to test effectiveness of a resistance exercise and dietary protein intervention for older adults implemented in a real-life setting. DesignA randomized controlled multicenter intervention study. Setting and ParticipantsOne hundred sixty-eight community-dwelling older adults were included (age 75 ± 6 years). A 12-week intensive support intervention including progressive resistance exercise supervised by a physiotherapist and dietitian guidance on increasing protein intake was followed by a voluntary 12-week moderate support intervention to continue the adapted lifestyle pattern. The control group received no intervention. MethodsCompliance was measured through attendance lists and 3-day food records. Physical functioning, leg strength (3-repetition maximum, knee extension strength), lean body mass [(LBM) dual-energy X-ray absorptiometry], and quality of life (5-level EQ-5D) were measured at baseline, and after 12 and 24 weeks. Differences in change between groups were assessed with linear mixed model analysis. ResultsThe intervention group increased protein intake and attended 83.6% of the training sessions. Short Physical Performance Battery score slightly increased in intervention participants [from 10.1 (95% confidence interval 9.7–10.5) to 10.4 (10.0–10.8) at week 12 and 10.6 (10.2–10.9) at week 24], where control participants decreased (time × treatment interactions, P < .05). Improvements in intervention group compared with controls were also observed for Timed Up-and-Go, strength and LBM at both time points (time × treatment interactions, P < .05). No difference between groups was found for the 6-Minute Walking Test, activities of daily living, and quality of life. Conclusions and ImplicationsProMuscle in Practice was effective on improving muscle strength and LBM, with small changes in the composite function score in community-dwelling older adults in a real-life setting. Further research should explore feasibility of real-life implementation, as well as improving long-term compliance.

Study of the Older Adults' Motivators and Barriers Engaging in a Nutrition and Resistance Exercise Intervention for Sarcopenia: An Embedded Qualitative Project in the MIlkMAN Pilot Study.

Objectives: The present study aimed to investigate motivators and barriers to older adults engaging in a nutrition and resistance exercise (RE) intervention for sarcopenia. Methods: We conducted a content analysis of structured interviews with 29 community-dwelling older adults (aged 65–80 years) completing the MIlk Intervention Muscle AgeiNg (MIlkMAN) study. Results: Content analysis revealed that self-perceived improved health, knowledge acquisition in nutrition and exercise, social well-being, professional support in a fun environment, and positive reported outcomes were motivators for engagement in the intervention. Peer encouragement, social bonds, and their retention were motivators to continuing engagement after study completion, especially in widowed women. Barriers to maintenance included affordability, environmental factors, and concerns over negative health outcomes. Discussion: Nutrition and RE interventions for sarcopenia should focus on knowledge acquisition about their health benefits, being enjoyable, and offering social opportunities that have the potential to last beyond the study duration to promote and maintain positive health behaviors.

Feasibility of Resistance Exercise for Posttraumatic Stress and Anxiety Symptoms: A Randomized Controlled Pilot Study.

Emerging evidence suggests that exercise may beneficially affect posttraumatic stress symptoms (PTSS), but few randomized trials exist. Additionally, the effects of resistance exercise (i.e., weight lifting or strength training) on PTSS have not been thoroughly examined. This study aimed to explore the feasibility of a brief high-intensity resistance exercise intervention for PTSS and related issues, such as anxiety, sleep, alcohol use, and depression, in non-treatment-seeking adults who screened positive for posttraumatic stress disorder (PTSD) and anxiety. The sample included 30 non-treatment-seeking, urban-dwelling adults (M age = 29.10 years, SD = 7.38; 73.3% female) who screened positive for PTSD and anxiety and were randomly assigned to either a 3-week resistance exercise intervention or a time-matched contact control condition. The results suggest the intervention was feasible, with 80.0% (n = 24) of participants completing the study, 88.9% of the resistance exercise sessions attended, and no adverse effects reported. Additionally, resistance exercise had large beneficial effects on symptoms of avoidance, d = 1.26, 95% CI [0.39, 2.14]; and hyperarousal, d = 0.90, 95% CI [0.06, 1.74], relative to the control condition. Resistance exercise also produced large improvements concerning sleep quality, d = 1.31, 95% CI [0.41, 2.21], and hazardous alcohol use, d = 0.99, 95% CI [0.13, 1.86], compared to the control condition. Overall, the findings suggest that 3 weeks of high-intensity resistance exercise is a feasible intervention for PTSS reduction in non-treatment-seeking adults who screen positive for PTSD and anxiety; additional research is needed to verify these preliminary findings.

HOME CARE AIDE-LED RESISTANCE EXERCISE FOR MEDICAID HOME AND COMMUNITY-BASED SERVICES CLIENTS

Home Care Aides (HCAs) assistance is the most common care provision to help clients with activities of daily living, but exercise is not currently provided, despite well-established health benefits. We developed a resistance exercise intervention using a stakeholder panel of physical therapists, HCAs, and clients. Stakeholders suggested a mobile application that played exercise videos. We then enrolled 128 HCA-client dyads (93% african american & 79% female) and randomized home care aides to lead the intervention with their clients in addition to usual care for 6 months or continue usual care. Our aims were to 1) evaluate the feasibility of the intervention and 2) determine the effects of the intervention on client physical performance, frailty classification, self-reported health, and strength. 96% of HCAs reported the training session successfully prepared them to lead exercise and we had no adverse events. There was high attrition rates among dyads (28.13%) at 6 months which was worse among HCAs (55%). We found no statistically significant differences between study arms. However, the range of completed sessions was 1-34 out of 52 possible sessions. Program evaluation indicated high satisfaction among clients and HCAs (8.9 & 8.6/10). HCA attrition limited client participation, technology did not facilitate exercise completion, and client motivation was a barrier to adherence. Results show it is feasible to train HCAs to lead exercise, however, given high turnover in the HCA profession, alternative implementation models should be studied. While the app use was an innovative way to engage older adults in exercise, technology challenged HCAs.

저항성 운동과 커큐민 보충 복합 중재가 제2형 당뇨 쥐의 골격근 내 염증 촉진 사이토카인의 mRNA 발현에 미치는 영향: 예비연구

저항성 운동과 커큐민 보충 복합 중재가 제2형 당뇨 쥐의 골격근 내 염증 촉진 사이토카인의 mRNA 발현에 미치는 영향: 예비연구

228P - Effects of aerobic and resistance exercise on android: Gynoid fat ratio in breast cancer survivors

BackgroundThe android:gynoid percent fat ratio (AGFR) is associated with increased risk of cardiovascular disease and type 2 diabetes in breast cancer survivors (BCS). Exercise reduces fat mass in BCS; however, few studies have focused on AGFR. The study purpose was to examine the effects of a 16-week aerobic and resistance exercise intervention on AGFR among BCS. We assessed whether exercise-induced changes in AGFR were associated with improved insulin resistance. MethodsBCS (Stage I-III) were randomized to exercise (n=50) or usual care (n=50). The thrice weekly 16-week intervention included supervised, progressive moderate-vigorous aerobic and resistance exercise. AGFR was obtained from a whole-body dual-energy x-ray absorptiometry. Insulin resistance was estimated using homeostatic model assessment of insulin resistance (HOMA-IR) calculated from fasting insulin and glucose levels. Within and between group differences were assessed by paired t-test and repeated measures ANOVA. Pearson’s correlation was computed to assess the association between AGFR and HOMA-IR in the exercise group. ResultsParticipants were 53 ± 10.4 years old, overweight (BMI>25.0kg/m2; 54%), Hispanic (63.1%), and had undergone a mastectomy (90%) and chemotherapy + radiation therapy (76%). Adherence to the intervention was 95% and post-intervention assessments were available on 91% of participants. Post-intervention, AGFR significantly decreased in the exercise group from baseline and when compared to usual care (p<0.001). Post-intervention, strong correlations were found between AGFR and HOMA-IR (r=0.95; p<0.01). ConclusionsA progressive aerobic and resistance exercise intervention is an effective strategy to decrease AGFR in BCS. BCS who experience exercise-induced improvements in AGFR may also experience improved insulin resistance thereby reducing the risk for comorbid conditions. Clinical trial identificationNCT01140282. Legal entity responsible for the studyThe authors. FundingNational Cancer Institute. DisclosureAll authors have declared no conflicts of interest.