tufts research slides s14
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Aging Research at Tufts UniversityFiatarone et al., 1990
Bassey et al., 1992
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High-Intensity Strength Training in Nonagenarians
• Effects on Skeletal Muscle• JAMA, 1990
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Rationale
• Biologic aging (??)• Disease• Sedentary lifestyle• Nutritional inadequacies• All related to type II fiber atrophy
• Intervention?• Weakness Falls
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Aims
To determine• Feasibility• Physiological consequences• High-resistance strength training in the
frail elderly
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Participants
• Long term care facility (“nursing home”)• Ambulatory• Not acutely ill• Follow instructions• No unstable disease
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Participant Characteristics (Table 1.)
Characteristic Mean±SEM Range
Age (y) 90.2 (1.1) 86-96
F 6
M 4
Length of stay (y) 3.4(0.8) 0.7-8.3
Hx of falls 8
Use of assistive device
7
Chronic dz/person 4.5 (0.6) 2-7
Daily meds/person 4.4 (0.8) 0-9
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Measures
• Body composition• Total and regional
• Diet records• 1RM • Safety measures
• Functional mobility
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Training
• 8 weeks• Con/Ecc leg extension• 3 x/wk• 3 sets of 8• 6-9 seconds• 1-2 min rest• 80% 1RM
• 2 & 4 weeks of detraining
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Results: Participants
• Level of care• Excluded• MI• Fracture• Behavioral• Arthritis
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Results: Participants
• 40% signs of under nutrition• FFM higher in men than in women• SSkFs highly related to BF% (r=0.89,
P<.001)• Regional muscle area highly related to
total body FFM (r=.98, P<.0001)
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Results: Baseline Muscle Function
• Right leg: 9.0±1.4• Left leg: 8.9±1.7• Corr with FFM
(r=.732; P<.01)• Corr with thigh
muscle area (r=.752, P<.01)
• Dietary intake• Chair stand
2.2±0.5 sec• 6m walk time
22.2±4.6 sec• Both related to
1RM (how?)
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Response to Training
• 9 of 10 completed protocol• 98.8% attendance• No CV complications• Minor joint discomfort
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Muscle Strength
• 174 ± 31% increase • 8.02±1.0 kg to 20.6 ± 2.4 kg (right)• 7.6±1.3 kg to 19.3±2.2 kg (left)• No plateau• Same among men and women
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Clinical Outcomes
• No change in gait speed• Tandem gait improvements (N=5)• 2 no longer needed canes• 1 of 3 could rise from chair w/o arms
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Discussion
• Dramatic increases in strength• 61-374% (!!!)
• Reversal of age-related weakness• Principle of specificity
• Previous research• Remarkable findings given potential limitations of
population• Familiarization??• Hypertrophy or neural improvements?• Well tolerated• Limitations• Safety of training versus not training (ie, falls)
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Leg extensor power and functional performance in very old men and women
• Bassey et al., 1992• Clinical Science
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Rationale & Aim
• Power is the basis for daily activities• Short time requirement• Importance of leg extensors in ADLs
….To what extent power output …..predicted performance in older people
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Participants
• Same location as in Fiatarone et al., 1990• N=26• Familiar with procedures (presumably
study staff)• Ambulatory but often used wheelchairs• Meds, falls, chronic conditions• Some cognitive impairment
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Participants
Age (yrs)
Wt (kg) Ht (m) # of CCs*
# of Meds
Men (N=13)
88 (1.6) 64.7 (2.7)
1.58 (0.03)
64 5.2 (2.4)
Women (N=13)
85 (1.5) 54.7 (2.8)
1.50 (0.03)
55 5.2 (2.1)
* Diabetes, hypertension, heart disease, Parkinson’s, neurological disease, arthritis, syncope, musculo-skeletal defect, cancer, other
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Measures
• Leg extensor power (<1 sec)• Right, left, both, best
•Chair rising (1 time)• Stair climbing (4 steps)•Walking (6 m)
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Results
• All completed • Leg extensor power• Walking speed
• Chair rise• N=1 (man)
• Stair climb• N=3 (women)
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Results
• Good reliability (test-retest)• Neurological & musculo-skeletal disease• Gender or sex??• Use of aids (ie, cane, walker, arms to rise)• 1.1 vs 1.9 W/kg• 0.86 vs 1.87 W/kg
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Discussion
• Feasibility• Normative data for power?• Power vs strength• Differences between men and women• Performance of participants• Threshold values• Walking (is this about balance?)• All
• Cause-effect?
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Summary
•Muscle strength•Muscle power• Feasibility•Approach to training?• Specificity!!