Pedro Lopez

Echo intensity independently predicts functionality in sedentary older men.

Introduction: The aim of this study was to examine the associations between quadriceps muscle functionality features in nonactive older men to determine predictors of functional performance. Methods: Quadriceps functional parameters, including quadriceps echo intensity (QEI), rate of torque development (RTD), and the 30 s sit‐to‐stand test (30SS), were assessed in 50 healthy sedentary older men (66 ± 5.4 years). RTD/QEI ratios were also calculated to identify the best predictor of functional performance. Results: 30SS performance was associated with RTD, muscle thickness, RTD‐50/QEI, RTD‐100/QEI, RTD‐50/QEI/WBM, and RTD‐100/QEI/WBM. A multiple stepwise linear regression demonstrated that QEI was the best single predictor of functional performance, explaining ∼30% of the 30SS variance. Conclusions: These results indicate that QEI was the strongest contributor to functionality of nonactive older men, suggesting that QEI may be an alternative tool for screening of muscle impairment that leads to decreased functional performance in this population. Muscle Nerve 55: 9–15, 2017

Benefits of resistance training in physically frail elderly: a systematic review

AimExercise is one of the most important components in frailty prevention and treatment. Therefore, we systematically reviewed the effect of resistance training (RT) alone or combined with multimodal exercise intervention on muscle hypertrophy, maximal strength, power output, functional performance, and falls incidence in physically frail elderly.MethodsMEDLINE, Cochrane CENTRAL, PEDro, and SPORTDiscus databases were searched from 2005 to 2017. Studies must have mentioned the effects of RT (i.e., included or not in multimodal training) on at least one of the following parameters: muscle mass, muscle strength, muscle power, functional capacity, and risk of falls in frail elderly.ResultsThe initial search identified 371 studies and 16 were used for qualitative analysis for describing the effect of strength training performed alone or in a multimodal exercise intervention. We observed that RT alone or in a multimodal training may induce increases of 6.6–37% in maximal strength; 3.4–7.5% in muscle mass, 8.2% in muscle power, 4.7–58.1% in functional capacity and risk of falls, although some studies did not show enhancements.ConclusionFrequency of 1–6 sessions per week, training volume of 1–3 sets of 6–15 repetitions and intensity of 30–70%1-RM promoted significant enhancements on muscle strength, muscle power, and functional outcomes. Therefore, in agreement with previous studies, we suggest that supervised and controlled RT represents an effective intervention in frailty treatment.

Effectiveness of Multimodal Training on Functional Capacity in Frail Older People: A Meta-Analysis of Randomized Controls Trials.

In this meta-analysis, we investigated the effect of resistance training (RT) alone or included in a multimodal training on physical frailty outcomes, and whether different variables of RT prescription affect these outcomes. We identified 15 relevant studies searching through MEDLINE, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PEDro database. Postintervention standardized mean difference scores were computed and combined using fixed effects meta-analysis. Analyses have shown positive effects of interventions on maximum strength, gait speed, and Timed Up and Go test. Further analyses have shown significant greater effect of shorter periods on maximum strength. Regarding RT prescription, percentage of one-repetition maximum showed significant effect on physical variables, whereas RT based on rate of perceived effort presented lower effect in the Timed Up and Go test. Although multimodal training is an effective intervention to increase physical capacity, caution should be taken regarding the period and the method to control RT intensity to optimize enhancements in frail older people.

Diuretic or sodium-restricted diet for obstructive sleep apnea—a randomized trial

Study Objectives Interventions that decrease leg fluid retention reduce obstructive sleep apnea (OSA) severity in nonrandomized experiments. We aimed to investigate in a randomized trial the effect of interventions that reduce fluid volume on OSA severity. Methods Men diagnosed with severe OSA were randomized to receive daily spironolactone 100 mg + furosemide 20 mg or nutritional counseling to sodium-restricted diet plus placebo pill or placebo pill. All participants underwent home sleep apnea testing at baseline and after 1 week follow-up. The change in apnea-hypopnea index (AHI) was the primary outcome. Results The study included 54 participants and all were assessed at follow-up. The average baseline value of the AHI was similar among groups and from baseline to follow-up the AHI reduced 14.4 per cent (δ value -7.3 events per hour; 95% confidence interval, -13.8 to -0.9) in the diuretic group, 22.3 per cent (-10.7; 95% CI, -15.6 to -5.7) in the diet group, and 0.8 per cent (0.4; 95% CI, -2.5 to 3.2) in the placebo group (p = .001 for time × group interaction). None of the patients had their AHI returned to normal. The reduction in the total body water was 2.2 ± 2.2 L in the diuretic group (p < .001) and 1.0 ± 1.6 l in the low salt diet group (p = .002). Sleepiness and neck circumference were significantly reduced only in the diet group (p = .007 and p < .001 for the time × group interactions, respectively). Conclusions Interventions to reduce bodily fluid content in men with severe OSA promoted a limited decrease of apnea frequency. This finding suggests that rostral fluid displacement affects only partially the OSA severity and/or that other factors prevail in determining pharyngeal collapsibility. Clinical Trial Sodium-Restricted Diet and Diuretic in the Treatment of Severe Sleep Apnea (DESALT), https://clinicaltrials.gov/ct2/show/NCT01945801 ClinicalTrials.gov number: NCT01945801.

Repetitions to failure versus not to failure during concurrent training in healthy elderly men: A randomized clinical trial

ABSTRACT This randomized clinical trial compared the neuromuscular adaptations induced by concurrent training (CT) performed with repetitions to concentric failure and not to failure in elderly men. Fifty‐two individuals (66.2±5.2years) completed the pre‐ and post‐measurements and were divided into three groups: repetitions to failure (RFG, n=17); repetitions not to failure (NFG, n=20); and repetitions not to failure with total volume equalized to RFG (ENFG, n=15). Participants were assessed in isometric knee extension peak torque (PTiso), maximal strength (1RM) in the leg press (LP) and knee extension (KE) exercises, quadriceps femoris muscle thickness (QF MT), specific tension, rate of torque development (RTD) at 50, 100 and 250ms, countermovement jump (CMJ) and squat jump (SJ) performance, as well as maximal neuromuscular activity (EMGmax) of the vastus lateralis (VL) and rectus femoris (RF) muscles. CT was performed over 12weeks, twice weekly. Along with each specific strength training program, each group also underwent an endurance training in the same session. After training, all groups improved similarly and significantly in LP and KE 1RM, PTiso, CMJ and SJ performance, RTD variables, specific tension, and VL EMGmax, (P<0.05–0.001). QF MT improved only in RFG and ENFG (P<0.01). These results suggest that repetitions until concentric failure does not provide further neuromuscular performance gains and muscle hypertrophy, and that even a low number of repetitions relative to the maximal possible (i.e., 50%) optimizes neuromuscular performance in elderly men. Moreover, training volume appears to be more important for muscle hypertrophy than training using maximal repetitions. HIGHLIGHTSIs there a need to perform repetitions to failure during strength training in elderly?It is unclear the minimal dose of strength training to optimize the adaptations in elderly.Repetitions to failure do not provide further neuromuscular gains in elderly.Low volume relative to the maximal per set optimizes neuromuscular gains in elderly.Greater volume of repetitions induces greater muscle hypertrophy in elderly men.

Higher muscle power training volume is not determinant for the magnitude of neuromuscular improvements in elderly women

&NA; The aim of this study was to compare the effects of 12 weeks of muscle power training using one‐ and three‐sets on neuromuscular adaptations in elderly women. Twenty six healthy elderly women were randomly assigned into two groups: one‐set (n = 13) and three‐sets (n = 13). Maximal dynamic and isometric strength, rapid force assessed as absolute and normalized rate of force development (RTD) and contractile impulse during unilateral leg knee extension at 0–50 and 0–200 ms, overall quadriceps muscle thickness, muscle power during a countermovement jump (CMJ), and functional performance using time‐up‐and‐go and the timed stair climb tests were evaluated before and after training. After 12 weeks, one‐set and three‐sets groups exhibited significant (p ≤ 0.05) and comparable increases in dynamic and isometric strength, absolute RTD and contractile impulse at 0–50 and at 0–200 ms and in the performance of both functional tests. No significant differences between groups were evident for any measured parameters (p > 0.05). Furthermore, the normalized RTD did not increase for any group (p > 0.05). Over 12 weeks, the muscle power training performing one‐ or three‐sets induced alike improvements in muscle function, mass and functionally. These evidences suggest that a low training volume is able to induce significant improvements in age‐related neuromuscular changes. HighlightsThe decline of the muscle power is a consequence of the aging process.Muscle power training is effective for mitigating impairments related to the aging.Muscle power training to mitigate declines in strength, muscle mass and muscle power.Muscle power training with one‐set promote significant neuromuscular improvements

Heat-induced extracellular HSP72 release is blunted in elderly diabetic people compared with healthy middle-aged and older adults, but it is partially restored by resistance training

Abstract Recent evidence suggests that the anti‐inflammatory heat shock response (HSR) is reduced in aging and diabetes. In this study we compared HSR between healthy middle‐aged adults, healthy elderly and type 2 diabetic (T2DM) elderly, and tested whether resistance training (RT) could improve the HSR in T2DM group. Thirty sedentary participants volunteered for this study. HSR (assessed as the capacity to export HSP72 during heat stress) was measured in the blood and compared between the groups. HSR was similar between healthy middle‐aged and healthy elderly volunteers, but diminished in elderly T2DM (p < 0.001). Hence, T2DM subjects (n = 12) were submitted to a 12‐week RT program, because exercise is a physiological HSR inducer. HSR, cytokines, metabolic parameters and visceral adipose tissue (VAT) were measured before and after the RT. Remarkably, VAT was negatively correlated with HSR (r = − 0.49, p < 0.01) while RT improved the HSR and reduced inflammation [TNF‐&agr;: from 51.5 ± 9 to 40.7 ± 4 pg/mL and TNF‐&agr;/IL‐10 ratio: from 1.55 ± 0.3 to 1.16 ± 0.2 (p < 0.001)], without affecting other parameters. All together, these findings confirm the hypothesis that the anti‐inflammatory HSR is depressed in elderly diabetic people, but can be partially restored by RT. HighlightsHeat Shock Response (HSR) is similar in healthy middle‐aged and elderly people, but is blunted in aged T2DM individuals.Visceral Adipose Tissue (VAT) is increased with age, and the increased VAT is correlated with a lower HSR.Resistance training (RT) is an efficient intervention to restore the HSR and reduce inflammation in aged T2DM individuals.Restoration of HSR may delay the appearance and the establishment of inflammatory‐related diseases.

Alternative assessment of knee joint muscle balance of soccer players through total work-based hamstring: quadriceps ratios

Abstract Isokinetic hamstring-to-quadriceps (H:Q) ratios are frequently used to assess knee muscle strength imbalances and risk of injuries/re-injuries. The use of peak torque (PT) or total work (TW) to estimate joint stability may lead to different results because of the differences between these two neuromuscular variables. Thus, the current study aimed to compare the conventional and functional H:Q ratios calculated by PT and TW. Ninety-three male professional soccer players from Brazilian first division teams performed isokinetic concentric and eccentric contractions of the quadriceps and the hamstrings at 60°/s. Muscle strength balance was calculated using the conventional torque ratio (CTR) and conventional work ratio (CWR), functional torque ratio (FTR) and functional work ratio (FWR) were highly and moderately correlated between them (r = 0.83 and r = 0.73, respectively). The Wilcoxon statistical test revealed significant differences between CTR and CWR, as well as FTR and FWR (p < 0.05). T-test demonstrated significant differences in mean CTR–CWR and FTR–FWR, whereas Bland–Altman plots showed non-consistent bias. In addition, the chi-square test demonstrated significant differences between players below the conventional reference values and functional reference values (p < 0.001). In conclusion, TW ratios seem to provide distinct and additional information regarding the H:Q strength balance in professional soccer players. Moreover, taking into account that TW captures torque information throughout the entire range of motion, it is possible that TW ratios represent a more comprehensive assessment of muscle strength imbalance.