Melanie Potiaumpai

High-speed circuit training vs hypertrophy training to improve physical function in sarcopenic obese adults: a randomized controlled trial.

BACKGROUNDnProgressive loss of muscle and strength with age is often coincident with increases in adiposity, leading to a condition called sarcopenic obesity. Studies have shown sarcopenic obese adults to be at higher risk for declines in physical function. Despite this rising public health concern, no intervention studies currently exist in this population.nnnMETHODSnA total of 21 sarcopenic obese adults, 60 years or older, were randomized into two groups, strength/hypertrophy (SH, n=9) and high-speed circuit (HSC, n=8) and were trained for 15 weeks. The primary outcome was the SPPB modified as a measure of physical function, assessed by assessors blinded to randomization. Secondary outcomes were lower body and upper body power and strength, instrumental activities of daily living (IADL), ratings of perceived exertion (RPE), body fat % (BF%), skeletal muscle index (SMI), and grip strength (GRP).nnnRESULTSnFor the SPPB results favored HSC over SH (1.1, 95% CI (-.1 to 2.4), p=.08) and showed a moderate effect size (Hedge g=0.6, 95% CI (-0.4, 1.6)). For secondary outcomes, lower body power (mean difference=158 W, 95% CI (2, 315); p=.01) and RPE (mean difference=-1.5, 95% CI (-2.9, -0.12); p=.04) also favored HSC. IADL, SMI, BF%, upper and lower body strength and upper body power, showed no statistically significant differences between groups.nnnCONCLUSIONSnConsidering the moderate effect size, the large treatment effect shown by the upper limit of the 95% CI, the low perceived exertion, and no adverse effects, HSC training should be further investigated with a larger sample size in sarcopenic obese adults.

Comparative Impacts of Tai Chi, Balance Training, and a Specially-Designed Yoga Program on Balance in Older Fallers

OBJECTIVEnTo compare the effect of a custom-designed yoga program with 2 other balance training programs.nnnDESIGNnRandomized controlled trial.nnnSETTINGnResearch laboratory.nnnPARTICIPANTSnA group of older adults (N=39; mean age, 74.15 ± 6.99 y) with a history of falling.nnnINTERVENTIONSnThree different exercise interventions (Tai Chi, standard balance training, yoga) were given for 12 weeks.nnnMAIN OUTCOME MEASURESnBalance performance was examined during pre- and posttest using field tests, including the 8-foot up-and-go test, 1-leg stance, functional reach, and usual and maximal walking speed. The static and dynamic balances were also assessed by postural sway and dynamic posturography, respectively.nnnRESULTSnTraining produced significant improvements in all field tests (P<.005), but group difference and time × group interaction were not detected. For postural sway, significant decreases in the area of the center of pressure with eyes open (P=.001) and eyes closed (P=.002) were detected after training. For eyes open, maximum medial-lateral velocity significantly decreased for the sample (P=.013). For eyes closed, medial-lateral displacement decreased for Tai Chi (P<.01). For dynamic posturography, significant improvements in overall score (P=.001), time on the test (P=.006), and 2 linear measures in lateral (P=.001) and anterior-posterior (P<.001) directions were seen for the sample.nnnCONCLUSIONSnYoga was as effective as Tai Chi and standard balance training for improving postural stability and may offer an alternative to more traditional programs.

Comparative Effect of Power Training and High-Speed Yoga on Motor Function in Older Patients With Parkinson Disease.

OBJECTIVESnTo compare the effects of power training (PWT) and a high-speed yoga program on physical performances in older patients with Parkinson disease (PD), and to test the hypothesis that both training interventions would attenuate PD symptoms and improve physical performance.nnnDESIGNnRandomized controlled trial.nnnSETTINGnA laboratory of neuromuscular research and active aging.nnnPARTICIPANTSnPatients with PD (N=41; mean age ± SD, 72.2 ± 6.5y).nnnINTERVENTIONSnTwo high-speed exercise interventions (specifically designed yoga program and PWT) were given for 12 weeks (twice a week), and 1 nonexercise control group.nnnMAIN OUTCOME MEASURESnUnified Parkinson Disease Rating Scale motor score (UPDRSMS), Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go, functional reach, single leg stance (SLS), postural sway test, 10-m usual and maximal walking speed tests, 1 repetition maximum (RM), and peak power (PPW) for leg press.nnnRESULTSnFor the posttests, both training groups showed significant improvements (P<.05) in all physical measurements except functional reach on the more affected side, SLS, and postural sway compared with the pretests, and significantly better scores for UPDRSMS, BBS, Mini-BESTest, Timed Up and Go, functional reach on the less affected side, 10-m usual and maximal walking speed tests, 1RM, and PPW than controls, with no differences detected between the yoga program and PWT.nnnCONCLUSIONSnBoth the specially designed yoga program and PWT programs can significantly improve physical performance in older persons with PD.

High velocity circuit resistance training improves cognition, psychiatric symptoms and neuromuscular performance in overweight outpatients with severe mental illness

We developed a physical exercise intervention aimed at improving multiple determinants of physical performance in severe mental illness. A sample of 12 (9M, 3F) overweight or obese community-dwelling patients with schizophrenia (n=9) and bipolar disorder (n=3) completed an eight-week, high-velocity circuit resistance training, performed twice a week on the computerized Keiser pneumatic exercise machines, including extensive pre/post physical performance testing. Participants showed significant increases in strength and power in all major muscle groups. There were significant positive cognitive changes, objectively measured with the Brief Assessment of Cognition Scale: improvement in composite scores, processing speed and symbol coding. Calgary Depression Scale for Schizophrenia and Positive and Negative Syndrome Scale total scores improved significantly. There were large gains in neuromuscular performance that have functional implications. The cognitive domains that showed the greatest improvements (memory and processing speed) are most highly predictive of disability in schizophrenia. Moreover, the improvements seen in depression suggest this type of exercise intervention may be a valuable add-on therapy for bipolar depression.

Power training induced change in bradykinesia and muscle power in Parkinson's disease

UNLABELLEDnPower-based resistance training (PWT), using low load and high velocity, can improve physical function and quality of life in older persons. Patients with Parkinsons disease (PD), exhibiting muscular weakness and reduced movement speed, have been shown to be benefit from resistance training; however, little is known about the advantages of PWT for PD.nnnPURPOSEnTo evaluate the effects of PWT on bradykinesia and muscular performance in older patients with PD.nnnMETHODSnTwenty-six patients with mild to moderate PD were randomly assigned to a PWT or control group (CON). The PWT program was three months, incorporating two sessions/wk of high-speed resistance training combined balance and agility drills. Outcome measures included: upper and lower limb bradykinesia scores, one repetition maximums (1RM) and peak powers on biceps curl, chest press, leg press, hip abduction and seated calf, and quality of life (PDQ-39).nnnRESULTSnThe PWT group produced significant improvement in both upper and lower limbs bradykinesia scores, 1RM and muscle peak power (p < .05), which surpassed the CON group except for power during the seated calf exercise. No significant correlations between changes in clinical measure of bradykinesia and muscle peak power were observed after training. Significant improvements were seen in the PDQ-39 overall score, subsections for mobility, activities of daily living and social support for the PWT group.nnnCONCLUSIONnThe 3-month PWT program significantly reduced bradykinesia and increased muscle strength and power in older patients with PD. Power training is an effective training modality to improve physical function and quality of life for PD.

Optimal Loads for Power Differ by Exercise in Older Adults

Abstract Potiaumpai, M, Gandia, K, Rautray, A, Prendergast, T, and Signorile, JF. Optimal loads for power differ by exercise in older adults. J Strength Cond Res 30(10): 2703–2712, 2016—Power training in older adults has been shown to increase muscle strength, power, and physical function, and decrease the risk of falls and related injuries. Although there are clear indications that optimal loads for power vary due to biomechanical factors, no studies have attempted to determine the optimal loads for specific exercises used to improve muscle power. Using the load that maximizes power output for individual exercises can maximize power gains, improve training efficiency, and augment gains in physical function. Seventy community-dwelling older adults (age = 70.5 ± 5.7 years) participated in strength and power testing during 2 sessions, each lasting for 1.5 hours. Participants were tested on 6 different pneumatic resistance machines to determine their one repetition maximum (1RM) and power. Power testing was performed at loads between 30 and 90% of each participants 1RM. For the chest press and seated row, the optimal load range was between 40 and 60% 1RM, with peak power at 50% (p < 0.001) for both machines. The LAT pull-down optimal load range was between 30 and 50%, with peak power occurring at 40% (p < 0.001). The leg curl and leg press optimal load range was between 50 and 70%, with peak power occurring at 60% (p < 0.001). Peak power for the calf raise occurred at 60% (p < 0.001). We conclude that different exercise movements require the use of different optimal load ranges to maximize muscle power in older persons.

Validity and reliability of a video questionnaire to assess physical function in older adults

BACKGROUNDnSelf-report questionnaires are widely used to assess physical function in older adults. However, they often lack a clear frame of reference and hence interpreting and rating task difficulty levels can be problematic for the responder. Consequently, the usefulness of traditional self-report questionnaires for assessing higher-level functioning is limited. Video-based questionnaires can overcome some of these limitations by offering a clear and objective visual reference for the performance level against which the subject is to compare his or her perceived capacity. Hence the purpose of the study was to develop and validate a novel, video-based questionnaire to assess physical function in older adults independently living in the community.nnnMETHODSnA total of 61 community-living adults, 60years or older, were recruited. To examine validity, 35 of the subjects completed the video questionnaire, two types of physical performance tests: a test of instrumental activity of daily living (IADL) included in the Short Physical Functional Performance battery (PFP-10), and a composite of 3 performance tests (30s chair stand, single-leg balance and usual gait speed). To ascertain reliability, two-week test-retest reliability was assessed in the remaining 26 subjects who did not participate in validity testing.nnnRESULTSnThe video questionnaire showed a moderate correlation with the IADLs (Spearman rho=0.64, p<0.001; 95% CI (0.4, 0.8)), and a lower correlation with the composite score of physical performance tests (Spearman rho=0.49, p<0.01; 95% CI (0.18, 0.7)). The test-retest assessment yielded an intra-class correlation (ICC) of 0.87 (p<0.001; 95% CI (0.70, 0.94)) and a Cronbachs alpha of 0.89 demonstrating good reliability and internal consistency.nnnCONCLUSIONSnOur results show that the video questionnaire developed to evaluate physical function in community-living older adults is a valid and reliable assessment tool; however, further validation is needed for definitive conclusions.

Differences in energy expenditure during high-speed versus standard-speed yoga: A randomized sequence crossover trial

OBJECTIVESnTo compare energy expenditure and volume of oxygen consumption and carbon dioxide production during a high-speed yoga and a standard-speed yoga program.nnnDESIGNnRandomized repeated measures controlled trial.nnnSETTINGnA laboratory of neuromuscular research and active aging.nnnINTERVENTIONSnSun-Salutation B was performed, for eight minutes, at a high speed versus and a standard-speed separately while oxygen consumption was recorded. Caloric expenditure was calculated using volume of oxygen consumption and carbon dioxide production.nnnMAIN OUTCOME MEASURESnDifference in energy expenditure (kcal) of HSY and SSY.nnnRESULTSnSignificant differences were observed in energy expenditure between yoga speeds with high-speed yoga producing significantly higher energy expenditure than standard-speed yoga (MD=18.55, SE=1.86, p<0.01). Significant differences were also seen between high-speed and standard-speed yoga for volume of oxygen consumed and carbon dioxide produced.nnnCONCLUSIONSnHigh-speed yoga results in a significantly greater caloric expenditure than standard-speed yoga. High-speed yoga may be an effective alternative program for those targeting cardiometabolic markers.

Improvements in cognition and associations with measures of aerobic fitness and muscular power following structured exercise

Objectives: Cognition, along with aerobic and muscular fitness, declines with age. Although research has shown that resistance and aerobic exercise may improve cognition, no consensus exists supporting the use of one approach over the other. The purpose of this study was to compare the effects of steady‐state, moderate‐intensity treadmill training (TM) and high‐velocity circuit resistance training (HVCRT) on cognition, and to examine its relationships to aerobic fitness and neuromuscular power. Methods: Thirty older adults were randomly assigned to one of three groups: HVCRT, TM, or control. Exercise groups attended training 3days/wk for 12weeks, following a 2week adaptation period. The NIH Cognitive Toolbox was used to assess specific components of cognition and provided an overall fluid composite score (FCS). The walking response and inhibition test (WRIT) was specifically used to assess executive function (EF) and provided an accuracy (ACC), reaction time (RT) and global score (GS). Aerobic power (AP) and maximal neuromuscular power (MP) were measured pre‐ and post‐intervention. Relationships between variables using baseline and mean change scores were assessed. Results: Significant increases were seen from baseline in ACC (MD=14.0, SE=4.3, p=.01, d=1.49), GS (MD=25.6, SE=8.0, p=.01, d=1.16), and AP (MD=1.4, SE=0.6, p=.046, d=0.31) for HVCRT. RT showed a trend toward a significant decrease (MD=−0.03, SE=0.016, p=.068, d=0.32) for HVCRT. No significant within‐group differences were detected for TM or CONT. Significant correlations were seen at baseline between AP and FCS, as well as other cognitive domains; but none were detected among change scores. Although no significant correlation was evident between MP and FCS or GS, there was a trend toward higher MP values being associated with higher FCS and GS scores. Conclusions: Our results support the use of HVCRT over TM for improving cognition in older persons, although the precise mechanisms that underlie this association remain unclear. HIGHLIGHTSCircuit power training caused greater aerobic increases than treadmill training.Significant correlations were seen for baseline aerobic fitness and cognition.Circuit power training can improve cognition, through an increase in aerobic power.

Effects of high-velocity circuit resistance and treadmill training on cardiometabolic risk, blood markers, and quality of life in older adults

The presence of cardiometabolic syndrome (CMS) confers an increased risk for cardiovascular disease (CVD) and mortality and is associated with reduced health-related quality of life (HRQoL). Although the effects of exercise on biomarkers, HRQoL, and future risk have been studied, no study has measured the effects on all three components. The present study compared the effects of steady-state, moderate-intensity treadmill training (TM) and high-velocity circuit resistance training (HVCRT) on biological markers, HRQoL, and overall CVD risk in adults with CMS and CVD risk factors. Thirty participants (22 females, 8 males) were randomly assigned to 1 of 3 groups: HVCRT, TM, or control. Participants in the exercise groups attended training 3 days/week for a total of 12 weeks. Of the 30 participants who began the study, 24 (19 females, 5 males) were included in the final analysis. Primary outcome measures included CMS criteria, hemodynamic measures, Framingham Risk Score (FRS), and HRQoL. All variables were measured pre- and post-intervention. CMS z score significantly decreased for HVCRT (p = 0.03), while there were no significant changes for TM or control. FRS significantly decreased for HVCRT compared with TM (p = 0.03) and control (p = 0.03). Significant decreases in systolic (p < 0.01) and diastolic blood pressures (p < 0.01) for HVCRT accompanied significant increases from baseline in stroke volume (p = 0.03) and end-diastolic volume (p < 0.01). Systemic vascular resistance significantly decreased (p = 0.05) for HVCRT compared with control. Emotional well-being significantly improved following HVCRT and TM compared with control (p = 0.04; p = 0.03). HVCRT represents a novel training modality that improved factors in each of the 3 components assessed.