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Tufts research slides s14
 

Tufts research slides s14

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    Tufts research slides s14 Tufts research slides s14 Presentation Transcript

    • Aging Research at Tufts University Fiatarone et al., 1990 Bassey et al., 1992
    • • Effects on Skeletal Muscle • JAMA, 1990 High-Intensity Strength Training in Nonagenarians
    • • • • • Biologic aging (??) Disease Sedentary lifestyle Nutritional inadequacies • All related to type II fiber atrophy • Intervention? • Weakness Rationale Falls
    • To determine • Feasibility • Physiological consequences • High-resistance strength training in the frail elderly Aims
    • • • • • • Long term care facility (“nursing home”) Ambulatory Not acutely ill Follow instructions No unstable disease Participants
    • Characteristic Age (y) F Mean±SEM 90.2 (1.1) 6 M Length of stay (y) Hx of falls Use of assistive device Chronic dz/person Daily meds/person 4 3.4(0.8) 8 7 4.5 (0.6) 4.4 (0.8) Range 86-96 0.7-8.3 2-7 0-9 Participant Characteristics (Table 1.)
    • • Body composition • Total and regional • Diet records • 1RM • Safety measures • Functional mobility Measures
    • • • • • 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 Training
    • • Level of care • Excluded • MI • Fracture • Behavioral • Arthritis 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) Results: Participants
    • • 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?) Results: Baseline Muscle Function
    • • • • • 9 of 10 completed protocol 98.8% attendance No CV complications Minor joint discomfort Response to Training
    • • 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 Muscle Strength
    • • 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 Clinical Outcomes
    • • 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) Discussion
    • • Bassey et al., 1992 • Clinical Science Leg extensor power and functional performance in very old men and women
    • • 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 Rationale & Aim
    • • 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 Participants
    • Men (N=13) Age Wt (kg) Ht (m) (yrs) 88 (1.6) 64.7 1.58 (2.7) (0.03) # of CCs* 64 # of Meds 5.2 (2.4) Women (N=13) 85 (1.5) 54.7 (2.8) 55 5.2 (2.1) 1.50 (0.03) * Diabetes, hypertension, heart disease, Parkinson’s, neurological disease, arthritis, syncope, musculoskeletal defect, cancer, other Participants
    • • Leg extensor power (<1 sec) • Right, left, both, best • Chair rising (1 time) • Stair climbing (4 steps) • Walking (6 m) Measures
    • • All completed • Leg extensor power • Walking speed • Chair rise • N=1 (man) • Stair climb • N=3 (women) 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 Results
    • • • • • • • 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? Discussion
    • • Muscle strength • Muscle power • Feasibility • Approach to training? • Specificity!! Summary