Eduardo Lusa Cadore

Effects of Different Exercise Interventions on Risk of Falls, Gait Ability, and Balance in Physically Frail Older Adults: A Systematic Review

The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the following four parameters: Incidence of falls, gait, balance, and lower-body strength. Twenty studies that investigated the effects of multi-component exercise training (10), resistance training (6), endurance training (1), and balance training (3) were included in the present revision. Ten trials investigated the effects of exercise on the incidence of falls in elderly with physical frailty. Seven of them have found a fewer falls incidence after physical training when compared with the control group. Eleven trials investigated the effects of exercise intervention on the gait ability. Six of them showed enhancements in the gait ability. Ten trials investigated the effects of exercise intervention on the balance performance and seven of them demonstrated enhanced balance. Thirteen trials investigated the effects of exercise intervention on the muscle strength and nine of them showed increases in the muscle strength. The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.

Echo intensity is associated with skeletal muscle power and cardiovascular performance in elderly men

The purpose of the present study was to investigate the relationship between echo intensity, neuromuscular and cardiorespiratory performances in the elderly. Thirty-one healthy elderly men (65.5±5.0) participated in this study. Echo intensity of rectus femoris and quadriceps femoris muscle thicknesses was determined by ultrasound images. Lower-body isometric and isokinetic peak torques (60, 180 and 360°(.s-1)), as well as rate of force development were evaluated as strength parameters. In addition, torque per unit of muscle mass was evaluated by the quotient between isometric peak torque of the knee extensors and the quadriceps femoris muscle thickness. The peak oxygen uptake (VO(2peak)), maximum aerobic workload (W(máx)), absolute (VT(1) and VT(2)) ventilatory thresholds, as well as workloads at VT(1) and VT(2) (W(VT1) and W(VT2)) were evaluated during a maximal incremental test on a cycle ergometer. There were significant negative correlations between the individual values of echo intensity with the corresponding individual values of isometric and isokinetic peak torques (60, 180 and 360°(.s-1)) (r=-0.48 to r=-0.64; P<0.05), as well as with W(VT1) (r=-0.46) and W(VT2) (r=-0.50) (P<0.05). In addition, significant positive correlations were observed between torque per unit of muscle mass and cardiovascular parameters (r=0.52 to r=0.60; P<0.001). The present results suggest that the echo intensity analysis using computer-aided gray-scale analysis is a low cost, easily accessible, and a safe method to evaluate the muscle quality, and may contribute to the research of neuromuscular and cardiovascular performances in the elderly.

Physiological effects of concurrent training in elderly men.

The aim of the present study was to investigate the effects of concurrent strength and endurance training on neuromuscular and hormonal parameters in elderly men. 23 healthy men (65±4 years) were randomly assigned to 1 of 3 groups: concurrent (CG, n=8), strength (SG, n=8) or endurance group (EG, n=7). The programs consisted, of strength training, endurance training on a cycle ergometer or a combination of both in the same session 3 times per week over a duration of 12 weeks. Subjects were evaluated on parameters related to muscle strength, muscle activation and serum hormones. There were significant increases in lower-body strength in all groups (P<0.05), with higher increases in SG (67%) than CG (41%) and both were higher than EG (25%) (p<0.01). Only SG and CG increased upper-body strength (p<0.01), with no significant difference between the 2 groups. Furthermore, there were significant decreases in free testosterone in EG after training. Significant increases in isometric strength and maximal muscle activation (p<0.05) as well as decreases in the submaximal muscle activation to the same load, were only seen in SG (p<0.05). The present results suggest that the interference effect observed due to concurrent strength and endurance training could be related to impairment of neural adaptations.

Strength prior to endurance intra-session exercise sequence optimizes neuromuscular and cardiovascular gains in elderly men

This study investigated the effects of different intra-session exercise sequences in the cardiovascular and neuromuscular adaptations induced by concurrent training in elderly. Twenty-six healthy elderly men (64.7±4.1years), were randomly placed into two concurrent training groups: strength training prior to (SE, n=13) or after (ES, n=13) endurance training. Subjects trained strength and endurance training 3 times per week performing both exercise types in the same training session. The peak oxygen uptake (VO(2peak)), maximum aerobic workload (W(máx)), absolute (VT(1) and VT(2)) and relative (VT(1)% and VT(2)%) ventilatory thresholds, as well as workloads at VT(1) and VT(2) (W(VT1) and W(VT2)) were evaluated during a maximal incremental test on a cycle ergometer before and after the training. In addition, muscle quality (MQ) was evaluated by the quotient between maximal dynamic strength (one repetition maximum test) of the knee extensors and the quadriceps femoris muscle thickness determined by ultrasonography. There were no modifications after training in the VT(1), VT(2), VT(1)%, and VT(2)%. There was significant increase in the W(VT1) only in SE (P<0.05), as well as significant increase in the W(VT2) in both groups (P<0.001). There was significant increase in the VO(2peak), with both groups showing increases (P<0.001), with no difference between groups; as well significant increase in the W(máx) (P<0.001) with no difference between SE and ES. The force per unit of muscle mass of knee extensors increased in both groups (P<0.001), but the increase was significantly higher in SE than in ES (27.5±12.7 vs. 15.2±10.3%, P<0.02). Hence, the intra-session exercise sequence had no influence in the maximal endurance power adaptations to concurrent training, but had influence in the magnitude of the muscle quality enhancements.

Strength and Endurance Training Prescription in Healthy and Frail Elderly

Aging is associated with declines in the neuromuscular and cardiovascular systems, resulting in an impaired capacity to perform daily activities. Frailty is an age-associated biological syndrome characterized by decreases in the biological functional reserve and resistance to stressors due to changes in several physiological systems, which puts older individuals at special risk of disability. To counteract the neuromuscular and cardiovascular declines associated with aging, as well as to prevent and treat the frailty syndrome, the strength and endurance training seems to be an effective strategy to improve muscle hypertrophy, strength and power output, as well as endurance performance. The first purpose of this review was discuss the neuromuscular adaptations to strength training, as well as the cardiovascular adaptations to endurance training in healthy and frail elderly subjects. In addition, the second purpose of this study was investigate the concurrent training adaptations in the elderly. Based on the results found, the combination of strength and endurance training (i.e., concurrent training) performed at moderate volume and moderate to high intensity in elderly populations is the most effective way to improve both neuromuscular and cardiorespiratory functions. Moreover, exercise interventions that include muscle power training should be prescribed to frail elderly in order to improve the overall physical status of this population and prevent disability.

Hormonal responses to resistance exercise in long-term trained and untrained middle-aged men.

Cadore, EL, Lhullier, FLR, Brentano, MA, Silva, EM, Ambrosini, MB, Spinelli, R, Silva, RF, and Kruel, LFM. Hormonal responses to resistance exercise in long-term trained and untrained middle-aged men. J Strength Cond Res 22(5): 1617-1624, 2008-This cross-sectional study compared hormonal responses to resistance exercise between trained and untrained men to investigate the adaptations of the endocrine system to long-term strength training in middle-aged men. Twenty-one middle-aged men were recruited for this study and matched into a strength-trained group (SG) (n = 10) and an untrained group (UG) (n = 11). In the SG, the individuals had practiced strength training for hypertrophy for at least 3 years. Upper- and lower-body muscle strength was measured with a 1 repetition maximum (1RM) test. Blood samples were collected at rest and after multiple sets of a superset strength training protocol (SSTP), with an intensity of 75% of 1RM values. With these blood samples, the levels of total testosterone (TT), free testosterone (FT), dehydroepiandrosterone (DHEA), cortisol, and sex hormone-binding globulin (SHBG) were determined. In addition, the TT-to-cortisol ratio and TT-to-SHBG ratio were calculated. There was no difference at rest between groups in hormonal values for TT, FT, DHEA, cortisol, the TT-to-SHBG ratio, and the TT-to-cortisol ratio. There were increases after SSTP in the levels of TT, FT, DHEA, and cortisol and the TT-to-SHBG ratio in the UG, but only FT increased in the SG. The SG demonstrated lower values in the TT-to-SHBG ratio after the training session. These results suggest the presence of alterations in anabolic and catabolic hormonal responses to resistance exercise in long-term trained middle-aged men, with the trained subjects demonstrating lower responsiveness in the hormone values. Long-term trained men seem to require a higher volume of training, at least similar to their daily workout, to stimulate greater hormone responses.

Correlations between serum and salivary hormonal concentrations in response to resistance exercise

Abstract The aim of present study was to examine the relationships between serum and salivary values of free testosterone, dehydroepiandrosterone, and cortisol before and after a session of resistance exercise. Twenty-eight healthy men (mean age 40 years, s = 4) participated in the present study. Serum and salivary samples were collected at rest and after a multiple-sets resistance exercise protocol, of approximately 25 minutes duration. Concentrations of free testosterone, dehydroepiandrosterone, and cortisol were measured using radioimmunoassay kits. No significant correlation was observed between serum free testosterone and salivary testosterone (r = 0.22 to 0.26, P > 0.05). Serum cortisol was significantly correlated with salivary cortisol before (r = 0.52, P = 0.005) and after (r = 0.62, P = 0.001) the exercise protocol. Serum and salivary concentrations of dehydroepiandrosterone were significantly correlated before (r = 0.68, P < 0.001) and after (r = 0.7, P < 0.001) exercise. The results of the present study suggest that even under exercise conditions, the salivary values of cortisol and dehydroepiandrosterone can reflect the behaviour of these hormones in blood. However, further studies are necessary to verify if salivary testosterone reflects the behaviour of serum free testosterone during resistance exercise.

Effects of Strength, Endurance, and Concurrent Training on Aerobic Power and Dynamic Neuromuscular Economy in Elderly Men

Cadore, EL, Pinto, RS, Pinto, SS, Alberton, CL, Correa, CS, Tartaruga, MP, Silva, EM, Almeida, APV, Trindade, GT, and Kruel, LFM. Effects of strength, endurance, and concurrent training on aerobic power and dynamic neuromuscular economy in elderly men. J Strength Cond Res 25(3): 758-766, 2011-The aim of this study was to investigate the effects of concurrent training on endurance capacity and dynamic neuromuscular economy in elderly men. Twenty-three healthy men (65 ± 4 years) were divided into 3 groups: concurrent (CG, n = 8), strength (SG, n = 8), and aerobic training group (EG, n = 7). Each group trained 3 times a week for 12 weeks, strength training, aerobic training, or both types of training in the same session. The maximum aerobic workload (Wmax) and peak oxygen uptake (&OV0312;O2peak) of the subjects were evaluated on a cycle ergometer before and after the training period. Moreover, during the maximal test, muscle activation was measured at each intensity by means of electromyographic signals from the vastus lateralis (VL), rectus femoris (RF), biceps femoris long head, and gastrocnemius lateralis to determine the dynamic neuromuscular economy. After training, significant increases in &OV0312;O2peak and Wmax were only found in the CG and EG (p < 0.05), with no difference between groups. Moreover, there was a significant decrease in myoelectric activity of the RF muscle at 50 (EG), 75 and 100 W (EG and CG) and in the VL for the 3 groups at 100 W (p < 0.05). No change was seen in the electrical signal from the lateral gastrocnemius muscle and biceps femoris. The results suggest specificity in adaptations investigated in elderly subjects, because the most marked changes in the neuromuscular economy occurred in the aerobically trained groups.

Physiological adaptations to strength and circuit training in postmenopausal women with bone loss.

Brentano, MA, Cadore, EL, Da Silva, EM, Ambrosini, AB, Coertjens, M, Petkowicz, R, Viero, I, Kruel, LFM. Physiological adaptations to strength and circuit training in postmenopausal women with bone loss. J Strength Cond Res 22(6): 1816-1825, 2008-Strength training (ST; high intensity/low volume/long rest) has been used in several populations, including children, young adults, and older adults. However, there is no information about circuit weight training (CWT; low intensity/high volume/short rest) in apparently healthy postmenopausal women. The purpose of the present study was to analyze the effects of high-intensity ST and circuit training on isometric strength (IS), upper limb dynamic strength (ULS) and lower limb dynamic strength (LLS), muscle activation of quadriceps (EMGquad), maximal oxygen uptake (&OV0312;o2max), time to exhaustion (TE), and bone mineral density (BMD). Twenty-eight postmenopausal women were divided into 3 groups: 1) ST group (STG, n = 9, 45-80% 1 repetition maximum (1RM), 2-4 sets, 20-6 reps), 2) circuit training group (CTG, n = 10, 45-60% 1RM, 2-3 sets, 20-10 reps), and 3) a control group (CON, n = 9, no exercise). Significance level was defined as p ≤ 0.05 for all analyses. After 24 weeks of training, increases were observed in STG and CTG. However, whereas in the STG, the IS (32.7%), ULS (28.7%), LLS (39.4%), EMGquad (50.7%), &OV0312;o2max (22%), and TE (19.3%) increased, CTG showed changes only in IS (17.7%), ULS (26.4%), LLS (42.2%), &OV0312;o2max (18.6%), and TE (16.8%). BMD did not change in any experimental group. In the CON, there were no changes in the variables analyzed. Our results suggest that ST and circuit training positively affect postmenopausal womens muscular strength, muscular activation, and cardiorespiratory fitness, with no changes in BMD.

The Relationship between Running Economy and Biomechanical Variables in Distance Runners.

In this study, we analyzed the relationship between running economy (RE) and biomechanical parameters in a group running at the same relative intensity and same absolute velocity. Sixteen homogeneous male long-distance runners performed a test to determine RE at 4.4 m.s-1, corresponding to 11.1% below velocity at the ventilatory threshold. We found significant correlations between RE and biomechanical variables (vertical oscillation of the center of mass, stride frequency, stride length, balance time, relative stride length, range of elbow motion, internal knee, ankle angles at foot strike, and electromyographic activity of the semitendinosus and rectus femoris muscles). In conclusion, changes in running technique can influence RE and lead to improved running performance.