This document summarizes two studies on aging research at Tufts University. The first study found that high-intensity strength training significantly increased muscle strength in nonagenarians (people in their 90s) living in a long-term care facility, with some participants showing functional improvements. The second study found that leg extensor power, a measure of muscle strength and speed, predicted performance on tasks like chair rising, stair climbing, and walking in very old adults, and identified gender differences and thresholds related to independence. Both studies demonstrated the feasibility and benefits of resistance training for frail elderly populations.

1. Aging Research at
Tufts University
Fiatarone et al., 1990
Bassey et al., 1992

2. • Effects on Skeletal Muscle
• JAMA, 1990
High-Intensity Strength
Training in
Nonagenarians

3. •
•
•
•
Biologic aging (??)
Disease
Sedentary lifestyle
Nutritional inadequacies
• All related to type II fiber atrophy
• Intervention?
• Weakness
Rationale
Falls

4. To determine
• Feasibility
• Physiological consequences
• High-resistance strength training in the
frail elderly
Aims

5. •
•
•
•
•
Long term care facility (“nursing home”)
Ambulatory
Not acutely ill
Follow instructions
No unstable disease
Participants

6. 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.)

7. • Body composition
• Total and regional
• Diet records
• 1RM
• Safety measures
• Functional mobility
Measures

8. •
•
•
•
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

9. • Level of care
• Excluded
• MI
• Fracture
• Behavioral
• Arthritis
Results: Participants

10. • 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

11. • 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

13. •
•
•
•
9 of 10 completed protocol
98.8% attendance
No CV complications
Minor joint discomfort
Response to Training

14. • 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

16. • 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

17. • 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

18. • Bassey et al., 1992
• Clinical Science
Leg extensor power and
functional performance
in very old men and
women

19. • 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

20. • 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

21. 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

22. • Leg extensor power (<1 sec)
• Right, left, both, best
• Chair rising (1 time)
• Stair climbing (4 steps)
• Walking (6 m)
Measures

23. • All completed
• Leg extensor power
• Walking speed
• Chair rise
• N=1 (man)
• Stair climb
• N=3 (women)
Results

29. •
•
•
•
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

30. •
•
•
•
•
•
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

31. • Muscle strength
• Muscle power
• Feasibility
• Approach to training?
• Specificity!!
Summary