ECSS Paris 2023: OP-MH40
INTRODUCTION: Sarcopenia is a geriatric pathology associated with an increased risk of disability and adverse health outcomes. The study aim was to investigate the effects of a 48-weeks, app-monitored, home-based, bodyweight resistance training program in improving muscle health in sarcopenic persons, both in general population (GP) and in persons with HIV (PWH). We here investigate gender-specific responses of physical tests, body composition, and cognitive parameters after 12 weeks (W12). METHODS: Subjects, aged >50 years (PWH) and >60 years (GP), with sarcopenia, defined by low appendicular skeletal muscle mass index (ASMMI) by bioimpedentiometry and/or low muscle strength by handgrip strength (HGS), were randomized (1:1) into an Experimental Group (EG), performing 4 training session/week with increasing number of repetitions and sets every 6 weeks, or a Control Group (CG), without specific exercise prescription. Assessments were conducted at baseline, after 12 weeks (W12), and after 48 week, including HGS, chair stand test (CST), 6-minute walking test (6MWT), Mini-BESTest, right and left leg maximal isometric strength (RLE, LLE), ASMMI, fat mass (FM), fat-free mass (FFM), and cognitive outcomes [Trail Making A (TMA), and B (TMB), and Digit Symbol (DS)]. Within-group changes were assessed using Wilcoxon signed-rank tests. Comparisons between genders and between the EG and CG were conducted using Mann-Whitney U tests. RESULTS: A total of 165/196 participants [98 males (EG:49, CG:49) and 67 females (EG:34, CG:33)] completed W12. In males, significant differences were observed in physical tests [HGS: EG (P=0.0124); CST: EG (P<0.0001), EG vs CG (P=0.0066); 6MWT: EG (P=0.0068), CG (P=0.0025); Mini-BESTest: EG (P=0.0089), CG (P=0.0276); LLE: EG (P=0.0085)], in body composition [ASMMI: EG (P=0.0044); FFM: EG (P=0.0038), EG vs CG (P=0.0422); FM: EG (P0.0011)], and in cognitive outcomes [TMA: EG (P=0.0020), CG (P=0.0124); TMB: EG (P=0.0198); DS: EG (P=0.0088), CG (P=0.0124)]. In females, significant differences were observed in physical tests [HGS: EG (P=0.0064); CST: (EG (P=0.0004), EG vs CG (P=0.0359); Mini-BESTest: EG (P=0.0359); RLE: EG (P=0.0176), EG vs CG (P=0.0497)], and in cognitive outcomes [TMB: EG (P=0.0153); DS: EG (P<0.0001), CG (P=0.0168)]. In gender-differences, significant changes were observed in EG in body composition [FM (P=0.0011)], and in CG in physical test [6MWT (P=0.0071)]. No other gender-differences were observed. CONCLUSION: At W12, significant improvements were found in physical tests, body composition, and cognitive function in both males and females. While both genders benefited, males showed greater improvements in body composition and some physical performance measures. No gender differences were observed in cognitive outcomes.
Read CV Federica MarmondiECSS Paris 2023: OP-MH40
INTRODUCTION: Bone fragility is pervasive in endurance athletes due to their high-volume training and elevated nutritional demands. Muscle size and quality has been shown to positively influence bone strength in various populations, however, few studies have investigated this relationship in endurance athletes. Further, there is limited research on the association between endurance sport-specific factors (e.g., physical activity/training, performance) and peripheral quantitative computed tomography (pQCT) measures of bone strength. Our primary objective was to evaluate the relationships between calf muscle size and density and tibial bone strength and volumetric bone mineral density (vBMD) in male and female endurance-trained individuals. We also explored whether physical activity and performance-based tests of muscle strength and cardiorespiratory fitness were associated with bone outcomes. METHODS: 50 participants (31 males/19 females) aged 18-35 years running >3 hours/week for the past 6 months completed one-time measures. Total, trabecular, and cortical vBMD, bone compressive strength (BSI) and stress-strain indices (SSI) at the tibia (4%, 38%, 66% sites), and calf muscle density and cross-sectional area (MSCA) were measured using pQCT. Body composition was measured using dual-energy X-ray absorptiometry. Upper and lower body muscle strength were determined by handgrip and knee extensor isometric tests. Aerobic capacity (VO2peak) was measured via an incremental cardiorespiratory fitness test to volitional exhaustion. Physical activity levels were assessed using accelerometers (i.e., moderate-to-vigorous physical activity (MVPA)) and the Bone-specific Physical Activity Questionnaire (BPAQ). Multivariable linear regression analyses between muscle (MCSA and muscle density), physical activity (MVPA, total, current and past BPAQ), and performance (VO2peak, muscle strength) variables and bone parameters were adjusted for age, sex, and body weight. RESULTS: Participants had a mean (95% CI) age of 26.0 years (24.6 – 27.4), body fat of 19.9% (18.0 – 21.9), VO2peak of 55.9 ml/kg/min (53.1 – 58.7), and maximum knee extensor and handgrip strength of 262.3 N*m (232.0 – 292.7) and 43.5 kg (40.2 – 46.8), respectively. Mean MVPA and total BPAQ scores were 12 hours/week (10.9 – 13.1) and 24.0 (19.0 – 29.1), respectively. Multivariable linear regression analyses revealed weak-to-moderate associations between MCSA and BSI 4% (B=0.285, p=0.044, R2=0.606), BSI 66% (B=0.426, p=0.018, R2=0.372), and cortical area 66% (B=0.339, p=0.009, R2=0.674). Muscle density and strength, VO2peak, MVPA, and BPAQ scores were not significantly associated with bone parameters after adjusting for confounding variables. CONCLUSION: In endurance-trained individuals, calf muscle size was positively correlated with tibial bone strength independent of age, sex, and body weight, particularly at proximal sites. Muscle size may represent an important modifiable target to improve bone strength in endurance athletes.
Read CV Sofia FerreiraECSS Paris 2023: OP-MH40
INTRODUCTION: Progressive resistance training is effective against the age-related decline in muscle strength and physical limitations in older adults. However, the optimal resistance training intensity for frail community-dwelling older adults remains unclear, with concerns about high-intensity exercise limiting participation. Emerging evidence suggests that training to volitional muscular failure may achieve similar benefits across various intensities. This study aimed to assess the optimum level of progressive resistance training intensity for enhancement of muscle strength in frail community-dwelling older adults. METHODS: This 12-week randomized controlled trial included 295 frail community-dwelling older adults (≥65 years) and were randomized into 12 training intensity groups, categorized into four clusters: low (25-35%), low-medium (40-50%), medium-high (55-65%), and high intensity (70-80% of one-repetition maximum). Twice-weekly, one-on-one progressive resistance training sessions were conducted, with all participants training to volitional muscular failure. The outcome was lower-extremity muscle strength, assessed using the leg press. Linear mixed models were used to examine overall improvements in muscle strength, and to analyse if there were linear or quadratic relationships between training intensity and improved strength, as well as between the training intensity clusters and improved strength. RESULTS: All participants demonstrated significant improvements in lower extremity muscle strength following the 12-week progressive resistance training, increasing from 101±27 kg at baseline to 126±35 kg at follow-up (+25 kg, p<0.001). No linear or quadratic relationship was observed between training intensity and improvements in muscle strength. Compared to the high intensity cluster, muscle strength improvements were +7±4 kg (p=0.045), +4±3 kg (p=0.222), and +9±3 kg (p=0.010) in the low intensity cluster, in the low-medium intensity cluster, in the medium-high intensity cluster, respectively. CONCLUSION: Progressive resistance training to volitional muscular failure effectively improves muscle strength in frail community-dwelling older adults. In this randomized study we did not find a clear optimum level of training intensity for improvement of muscle strength. The high intensity training appeared suboptimal compared to lower levels of training intensity.
Read CV Mohammed BenaliECSS Paris 2023: OP-MH40