Resistance Exercise Training Program Research Articles

The nutritional support to prevent sarcopenia in the elderly

Sarcopenia has been described as a muscle disease, with multiple adverse consequences on human health. Recommendations aimed at supporting awareness, prevention, early detection and treatment of this disease are needed. This review focuses on the epidemiology, pathophysiology and early detection of elderly sarcopenia. As far as treatment is concerned, physical activity and nutritional support are specifically evaluated. An individually tailored resistance exercise training program appears to be crucial for a positive outcome of the sarcopenia prevention and treatment. The nutritional intervention is mostly based on the supplementation with high-quality proteins (i.e., whey protein) in order to increase the intake of essential amino acids and in particular of leucine. In addition, of relevant importance appears to be the supplementation with vitamin D, with omega-3 fatty acids and probiotics. This review evaluates the results of the most qualified studies on the nutritional supplementation of sarcopenic elderly subjects and shows that promising results have been achieved in community elderly subjects, or subjects followed in rehabilitation centers and in nursing homes, with additional resistance exercise programs.

The effects of telerehabilitation in adults with complex biventricular congenital heart conditions: protocol for a multi-centre, randomised controlled trial—CH-FIT

BackgroundAccumulated evidence suggests that exercise training exerts beneficial effects on people with congenital heart conditions. These findings are predominantly derived from small, single-centre exercise trials conducted in outpatient rehabilitation facilities. In recent years, the delivery of exercise interventions remotely has increased through digital communications technology (telerehabilitation). However, very little research to date has been conducted into the efficacy of telerehabilitation in people with a congenital heart condition.AimsTo evaluate the effects of a telehealth-delivered exercise intervention in people with a history of a surgical biventricular repair due to a congenital heart condition.MethodsOne hundred eligible adolescent (≥ 16 years) and adult participants living with a complex biventricular congenital heart condition will be recruited from four Australian sites and randomised to either (1) a 16-week telehealth-delivered combined (aerobic and resistance) exercise training programme of moderate-to-vigorous intensity or (2) usual care (control group), in a 1:1 allocation, with an 8-month follow-up.Outcomes of interestThe primary outcome will be the change in aerobic capacity expressed as peak oxygen uptake (VO2peak). Secondary outcomes will include changes in vascular function, muscle oxygenation, metabolic profile, body composition and musculoskeletal fitness, neurohormonal activation, neurocognitive function, physical activity levels, dietary and nutritional status, and quality of life. Outcomes will be assessed at baseline, 16 weeks, and 12 months (to determine longer-term maintenance potential).DiscussionIf found to be efficacious, telerehabilitation may be an alternative option for delivering exercise, improving health outcomes, and increasing accessibility to exercise programmes. Efficacy data is required to quantify the clinical significance of this delivery mode of exercise.Trial registrationACTRN12622000050752Trial registration date: 17 January 2022Trial registration URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382635&showOriginal=true&isReview=trueTrial registry name: Australian and New Zealand Clinical Trials Registry

IMPROVE-BMT: A Pilot Randomized Controlled Trial of Prehabilitation Exercise for Adult Hematopoietic Stem Cell Transplant Recipients.

Background: There is limited evidence on the effects of aerobic and resistance training exercise interventions to improve physical function and patient-reported outcomes prior to autologous and allogeneic hematopoietic stem cell transplant (HSCT). IMPROVE-BMT was a single-site, pilot randomized controlled trial investigating the feasibility, acceptability, and safety of a pragmatic resistance training exercise program prior to HSCT compared to usual HSCT care. Secondary aims included differences in physical function between the exercise group (EX) and usual care control group (UC). Methods: Outcome measurements were assessed: prior to HSCT, on/around day of HSCT admission, +30 days post-HSCT, and +100 days post-HSCT. The exercise intervention was a home-based exercise program that incorporated resistance-band and bodyweight exercises. Results: Acceptability among participants was 83%; exercise adherence averaged at 92%; and there were zero exercise-related adverse or serious adverse events. The average pre-transplant exercise phase was 6.28 weeks (2.71-18.29 weeks). EX (n = 36) demonstrated larger increases in the six-minute walk test distance, short physical performance battery scores, and 30-s chair stands compared to UC (n = 38) and demonstrated significant within-group improvements for the six-minute walk test, the short physical performance battery, the 30-s chair stands, and the timed up-and-go test. Conclusions: IMPROVE-BMT demonstrates that pragmatic exercise is highly feasible for HSCT recipients and can potentially lead to enhanced recovery that may not be achievable in non-exercisers.

Supplementation with Lactiplantibacillus brevis GKEX Combined with Resistance Exercise Training Improves Muscle Mass, Strength Performance, and Body Fat Condition in Healthy Humans.

In addition to maintaining good exercise and dietary habits, recent studies have shown that probiotics may have potential benefits for muscle mass and strength. It is worth noting that the effects may vary depending on the specific strains used. To date, no studies have analyzed the effects of Lactiplantibacillus brevis in this context. Here, we combine the L. brevis strain GKEX with resistance training to further understand its effects on muscle mass, thickness, performance, and fat loss. In a six-week intervention for a double-blind randomized trial, 52 healthy subjects were divided into two groups (10 male and 16 female participants in each group): a placebo group (two capsules/day, containing 0 CFU of GKEX per capsule) and a GKEX group (two capsules/day, containing 1 × 1010 CFU of GKEX per capsule). Before the intervention, no differences were observed between the two groups in any of the tests (body composition, muscle thickness, exercise performance, and blood parameters). However, supplementation with GKEX significantly improved muscle mass and thickness, as well as grip strength, muscle strength, and explosive performance, when compared to the associated parameters before the intervention. Additionally, GKEX supplementation promoted a reduction in the body fat percentage (p < 0.05). Through analysis of the change amount, we observed that GKEX supplementation yielded significantly improved benefits when compared to the placebo group (p < 0.05). In summary, our findings support the notion that a six-week resistance exercise training program combined with L. brevis GKEX supplementation has superior additive effects that enhance muscle mass and strength performance, while also reducing body fat percentage. This intervention can promote muscle gain and fat loss.

Effect of experimental pulmonary arterial hypertension on renal and bone parameters of rats submitted to resistance exercise training.

Pulmonary arterial hypertension (PAH) is characterized by right ventricular failure and diminished cardiac output, potentially leading to renal and bone impairments. In contrast, resistance exercise training (RT) offers cardiovascular and bone health benefits. This study aimed to assess the impacts of stable PAH induced by monocrotaline (MCT) and RT on renal morphometry, as well as bone morphometry and biomechanical properties in male Wistar rats. Four experimental groups, untrained control (UC, n=7), trained control (TC, n=7), untrained hypertensive (UH, n=7), trained hypertensive (TH, n=7), were defined. After the first MCT or saline injection (20 mg/kg), trained rats were submitted to a RT program (i.e., Ladder climbing), 5 times/week. Seven days later the rats received the second MCT or saline dose. After euthanasia, renal and femoral histomorphometry and femoral biomechanical properties were assessed. PAH reduced renal glomerular area and volume, which was prevented by the RT. While PAH did not harm the femoral morphometry, structural and mechanical properties, RT improved the femoral parameters (e.g., length, percentage of trabeculae and bone marrow, ultimte and yield loads). Experimental stable PAH promotes renal but not bone damages, whereas RT prevents renal deteriorations and improves the femoral morphological and biomechanical properties.

Preventing lower limb lymphedema after pelvic lymphadenectomy with progressive resistance exercise training: A randomized controlled trial

ObjectiveThis study aimed to assess the efficacy of a self-designed progressive resistance exercise training program for preventing the development of lower limb lymphedema. MethodsAn open-label randomized controlled trial was conducted in patients who underwent radical surgery for cervical cancer treatment in our department between October 7, 2019, and October 7, 2021. The participants were randomly assigned to one of three groups: progressive resistance exercise training, graduated compression stocking, and control group. ResultsA total of 267 patients were enrolled (89 in each group). The incidence of lower limb lymphedema was 9.0% (n = 8) in the progressive resistance exercise training group, 28.1% (n = 25) in the graduated compression stocking group, and 42.7% (n = 38) in the control group. Over the 2-year follow-up period, the risk of lower limb lymphedema was significantly lower in the progressive resistance exercise training group than in the control group, with a hazard ratio (HR) (95% confidence interval [CI]) of 0.156 (0.073–0.335). The study was underpowered to demonstrate a statistically significant reduction in risk in the graduated compression stocking group, with an HR (95% CI) of 0.624 (0.376–1.033). ConclusionsProgressive resistance exercise training is an effective strategy for preventing lower limb lymphedema after pelvic lymphadenectomy for cervical cancer. It imposes no additional economic burden and can be performed conveniently without the need for dedicated exercise facilities. This makes it particularly accessible to patients in developing countries, allowing them to exercise at their convenience. Trial registrationChiCTR1800014905.

Effect of Moderate Versus Vigorous Exercise Intensity on Body Composition in Young Untrained Adults: The Activating Brown Adipose Tissue Through Exercise (ACTIBATE) Randomized Controlled Trial.

The present study aimed to investigate the effect of a 24-week aerobic + resistance training programs at moderate versus vigorous intensity on body composition, and the persistence of the changes after a 10-month free-living period, in young untrained adults. This report is based on a secondary analysis from the activating brown adipose tissue through exercise (ACTIBATE) single-center unblinded randomized controlled trial. A total of 144 young adults (65.6% women) aged 18-25years were randomly allocated to three different groups: (a)aerobic + resistance exercise training program based on the international physical activity recommendations at vigorous intensity (Ex-Vigorous group), (b)at moderate intensity (Ex-Moderate group), and (c)control group (no exercise). Body composition outcomes were determined by a dual-energy X-ray absorptiometry scanner. Both Ex-Vigorous and Ex-Moderate decreased body weight, fat mass, and visceral adipose tissue mass in a similar manner (all p < .04). After a 10-month free-living period, these parameters returned to baseline levels in both exercise groups (all ps < .03). No differences between the exercise groups and the control group were noted in lean mass changes (all ps > .1). A 24-week aerobic + resistance training intervention based on the international physical activity recommendations was enough to improve body weight, fat mass, and visceral adipose tissue mass in untrained young adults, independently of the exercise intensity (moderate vs. vigorous).

Resistance exercise training benefits pulmonary, cardiac, and muscular structure and function in rats with stable pulmonary artery hypertension

AimWe tested the effects of low- to moderate-intensity resistance exercise training (RT) on the structure and function of pulmonary, right ventricle (RV), and skeletal muscle tissues in rats with stable pulmonary artery hypertension (PAH). Main methodsAfter the first monocrotaline (MCT; 20 mg/kg) injection, male rats were submitted to a RT program (Ladder climbing; 55–65 % intensity), 5 times/week. Seven days later rats received the second MCT dose. Physical effort tolerance test and echocardiographic examination were performed. After euthanasia, lung, heart, and biceps brachii were processed for histological, single myocyte, and biochemical analysis. Key findingsRT improved survival and physical effort tolerance (i.e., maximum carrying load), mitigated the pulmonary artery resistance increase (i.e., TA/TE), and preserved cardiac function (i.e., fractional shortening, ejection fraction, stroke volume and TAPSE). RT counteracted oxidative stress (i.e., CAT, SOD, GST, MDA and NO) and adverse remodeling in lung (i.e., collapsed alveoli) and in biceps brachii (i.e., atrophy and total collagen) tissues. RT delayed RV adverse remodeling (i.e., hypertrophy, extracellular matrix, collagen types I and III, and fibrosis) and impairments in single RV myocyte contractility (i.e., amplitude and velocity to peak and relaxation). RT improved the expression of gene (i.e., miRNA 214) and intracellular Ca2+ cycling regulatory proteins (i.e., PLBser16); and of pathological (i.e., α/β-MHC and Foxo3) and physiological (i.e., Akt, p-Akt, mTOR, p-mTOR, and Bcl-xL) hypertrophy pathways markers in RV tissue. SignificanceLow- to moderate-intensity RT benefits the structure and function of pulmonary, RV, and skeletal muscle tissues in rats with stable pulmonary artery hypertension.

Influence of a Concurrent Exercise Training Program on Health-Related Quality of Life During Advanced Pregnancy: The GESTAFIT Project.

Health-related quality of life (HRQoL) may be altered during pregnancy due to pregnancy-related changes in all domains of women's health. A supervised concurrent exercise-training program from the 17th gestational week until birth positively influences HRQoL. Randomized controlled trial. Level 1. Eighty-six pregnant women (age, 33.1 ± 4.6 years; prepregnancy body mass index, 23.5 kg/m2), divided into exercise (n = 41) and control (n = 45) groups, participated in this study (per-protocol basis). The exercise group followed a 60-min, 3 days/week, concurrent (aerobic + resistance) exercise training program. HRQoL was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores (0-100) indicate better HRQoL. After adjusting for potential confounders, the exercise group decreased 16.1 points less than the control group in the SF-36 physical functioning domain [between-group differences (B): 95% confidence interval (CI), 9.02 to 23.22; P < 0.01], and 4.5 points less in the SF-36 physical component summary than the control group (between-group differences (B): 95% CI, 0.65 to 8.28; P = 0.02). Intention-to-treat basis analyses depicted similar results, where the exercise group decreased 10.03 points less than the control group the in the SF-36 social functioning domain (between-group differences (B): 95% CI, 0.39 to 19.68; P = 0.04). A supervised concurrent exercise training program ameliorates HRQoL decreases along gestation. Although HRQoL decreased throughout pregnancy in both groups, this impact was less in the exercise group, especially in the SF-36 physical functioning, the SF-36 social functioning, and the SF-36 physical component summary. Healthcare providers may encourage pregnant women to exercise in this physiological stage for a better HRQoL throughout pregnancy. NCT02582567; Date of registration: 20/10/2015.

Low energy availability reduces myofibrillar and sarcoplasmic muscle protein synthesis in trained females.

Low energy availability (LEA) describes a state where the energy intake is insufficient to cover the energy costs of both exercise energy expenditure and basal physiological body functions. LEA has been associated with various physiological consequences, such as reproductive dysfunction. However, the effect of LEA on skeletal muscle protein synthesis in females performing exercise training is still poorly understood. We conducted a randomized controlled trial to investigate the impact of LEA on daily integrated myofibrillar and sarcoplasmic muscle protein synthesis in trained females. Thirty eumenorrheic females were matched based on training history and randomized to undergo 10days of LEA (25kcal·kg fat-free mass (FFM)-1 ·day-1 ) or optimal energy availability (OEA, 50kcal·kg FFM-1 ·day-1 ). Before the intervention, both groups underwent a 5-day 'run-in' period with OEA. All foods were provided throughout the experimental period with a protein content of 2.2gkg lean mass-1 ·day-1 . A standardized, supervised combined resistance and cardiovascular exercise training programme was performed over the experimental period. Daily integrated muscle protein synthesis was measured by deuterium oxide (D2 O) consumption along with changes in body composition, resting metabolic rate, blood biomarkers and 24h nitrogen balance. We found that LEA reduced daily integrated myofibrillar and sarcoplasmic muscle protein synthesis compared with OEA. Concomitant reductions were observed in lean mass, urinary nitrogen balance, free androgen index, thyroid hormone concentrations and resting metabolic rate following LEA. These results highlight that LEA may negatively affect skeletal muscle adaptations in females performing exercise training. KEY POINTS: Low energy availability (LEA) with potential health and performance impairments is widespread among female athletes. We investigated the impact of 10days of LEA on daily integrated myofibrillar and sarcoplasmic muscle protein synthesis in young, trained females. We show that LEA impairs myofibrillar and sarcoplasmic muscle protein synthesis in trained females performing exercise training. These findings suggest that LEA may have negative consequences for skeletal muscle adaptations and highlight the importance of ensuring adequate energy availability in female athletes.

The effect of combined β-lactoglobulin supplementation and resistance exercise training prior to limb immobilisation on muscle protein synthesis rates in healthy young adults: study protocol for a randomised controlled trial

BackgroundThe decline in skeletal muscle mass experienced following a short-term period (days to weeks) of muscle disuse is mediated by impaired rates of muscle protein synthesis (MPS). Previous RCTs of exercise or nutrition prehabilitation interventions designed to mitigate disuse-induced muscle atrophy have reported limited efficacy. Hence, the aim of this study is to investigate the impact of a complex prehabilitation intervention that combines β-lactoglobulin (a novel milk protein with a high leucine content) supplementation with resistance exercise training on disuse-induced changes in free-living integrated rates of MPS in healthy, young adults.Methods/designTo address this aim, we will recruit 24 healthy young (18–45 years) males and females to conduct a parallel, double-blind, 2-arm, randomised placebo-controlled trial. The intervention group will combine a 7-day structured resistance exercise training programme with thrice daily dietary supplementation with 23 g of β-lactoglobulin. The placebo group will combine the same training programme with an energy-matched carbohydrate (dextrose) control. The study protocol will last 16 days for each participant. Day 1 will be a familiarisation session and days 2–4 will be the baseline period. Days 5–11 represent the ‘prehabilitation period’ whereby participants will combine resistance training with their assigned dietary supplementation regimen. Days 12–16 represent the muscle disuse-induced ‘immobilisation period’ whereby participants will have a single leg immobilised in a brace and continue their assigned dietary supplementation regimen only (i.e. no resistance training). The primary endpoint of this study is the measurement of free-living integrated rates of MPS using deuterium oxide tracer methodology. Measurements of MPS will be calculated at baseline, over the 7-day prehabilitation period and over the 5-day immobilisation period separately. Secondary endpoints include measurements of muscle mass and strength that will be collected on days 4 (baseline), 11 (end of prehabilitation) and 16 (end of immobilisation).DiscussionThis novel study will establish the impact of a bimodal prehabilitation strategy that combines ß-lactoglobulin supplementation and resistance exercise training in modulating MPS following a short-term period of muscle disuse. If successful, this complex intervention may be translated to clinical practice with application to patients scheduled to undergo, for example, hip or knee replacement surgery.Trial registrationNCT05496452. Registered on August 10, 2022.Protocol version: 16-12-2022/1

Aerobic and resistance exercise in heart failure inpatients: a scoping review.

Exercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart failure, there is still no consensus on their prescription in patients hospitalized with acute heart failure undergoing clinical stabilization. The aim of this study is to identify the literature on exercise programs encompassing the components of aerobic and resistance training for hospitalized patients admitted for acute heart failure. A scoping review was conducted according to the proposed methodology of the Joanna Briggs Institute. Studies with adults over 18years old, hospitalized, and diagnosed with acute heart failure who participated in aerobic and resistance exercise training programs during their hospital stay were included. Three studies met the inclusion criteria. One was a retrospective, observational analytical cohort study, in which the main outcome of the exercise program was improvement in the previous disabilities of the participants. The other two were multicenter randomized controlled studies that showed greater improvement in physical function, functional capacity, depression, quality of life, and frailty status in the intervention groups. The exercise prescriptions differed according to the principles of the exercise prescription-frequency of exercise, intensity of exercise, exercise time (duration), type (mode), exercise volume, and progression. It is too early to make recommendations based on evidence of the type structure of an exercise program with aerobic and strength-training components in this population. However, in the exercise programs of the reviewed studies, the predominance of light to moderate intensity and the importance of progressively increase the frequency and duration of the training sessions were demonstrated, with bicycle ergometers and walking being the most common types of aerobic exercises. It is recommended that investment and research in this area should continue with more methodologically robust studies.

The effect of fish oil supplementation on resistance training-induced adaptations.

Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3days·week-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES). Twenty-one of 28 male and female participants (FOS, n =10 [4 withdrawals]; PL, n =11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p<.001) and did not change in the PL group (+1.3%, p =.938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p =.457), FM (FOS: -5.2%, PL: 0.0%, p =.092), and %BF (FOS: -5.9%, PL: -2.5%, p =.136) were observed, although, the between-group ES was considered large for FM (d =0.84). Absolute and relative (kg·kg [body mass]-1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p =.047; FOS: +17.6% vs. PL: +7.3%, p =.011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p =.191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p =.045). When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.

Effects of Sitting Callisthenic Balance and Resistance Exercise Programs on Cognitive Function in Older Participants.

Exercise training programs have the potential to improve cognitive function in older subjects. However, the majority of training programs are based on aerobic modality. In the current study, the influence of 3 months programs of sitting callisthenic balance (SCB) and resistance training (RT) on cognitive functioning and the mediating role that a change in the level of neurotrophic factors and strength in older, healthy participants plays were examined. Global cognitive function was examined using MoCA, short-term memory using Digit Span and Delayed Matching to Sample, set shifting using Trial Making Test Part B, speed of processing simple visual stimuli using Simple Reaction Time, decision making using Choice Reaction Time, visual attention with Visual Attention Test (VAT), tests. Strength of lower and upper limbs, neurotrophin level (irisin, brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), neurotrophin 4/5 (NT 4/5) were examined. Improved scores in RT vs. SCB were noted in MoCA (p = 0.02), reaction time in SRT (p = 0.02), TMT B (p = 0.03), errors committed in CRT (p = 0.04) and VAT (p = 0.02) were observed. No significant changes in the level of neurotrophic factors were observed. Changes in upper limb strength were related to changes in the number of errors committed in the SRT (p = 0.03). Lower limb strength changes explained the dynamics of the number of correct answers (p = 0.002) and errors committed (p = 0.006) in VAT. Both SCB and RT influenced multiple cognitive domains. The RT program improved global cognitive functioning, while no improvement was noticed in the SCB group. Decision making, visual attention and global cognitive function were improved after the RT program. Set-shifting, short-term visual memory processing speed of simple visual stimuli were improved after the SCB program, while a decrease in the processing speed of simple visual stimuli was noted in the RT group. Changes in irisin were related to set-shifting and short-term memory, while in BDNF to an improvement in the processing speed of simple visual stimuli. Resistance exercise training programs could be applied to prevent age related declines of cognitive function in healthy older subjects.

Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial

The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain. Multicenter, parallel group, randomized controlled trial. Adults 55 years and older with estimated glomerular filtration rate (eGFR) of 15 to<45 mL/min/1.73 m2 enrolled from centers in Baltimore and Boston. Twelve months of in-center supervised exercise training incorporating majority aerobic but also muscle strengthening activities or a group health education control intervention, randomly assigned in 1:1 ratio. Primary outcomes were cardiorespiratory fitness and submaximal gait at 6 and 12 months quantified by peak oxygen consumption (Vo2peak) on graded exercise treadmill test and distance walked on the 6-minute walk test, respectively. Secondary outcomes were changes in lower extremity function, eGFR, albuminuria, glycemia, blood pressure, and body mass index. Among 99 participants, the mean age was 68 years, 62% were African American, and the mean eGFR was 33 mL/min/1.73 m2; 59% had diabetes, and 29% had coronary artery disease. Among those randomized to exercise, 59% of exercise sessions were attended in the initial 6 months. Exercise was well tolerated without excess occurrence of adverse events. At 6 months, aerobic capacity was higher among exercise participants (17.9 ± 5.5 vs 15.9 ± 7.0 mL/kg/min, P= 0.03), but the differences were not sustained at 12 months. The 6-minute walk distance improved more in the exercise group (adjusted difference: 98 feet [P= 0.02; P= 0.03 for treatment-by-time interaction]). The exercise group had greater improvements on the Timed Up and Go Test (P= 0.04) but not the Short Physical Performance Battery (P= 0.8). Planned sample size was not reached. Loss to follow-up and dropout were greater than anticipated. Among adults aged≥55 years with CKD stages 3b-4 and a high level of medical comorbidity, a 12-month program of in-center aerobic and resistance exercise training was safe and associated with improvements in physical functioning. Government grants (National Institutes of Health). Registered at ClinicalTrials.gov with study number NCT01462097.

Resistance exercise training and the motor unit.

Resistance exercise training (RET) is a key modality to enhance sports performance, injury prevention and rehabilitation, and improving overall health via increases in muscular strength. Yet, the contribution of neural mechanisms to increases in muscular strength are highly debated. This is particularly true for the involvement of the motor unit, which is the link between neural (activation) and mechanical (muscle fiber twitch forces) mechanisms. A plethora of literature that examines the effects of RET on skeletal muscle speculate the role of motor units, such as increases in firing rates partially explains muscular strength gains. Results, however, are mixed regarding changes in firing rates in studies that utilize single motor unit recordings. The lack of clarity could be related to vast or subtle differences in RET programs, methods to record motor units, muscles tested, types of contractions and intensities used to record motor units, etc. Yet to be discussed, mixed findings could be the result of non-uniform MU behavior that is not typically accounted for in RET research. The purpose of this narration is to discuss the effects of acute resistance exercise training studies on MU behavior and to provide guidance for future research.

Abstract CT531: A 16-week circuit interval-based exercise intervention reduces systemic inflammation in obese, sedentary cancer survivors

Abstract Introduction: Obesity and a lack of physical activity lead to systemic and chronic inflammation among cancer survivors, which are highly associated with various comorbidities (e.g., type 2 diabetes, hypertension, and metabolic syndrome) and poor oncologic prognosis. Exercise, optimized to benefit physiological responses, can be an effective strategy to reduce systemic inflammation. The objective of the study was to investigate the effects of a 16-week circuit, interval-based exercise training program on proinflammatory cytokines in cancer survivors who are obese and sedentary. Methods: This study was a single center, pilot randomized controlled trial in 90 survivors of breast, prostate, and colorectal cancers who were sedentary (&amp;lt;60 mins of exercise per week) and overweight/obese (body mass index &amp;gt; 25.0 kg/m2). Participants were randomly assigned to either the exercise group (n=60) or the usual care group (n=30). The exercise intervention was moderate to vigorous intensity aerobic (65-85% of VO2max) and resistance (65-85% of 1-repetition maximum) exercise training in a supervised, circuit, interval-based format performed thrice-weekly for 16 weeks. Blood samples were obtained at baseline and post-intervention to measure serum levels of proinflammatory cytokines, including interleukin (IL)-6, IL-8, tumor necrosis factor-α (TNF-α), and high-sensitive c-reactive protein (hsCRP). Paired t-test and repeated measure ANOVA were used to determine the between-group differences. Results: Participants were aged 63.2±10.8 years and diagnosed with breast (35%), prostate (30%), and colorectal (35%) cancers. 55% were female and mean BMI was 34.7±5.9. 75% completed chemotherapy and/or radiation therapy. Retention and adherence rates to the exercise intervention was high (100% and 92%, respectively). Compared to usual care, circuit, interval-based exercise significantly reduced IL-6 (between group mean difference, -1.2 pg/mL; p&amp;lt;0.001), IL-8 (-2.4; p&amp;lt;0.001), TNF-α (-1.9 pg/mg; p&amp;lt;0.001), and hsCRP (-0.8 mg/L; p=0.02). Conclusions: A 16-week circuit, interval-based aerobic and resistance exercise training program induced a reduction in systemic levels of proinflammatory cytokines among sedentary and obese breast, prostate, and colorectal cancer survivors. Our findings suggest that combined aerobic and resistance exercise may be an effective strategy to offset elevated systemic inflammation associated with obesity and sedentary behavior in cancer survivors. Citation Format: Dong-Woo Kang, Cami N. Christopher, Amber J. Normann, Mary K. Norris, Christina M. Dieli-Conwright. A 16-week circuit interval-based exercise intervention reduces systemic inflammation in obese, sedentary cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT531.

Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia.

Sarcopenia has been recognized as a muscle disease, with adverse consequences on health. Updated recommendations, aimed at increasing awareness of sarcopenia and its accompanying risks, have been produced to urge the early detection and treatment of this disease. Recommended treatment is based on an individually tailored resistance exercise training program, the optimization of protein intake using high-quality protein sources (i.e., whey protein) in order to provide a high amount of essential amino acids—particularly leucine—and addressing vitamin D deficiency/insufficiency. The purpose of this review is to collate and describe all of the relevant efficacy studies carried out with a muscle-targeted oral nutritional supplementation (MT-ONS)—namely a whey-protein-based, leucine- and vitamin D-enriched formula aimed at optimizing their intake and satisfying their requirements—in different patient populations and clinical settings in order to determine if there is enough evidence to recommend prescription for the treatment of sarcopenia or its prevention in high-risk patient populations. Trials using a MT-ONS with or without a concomitant physical exercise program were systematically searched (up to June 2021), and those addressing relevant endpoints (muscle mass, physical performance and function) were critically reviewed. In total, 10 articles providing efficacy data from eight trials were identified and narratively reviewed. As far as older patients with sarcopenia are concerned, MT-ONS has been pertinently tested in six clinical trials (duration 4–52 weeks), mostly using a high-quality randomized controlled trial design and demonstrating efficacy in increasing the muscle mass and strength, as well as the physical performance versus iso-caloric placebo or standard practice. Consistent results have been observed in various clinical settings (community, rehabilitation centers, care homes), with or without adjunctive physical exercise programs. A positive effect on markers of inflammation has also been shown. A muscle-protein-sparing effect, with benefits on physical performance and function, has also been demonstrated in patients at risk of losing skeletal muscle mass (three trials), such as older patients undergoing weight loss or intensive rehabilitation programs associated with neurological disability (Parkinson’s disease). MT-ONS has demonstrated not only a significant efficacy in clinical variables, but also a positive impact on healthcare resource consumption in the rehabilitation setting (length of stay and duration of rehabilitation). In summary, MT-ONS, alone or in association with an appropriate exercise program, is an effective therapy for older patients with sarcopenia and should be offered as a first-line treatment, not only to improve clinical outcomes but also to reduce healthcare resource consumption, particularly in patients admitted to a rehabilitation center.

Hematological responses of HIV-seropositive patients to aerobic and resistance exercise training programs

This study investigated the alterations of haematologic parameters of HIV-positive patients due to a 10-week aerobic and resistance exercise training. The study examined the influence of aerobic and resistance exercises on White Blood Cells (WBC), Red Blood Cells (RBC), Haematocrit (HCT), and Platelets (PLT). The pretest-posttest control-group experimental design was employed in this study. Eighty-eight HIV-seropositive patients in the first two stages of HIV and attending the outpatient clinic at the University of Benin Teaching Hospital participated in the study. Randomization was done into control (30) and two experimental groups, aerobic exercise (28) and resistance exercise (30). The experimental groups exercised for 45 minutes, thrice a week for 10 weeks and the non-experimental group received usual anti-retroviral drugs and counseling. The initial intensity of the exercise was 60% HRmax and 1-RM and progression was by 10% every 3 weeks. Haematologic parameters were recorded initially and on termination of 10 weeks for all three groups. Frequency, mean, standard deviation, and analysis of co-variates (ANCOVA) were used for data analysis. The Bonferroni pairwise comparison was used as a Post-hoc test to identify the source of differences. The outcome of this research showed that exercise resulted in significant alterations in haematologic parameters of WBC, RBC, HCT, and PLT. Recommendations were made based on the outcome of this research that health personnel should prescribe exercise for HIV-infected persons due to the enhancement of haematologic parameters which in turn improves health.

Comparison of Bioelectrical Impedance Analysis with DXA in Adolescents with Cystic Fibrosis before and after a Resistance Training Intervention.

Background: The purpose of this pilot study was to compare body composition metrics obtained by two portable bioelectrical impedance analysis (BIA) devices with dual-energy X-ray absorptiometry (DXA) among adolescents with cystic fibrosis (CF) before and after a resistance exercise training program. Methods: Participants with CF were assessed using DXA, single-frequency BIA (SFBIA), and multiple-frequency BIA (MFBIA) to quantify percent body fat (%Fat), fat mass (FM), and fat-free mass (FFM) at baseline and after a home-based resistance training intervention comprised of 36, 1 h sessions completed in 12–14 weeks. Repeated measures analysis of variance, paired samples t-tests, Cohen’s d effect sizes, and Pearson’s correlations were used to compare differences between and within methods at baseline and post-intervention. Results: Ten participants (15.8 ± 2.2 yr, 60.1 ± 15.1 kg) completed the assessments. At baseline, both SFBIA and MFBIA scales significantly underestimated %Fat and FM and overestimated FFM, with small to moderate effect sizes. Post-intervention, small, non-significant differences were found between DXA and both BIA scales for all body composition metrics. Significant changes in %Fat and FFM were observed with DXA. MFBIA displayed less constant error than SFBIA when compared to DXA for pre- and post-intervention assessments for %Fat (MFBIA: pre and post −2.8 and −0.8 vs. SFBIA: −4.6 and −2.0), FM (−0.4 and −0.4 vs. −3.0 and −1.1), and FFM (+0.8 and +0.6 vs. +3.1 and +1.3). Near-perfect correlations were observed at both time points between DXA and each BIA scale. Conclusions: Portable BIA results should be interpreted with caution, and further validation studies in CF patients are needed prior to clinical use.