Abstract Objective To determine the effect of exercise frequency on various diseases and risk factors of the elderly. Design Retrospective analysis of a randomized controlled 18-month exercise trial. ...Setting University ambulatory group setting. Participants Community-dwelling women aged ≥65 years (N=162) in the area of Northern Bavaria. Intervention Mixed, intense aerobic, resistance, and balance protocol for 18 months. Subjects were retrospectively subdivided into 2 groups according to their effective attendance over 18 months (>1–<2 vs ≥2–4 sessions/wk). Main Outcome Measures Bone mineral density (BMD), lean body mass, appendicular skeletal muscle mass by dual-energy x-ray absorptiometry, Framingham study-based 10-year coronary heart disease (CHD) risk, and number of falls by calendar method. Results Significant differences between the low-frequency exercise group (LF-EG) and the high-frequency exercise group (HF-EG) were observed for lumbar spine BMD (HF-EG, 2.4%±2.8% vs LF-EG, 0.3%±2.2%; P <.001) and proximal femur BMD (HF-EG, 2.4%±2.8% vs LF-EG, −0.5%±1.6%; P =.014), lean body mass (1.6%±3.4% vs 0.3%±2.6%, P =.053), and appendicular skeletal muscle mass (0.9%±4.5% vs −1.3%±3.2%, P =.011). No differences between both exercise groups were observed for 10-year CHD risk (−1.94%±4.14% vs −2.00%±3.13%; P =.943) and number of falls (0.95±1.36 vs 1.03±1.21 falls/person). Comparing the LF-EG with the less active control group (n=47), only nonsignificant effects for fall number ( P =.065) and 10-year CHD risk ( P =.178) were evaluated. Conclusions Although this result might not be generalizable across all exercise types and cohorts, it indicates that an overall exercise frequency of at least 2 sessions/wk may be crucial for impacting bone and muscle mass of elderly subjects.
Temporary cessation of exercise but maintenance of habitual physical activity might be a frequent situation in older people's lives. Particularly the COVID-19 induced lockdown of exercise training ...facilities with individual outdoor activities still being allowed might be a blueprint for this potentially harmful scenario. Thus, the aim of the present study was to determine the effects of 6 months of detraining after 18 months of high-intensity resistance exercise (HIT-RT) on body composition and cardiometabolic outcomes in predominately obese older men with osteosarcopenia.
Community-dwelling predominately obese men 72-91 years old with low muscle and bone mass (n=43) were randomly assigned to an 18-month HIT-RT (EG: n=21) or a non-training control group (CG, n=22). After the intervention, participants of the EG discontinued HIT-RT for 6 months, but increased their habitual physical activity. Study outcomes were group differences in detraining changes ("effects") for lean body mass (LBM), total and abdominal body fat rate (determined by dual-energy x-ray absorptiometry) and the Metabolic Syndrome Z-Score (MetSZ). We applied an intention-to-treat analysis with multiple imputation to analyze the data.
After the 18-month HIT-RT, we observed significant positive training effects for LBM, total and abdominal body fat rate and the MetSZ (all p<0.001). Abrupt cessation of HIT-RT for 6 months resulted in significantly higher unfavorable changes in the HIT-RT compared with the CG for LBM (p=0.001), total body fat (p=0.003) and the MetSZ (p=0.003), apart from abdominal body fat (p=0.059). However, significant overall effects were still present after 24 months for LBM and body fat indices but not for the MetSZ.
The present study clearly indicates the unfavorable effects of 6 months of detraining after HIT-RT. Correspondingly, exercise protocols particularly for older people should focus on continuous exercise with short regeneration periods rather than on intermitted protocols with pronounced training breaks.
In this sub-analysis of a comprehensive meta-analysis, we aimed to determine the effect of different types of exercise on (areal) bone mineral density (BMD) in postmenopausal women. A systematic ...review of the literature according to the PRISMA statement included (a) controlled trials, (b) with at least one exercise and one control group, (c) intervention ≥ 6 months, (d) BMD assessments at lumbar spine (LS), femoral neck (FN) or total hip (TH), (e) in postmenopausal women. Eight electronic databases were scanned without language restrictions up to March 2019. The present subgroup analysis was conducted as a mixed-effect meta-analysis with “type of exercise” as the moderator. The 84 eligible exercise groups were classified into (a) weight bearing (WB,
n
= 30) exercise, (b) (dynamic) resistance exercise (DRT,
n
= 18), (c) mixed WB&DRT interventions (
n
= 36). Outcome measures were standardized mean differences (SMD) for BMD-changes at LS, FN and TH. All types of exercise significantly affect BMD at LS, FN and TH. SMD for LS average 0.40 (95% CI 0.15–0.65) for DRT, SMD 0.26 (0.03–0.49) for WB and SMD 0.42 (0.23–0.61) for WB&DRT. SMD for FN were 0.27 (0.09–0.45) for DRT, 0.37 (0.12–0.62) for WB and 0.35 (0.19–0.51) for WB&DRT. Lastly, SMD for TH changes were 0.51 (0.28–0.74) for DRT, 0.40 (0.21–0.58) for WB and 0.34 (0.14–0.53) for WB&DRT. In summary, we provided further evidence for the favorable effect of exercise on BMD largely independent of the type of exercise. However, in order to generate dedicated exercise recommendations or exercise guideline, meta-analyses might be a too rough tool.
There is some evidence that an adequate "anabolic hormonal milieu" is essential for mechanosensitivity/-transduction/-response of bone tissue.
To determine whether enhancing Hormone Therapy (HT) with ...exercise increases the isolated effect of HT on BMD at lumbar spine (LS) and femoral neck (FN).
A comprehensive search of six electronic databases according to the PRISMA statement up to April 28, 2021 included controlled trials longer than 6 months with three study arms: (a) HT, (b) exercise, (c) HT plus exercise (HT+E). Apart from HT, no pharmaceutic therapy or diseases with relevant osteo-anabolic or -catabolic effect on bone metabolism were included. The present analysis was conducted as a random-effects meta-analysis. Outcome measures were standardized mean differences (SMD) for BMD changes at the LS, and FN.
Our search identified six eligible studies (n=585). Although the effect of HT+E was more pronounced on LS (SMD: 0.19, 95%-CI: -0.15 to 0.53) and FN-BMD (0.18, -0.09 to 0.44) compared to the HT group, we did not observe significant differences between the two groups. We observed a low (I 2: 29%) or moderate (I 2: 49%) level of heterogeneity between the trials for FN or LS.
We do not observe a significant effect of HT+E vs. HT alone. We largely attribute this result to varying HT supplementation and hormonal status. Bearing in mind that synergistic/additive effects between HT and mechanical stimulation can only be expected in situations of hormonal insufficiency, further clinical studies should consider baseline endogenous estrogen production but also HT dosing more carefully.
Whole-body electromyostimulation (WB-EMS), an innovative training technology, is considered as a joint-friendly, highly customizable and particularly time-effective option for improving muscle ...strength and stability, body composition and pain relief. The aim of the present study was to determine the effect of 16 weeks of once-weekly WB-EMS on maximum isometric trunk (MITS), leg extensor strength (MILES), lean body mass (LBM) and body-fat content. A cohort of 54 male amateur golfers, 18 to 70 years old and largely representative for healthy adults, were randomly assigned to a WB-EMS (n = 27) or a control group (CG: n = 27). Bipolar low-frequency WB-EMS combined with low-intensity movements was conducted once per week for 20 min at the participants’ locations, while the CG maintained their habitual activity. The intention to treat analysis with multiple imputation was applied. After 16 weeks of once-weekly WB-EMS application with an attendance rate close to 100%, we observed significant WB-EMS effects on MITS (p < 0.001), MILES (p = 0.001), LBM (p = 0.034), but not body-fat content (p = 0.080) and low-back pain (LBP: p ≥ 0.078). In summary, the commercial setting of once-weekly WB-EMS application is effective to enhance stability, maximum strength, body composition and, to a lower extent, LBP in amateur golfers widely representative for a healthy male cohort.
The menopausal transition is a critical period in women's lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the ...pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1-5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002±.018 versus CG: -.009±0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: -0.01±.016 versus CG: -.009±0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39±1.08 vs -0.37±1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (-1.44±1.49 vs -0.02±1.55 kg, p=0.002 and -1.50±2.33 vs 0.08±2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p<0.001) and power (p<0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.
Objective
This study aimed to compare a state‐of‐the‐art bioelectrical impedance analysis (BIA) device with two‐point Dixon magnetic resonance imaging (MRI) for the quantification of visceral adipose ...tissue (VAT) as a health‐related risk factor.
Methods
A total of 63 male participants were measured using a 3‐T MRI scanner and a segmental, multifrequency BIA device. MRI generated fat fraction (FF) maps, in which VAT volume, total abdominal adipose tissue volume, and FF of visceral and total abdominal compartments were quantified. BIA estimated body fat mass and VAT area.
Results
Coefficients of determination between abdominal (r2 = 0.75) and visceral compartments (r2 = 0.78) were similar for both groups, but slopes differed by a factor of two. The ratio of visceral to total abdominal FF was increased in older men compared with younger men. This difference was not detected with BIA. MRI and BIA measurements of the total abdominal volume correlated moderately (r2 = 0.31‐0.56), and visceral measurements correlated poorly (r2 = 0.13‐0.44).
Conclusions
Visceral BIA measurements agreed better with MRI measurements of the total abdomen than of the visceral compartment, indicating that BIA visceral fat area assessment cannot differentiate adipose tissue between visceral and abdominal compartments in young and older participants.
The primary aim of the project was to determine the combined effect of whole-body electromyostimulation (WB-EMS) and protein supplements on local and overall muscle/fat distribution in older man with ...sarcopenic obesity (SO). Community-dwelling (cdw) men ≥ 70 years with SO were randomly allocated to a WB-EMS and protein supplementation (
n
= 33) or a non-intervention control group (CG:
n
= 34). WB-EMS was conducted 1.5 sessions of 20 min/week for 16 weeks. Whey protein supplementation aimed to ensure a daily intake of 1.8 g/kg body mass. The primary study endpoint was muscle/fat distribution of the total intra-fascial volume of the mid-thigh as determined by MRI. The core secondary endpoint was appendicular muscle mass (ASMM) and trunk fat; subordinate secondary endpoint was lower-leg performance. Thigh lean muscle volume increased significantly in the WB-EMS&P (
p
< 0.001) and increased slightly in the CG (
p
= 0.435). In parallel, fat volume increased significantly in the CG (
p
< 0.001) and was maintained in the WB-EMS&P group (
p
= 0.728). Group differences for both parameters were significant (
p
= 0.033 and
p
= 0.002). ASMM and trunk fat also differed significantly (
p
< 0.001) between WB-EMS and CG, with significant positive changes in the WB-EMS&P (
p
< 0.001) and no relevant changes in the CG (
p
≥ 0.458). Finally, changes of gait velocity, leg-extensor strength, and advanced lower extremity function of the WB-EMS&P group differed significantly from the CG (
p
≤ 0.002). WB-EMS combined with whey protein supplements favorably affects local and overall muscle/fat distribution and lower limb functioning in cdw men 70+ with SO. Thus, this time-saving, joint-friendly, and highly customizable approach may be an option for people either unable or unmotivated to conduct intense (resistance) exercise protocols.
Trial registration number
NCT02857660 on
http://www.clinicaltrials.gov
.
PDF
