Simon von Stengel

Effect of Compression Stockings on Running Performance in Men Runners

Kemmler, W, von Stengel, S, Köckritz, C, Mayhew, J, Wassermann, A, and Zapf, J. Effect of compression stockings on running performance in men runners. J Strength Cond Res 23(1): 101-105, 2009-The purpose of this study was to determine the effect of below-knee compression stockings on running performance in men runners. Using a within-group study design, 21 moderately trained athletes (39.3 ± 10.9 years) without lower-leg abnormities were randomly assigned to perform a stepwise treadmill test up to a voluntary maximum with and without below-knee compressive stockings. The second treadmill test was completed within 10 days of recovery. Maximum running performance was determined by time under load (minutes), work (kJ), and aerobic capacity (ml·kg−1·min−1). Velocity (km·h−1) and time under load were assessed at different metabolic thresholds using the Dickhuth et al. lactate threshold model. Time under load (36.44 vs. 35.03 minutes, effect size [ES]: 0.40) and total work (422 vs. 399 kJ, ES: 0.30) were significantly higher with compression stockings compared with running socks. However, only slight, nonsignificant differences were observed for &OV0312;o2max (53.3 vs. 52.2 ml·kg−1·min−1, ES: 0.18). Running performance at the anaerobic (minimum lactate + 1.5 mmol·L−1) threshold (14.11 vs. 13.90 km·h−1, ES: 0.22) and aerobic (minimum lactate + 0.5 mmol·L−1) thresholds (13.02 vs. 12.74 km·h−1, ES: 0.28) was significantly higher using compression stockings. Therefore, stockings with constant compression in the area of the calf muscle significantly improved running performance at different metabolic thresholds. However, the underlying mechanism was only partially explained by a slightly higher aerobic capacity.

Exercise Effects on Bone Mineral Density, Falls, Coronary Risk Factors, and Health Care Costs in Older Women: The Randomized Controlled Senior Fitness and Prevention (SEFIP) Study

BACKGROUND Physical exercise affects many risk factors and diseases and therefore can play a vital role in general disease prevention and treatment of elderly individuals and may reduce costs. We sought to determine whether a single exercise program affects fracture risk (bone mineral density [BMD] and falls), coronary heart disease (CHD) risk factors, and health care costs in community-dwelling elderly women. METHODS We conducted a randomized, single-blinded, controlled trial from May 1, 2005, through July 31, 2008, recruiting women 65 years or older who were living independently in the area of Erlangen-Nuremberg, Germany. In all, 246 women were randomly assigned to an 18-month exercise program (exercise group) or a wellness program (control group). The exercise group (n = 123) performed a multipurpose exercise program with special emphasis on exercise intensity; the controls (n = 123) focused on well-being with a low-intensity, low-frequency program. The main outcome measures were BMD, the number of falls, the Framingham-based 10-year CHD risk, and direct health care costs. RESULTS For the 227 women who completed the 18-month study, significant exercise effects were observed for BMD of the lumbar spine (mean [95% confidence interval (CI)] percentage of change in BMD [baseline to follow-up] for the exercise group: 1.77% [1.26% to 2.28%] vs controls: 0.33% [-0.24% to 0.91%]; P < .001), femoral neck (exercise group: 1.01% [0.37% to 1.65%] vs controls: -1.05% [-1.70% to -0.40%]; P < .001), and fall rate per person during 18 months (exercise group: 1.00 [0.76 to 1.24] vs controls: 1.66 [1.33 to 1.99]; P = .002). The 10-year CHD risk was significantly affected in both subgroups (absolute change for the exercise group: -1.96% [95% CI, -2.69% to -1.23%] vs controls: -1.15% [-1.69% to -0.62%]; P = .22), with no significant difference between the groups. The direct health care costs per participant during the 18-month intervention showed nonsignificant differences between the groups (exercise group: 2255 euros[95% CI, 1791 euros-2718 euros] vs controls: 2780 euros [2187 euros-3372 euros]; P = .20). CONCLUSION Compared with a general wellness program, our 18-month exercise program significantly improved BMD and fall risk, but not predicted CHD risk, in elderly women. This benefit occurred at no increase in direct costs. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00267839.

Differential effects of strength versus power training on bone mineral density in postmenopausal women: a 2-year longitudinal study

Objectives: To investigate the effect of two different schemes of loading in resistance training on bone mineral density (BMD) and pain in pretrained postmenopausal women. Methods: 53 pretrained women (mean (SD) age 58.2 (3.7) years) who carried out a mixed resistance and gymnastics programme were randomly assigned to a strength training (ST) or power training (PT) group. The difference between the two groups was the movement velocity during the resistance training (ST, 4 s (concentric)/4 s (eccentric); PT, explosive/4 s). Otherwise both groups carried out periodised progressive resistance training (10–12 exercises, 2–4 sets, 4–12 repetitions at 70–92.5% of the one-repetition maximum (2/week) for 2 years. Mechanical loading was determined with a force measuring plate during the leg press exercise. At baseline and after 2 years, BMD was measured at different sites with dual x-ray absorptiometry. Pain was assessed by questionnaire. Results: Loading magnitude, loading/unloading rate, loading amplitude and loading frequency differed significantly (p<0.001) between the two groups. After 2 years, significant between-group differences were detected for BMD (PT, −0.3%; ST, −2.4%; p<0.05) and bone area (PT, 0.4%; ST, −0.9%; p<0.05) at the lumbar spine. At the hip, there was a non-significant trend in favour of the PT group. Also the incidence of pain indicators at the lumbar spine was more favourable in the PT group. Conclusion: The results show that PT may be superior for maintaining BMD in postmenopausal women. Furthermore, PT was safe as it did not lead to increased injury or pain.

Effects of whole-body vibration training on different devices on bone mineral density.

PURPOSE Whole-body vibration (WBV) is a new nonpharmacological approach to counteract osteoporosis. However, the specific vibration protocol to most effectively reduce osteoporotic risk has not been reported. In the ELVIS II (Erlangen Longitudinal Vibration Study II) trial, we determined the effect of different WBV devices on bone mineral density (BMD) and neuromuscular performance. METHODS A total of 108 postmenopausal women (65.8 ± 3.5 yr) were randomly allocated to 1) rotational vibration training (RVT), i.e., 12.5 Hz, 12 mm, three sessions per week, for 15 min, including dynamic squat exercises; 2) vertical vibration training (VVT), i.e., 35 Hz, 1.7 mm, as above; and 3) a wellness control group (CG), i.e., two blocks of 10 low-intensity gymnastics sessions. BMD was measured at the hip and lumbar spine at baseline and after 12 months of training using dual-energy x-ray absorptiomety. Maximum isometric leg extension strength and leg power were determined using force plates. RESULTS A BMD gain at the lumbar spine was observed in both vibration VT groups (RVT = +0.7% ± 2.2%, VVT = +0.5% ± 2.0%), which was significant compared with the CG value (-0.4% ± 2.0%) for RVT (P = 0.04) and borderline nonsignificant for VVT (P = 0.08). In the neck region, no significant treatment effect occurred. Neck BMD values tended to increase in both VT groups (RVT = +0.3% ± 2.7%, VVT = +1.1% ± 3.4%) and remained stable in CG (-0.0% ± 2.1%).Both VT groups gained maximum leg strength (RVT = +27% ± 22%, VVT = +24% ± 34%) compared with CG (+6% ± 20%, P = 0.000), whereas power measurements did not reach the level of significance (P = 0.1). CONCLUSIONS WBV training is effective for reducing the risk for osteoporosis by increasing lumbar BMD and leg strength.

Exercise effects on menopausal risk factors of early postmenopausal women: 3-yr Erlangen fitness osteoporosis prevention study results.

PURPOSE To determine the impact of multipurpose exercise training on bone, body composition, blood lipids, physical fitness, and menopausal symptoms in early postmenopausal women with osteopenia. METHODS Forty-eight fully compliant (more than two sessions per week for 38 months) women (55.1 +/- 3.3 yr) without any medication or illness affecting bone metabolism took part in the exercise training (EG); 30 women (55.5 +/- 3.0 yr) served as the nontraining control group (CG). Both groups were individually supplemented with calcium and vitamin D. Bone mineral density (BMD) at various sites (lumbar spine, hip, forearm, calcaneus) was measured by dual x-ray absorptiometry (DXA) and quantitative ultrasound (QUS). Maximal isometric and dynamic strength, maximal oxygen consumption (VO(2max)), CHD risk factors (blood lipids, body composition), and menopausal symptoms were determined. RESULTS After 38 months, significant differences between EG and CG were observed for the BMD at the lumbar spine (0.7% vs -3.0%) and the femoral neck (-0.7% vs -2.6%), body composition (waist circumference, waist-to-hip ratio), blood lipids (total cholesterol, triglycerides), and menopausal symptoms (insomnia, migraines, mood changes). Maximal isometric strength increased significantly by 10-36% in the EG, whereas, with one exception, changes in the CG were all negative. One-repetition maximum increased significantly at all sites measured (15-43%, P < 0.001). VO(2max) of the EG increased throughout the study with a significant 13.9 +/- 15.6% net increase after 3 yr. No significant changes after 3 yr could be observed in the CG. CONCLUSIONS Our mixed high-intensity exercise program effectively compensates for most negative changes related to the menopausal transition.

Exercise, Body Composition, and Functional Ability: A Randomized Controlled Trial

CONTEXT In women, age and the menopausal transition contribute to an increase of body fat and a reduction of lean body mass associated with functional decline, affecting independent living. BACKGROUND Sarcopenia and adiposity in the elderly has been associated with increased mortality and functional decline affecting independent living. PURPOSE This study was conducted to determine the effect of a multipurpose exercise program on the body composition and functional ability of elderly women living in a community. DESIGN An 18-month single-blinded RCT comparing participants in an exercise program with an active control group was conducted from May 2005 through December 2007. Analyses were conducted from January 2008 to July 2008. SETTING/PARTICIPANTS Two hundred forty-six women (aged 69.1+/-4.0 years) living independently in the area of Erlangen-Nürnberg (Germany) participated in the study. INTERVENTION Subjects (n=123) performed a multipurpose exercise program with special emphasis on exercise intensity but with low-level requirements for training facilities and materials. The 123 women in the control group focused primarily on well-being. MAIN OUTCOME MEASURES Body composition was assessed by dual-energy x-ray absorptiometry. Further, strength was evaluated using isometric techniques for the back and legs. Aerobic fitness was determined from a progressive-intensity treadmill test. RESULTS After 18 months, significant effects in favor of the exercise program for body composition were increases in appendicular skeletal muscle mass and lean body mass along with reductions in abdominal fat and total body fat. Significant performance effects also favored the exercise program and included enhanced isometric maximum trunk-extensor and leg press strength, leg press power, timed up-and-go test, and aerobic fitness. CONCLUSIONS A high-intensity multipurpose exercise program produced significant improvements in body composition and functional ability in a cohort of elderly women living in a community.

Exercise decreases the risk of metabolic syndrome in elderly females.

PURPOSE To determine the effect of exercise based on a multiple purpose, high-intensity philosophy on parameters of metabolic syndrome (MetS) in older females with the MetS. METHODS Thirty-two women (68.7 +/- 3.4 yr) with the MetS according to the International Diabetes Federation (IDF) took part in the exercise training (EG), and 33 females (69.5 +/- 4.3 yr) also with MetS served as control group (CG). Beside the diagnostic tools of the MetS (waist circumference, triglycerides, HDL-C, blood pressure, and glucose), corresponding anthropometric parameters, total cholesterol, and high-sensitivity C-reactive protein (hsCRP) were determined. RESULTS After 12 months of exercise, significant effects were observed for total body fat [EG: -1287 g vs CG: +484 g; P = 0.001; confidence interval (CI) = -2787 to -744 g], trunk fat (-1070 vs -203 g; P = 0.005; CI = -1460 to -274 g), hip circumference (-2.1 vs +1.0 cm; P = 0.001; CI = -4.8 to -1.3 cm), triglycerides: (-24.1 vs -0.3 mg dL(-1); P = 0.021; CI = -43.9 to -3.7 mg dL(-1)), total cholesterol: (-19.8 vs +0.2 mg dL(-1); P = 0.008; CI = -34.6 to -5.5 mg dL(-1)), and HDL-C: (+3.8 vs -0.2 mg dL(-1); P = 0.036; CI = 0.3 to 7.6 mg dL(-1)). Waist circumference slightly decreased in both groups (EG: -0.7% vs CG: -0.6%; P = 0.94). Resting systolic (-7.1 vs -6.4 mm Hg; P = 0.84) and diastolic (-8.0 vs -+9.8 mm Hg; P = 0.39) blood pressure significantly decreased in both groups. Changes of glucose and hsCRP did not significantly vary between groups (glucose: +0.7 vs +1.0 mg dL(-1), P = 0.88; hsCRP: -0.68 vs -0.50 mg L(-1), P = 0.36). The number of criteria of the MetS significantly decreased in the EG (4.13-3.66) and slightly decreased in the CG (4.12-3.97); however, significant time group interactions were not observed (P = 0.15; CI = -0.74 to 0.12). CONCLUSION Our multipurpose exercise program significantly affects most parameters of the MetS in elderly women.

Effects of Whole-body Electromyostimulation on Resting Metabolic Rate, Body Composition, and Maximum Strength in Postmenopausal Women: the Training and Electrostimulation Trial

Kemmler, W, Schliffka, R, Mayhew, JL, and von Stengel, S. Effects of whole-body electromyostimulation on resting metabolic rate, body composition, and maximum strength in postmenopausal women: the Training and ElectroStimulation Trial. J Strength Cond Res 24(7): 1880-1887, 2010-We evaluated the effect of whole-body electromyostimulation (WB-EMS) during dynamic exercises over 14 weeks on anthropometric, physiological, and muscular parameters in postmenopausal women. Thirty women (64.5 ± 5.5 years) with experience in physical training (>3 years) were randomly assigned either to a control group (CON, n = 15) that maintained their general training program (2 × 60 min·wk−1 of endurance and dynamic strength exercise) or to an electromyostimulation group (WB-EMS, n = 15) that additionally performed a 20-minute WB-EMS training (2 × 20 min·10 d−1). Resting metabolic rate (RMR) determined from spirometry was selected to indicate muscle mass. In addition, body circumferences, subcutaneous skinfolds, strength, power, and dropout and adherence values. Resting metabolic rate was maintained in WB-EMS (−0.1 ± 4.8 kcal·h−1) and decreased in CON (−3.2±5.2 kcal·h−1, p = 0.038); although group differences were not significant (p = 0.095), there was a moderately strong effect size (ES = 0.62). Sum of skinfolds (28.6%) and waist circumference (22.3%) significantly decreased in WB-EMS whereas both parameters (1.4 and 0.1%, respectively) increased in CON (p = 0.001, ES = 1.37 and 1.64, respectively), whereas both parameters increased in CON (1.4 and 0.1%, respectively). Isometric strength changes of the trunk extensors and leg extensors differed significantly (p ≤ 0.006) between WB-EMS and CON (9.9% vs. −6.4%, ES = 1.53; 9.6% vs. −4.5%, ES = 1.43, respectively). In summary, adjunct WB-EMS training significantly exceeds the effect of isolated endurance and resistance type exercise on fitness and fatness parameters. Further, we conclude that for elderly subjects unable or unwilling to perform dynamic strength exercises, electromyostimulation may be a smooth alternative to maintain lean body mass, strength, and power.

Long-term four-year exercise has a positive effect on menopausal risk factors: the Erlangen Fitness Osteoporosis Prevention Study.

The purpose of the study was to determine the effect of long-term exercise on coronary heart disease, osteoporotic risk factors, and physical fitness parameters in postmenopausal women. Forty early postmenopausal women (age 55.1 ± 3.3 years) with no medication or illness affecting bone metabolism exercised (high impact aerobic, multilateral jumps, multi-set resistance exercise) for 50 months (EG), while 28 women (age 55.5 ± 3.0 years) served as a nontraining control (CG). Both groups were supplemented with calcium and cholecalciferol. Bone mineral density (BMD) was measured at the lumbar spine, hip, and forearm by dual energy x-ray absorptiometry. Blood lipids were determined using serum samples, and body composition was determined using the bioimpedance technique. Further, maximum isometric strength was determined (Schnell M3, Schnell Trainer). The BMD at the lumbar spine (+1.0%, p = 0.037) and the total hip (−0.3%, p = 0.194) were maintained in the EG, while significant (p < 0.001) decreases were observed in the CG (lumbar spine −3.2; total hip −2.3%). Differences between both groups were significant (p < 0.001). Significant differences between EG and CG were also observed, respectively, for total cholesterol (−6.1 vs. +3.5%, p = 0.008), HDL-cholesterol (+14.1 vs. −7.1%, p = 0.007), triglycerides (−10.2 vs. +27.5%, p = 0.002), body fat (−3.3 vs. +1.3%, p = 0.041), and waist-hip-ratio (−3.5 vs. +0.2%, p > 0.001). Maximum isometric strength significantly (p < 0.001) increased in the EG, while strength parameters decreased in the CG (−0.5 to −6.4%). Thus, the study demonstrated that multipurpose high-intensity exercise programs significantly affect relevant menopausal risk factors and, therefore, may be individually considered as an alternative to hormone replacement therapy.

Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TesT-III trial

Background The primary aim of this study was to determine the effect of 12 months of whole-body electromyostimulation (WB-EMS) exercise on appendicular muscle mass and abdominal fat mass in subjects specifically at risk for sarcopenia and abdominal obesity, but unable or unwilling to exercise conventionally. Methods Forty-six lean, nonsportive (<60 minutes of exercise per week), elderly women (aged 75 ± 4 years) with abdominal obesity according to International Diabetes Federation criteria were randomly assigned to either a WB-EMS group (n=23) which performed 18 minutes of intermittent, bipolar WB-EMS (85 Hz) three sessions in 14 days or an “active” control group (n=23). Whole-body and regional body composition was assessed by dual energy X-ray absorptiometry to determine appendicular muscle mass, upper leg muscle mass, abdominal fat mass, and upper leg fat mass. Maximum strength of the leg extensors was determined isometrically by force plates. Results After 12 months, significant intergroup differences were detected for the primary end-points of appendicular muscle mass (0.5% ± 2.0% for the WB-EMS group versus −0.8% ± 2.0% for the control group, P=0.025) and abdominal fat mass (−1.2% ± 5.9% for the WB-EMS group versus 2.4% ± 5.8% for the control group, P=0.038). Further, upper leg lean muscle mass changed favorably in the WB-EMS group (0.5% ± 2.5% versus −0.9% ± 1.9%, in the control group, P=0.033), while effects for upper leg fat mass were borderline nonsignificant (−0.8% ± 3.5% for the WB-EMS group versus 1.0% ± 2.6% for the control group, P=0.050). With respect to functional parameters, the effects for leg extensor strength were again significant, with more favorable changes in the WB-EMS group (9.1% ± 11.2% versus 1.0% ± 8.1% in the control group, P=0.010). Conclusion In summary, WB-EMS showed positive effects on the parameters of sarcopenia and regional fat accumulation. Further, considering the good acceptance of this technology by this nonsportive elderly cohort at risk for sarcopenia and abdominal obesity, WB-EMS may be a less off-putting alternative to impact appendicular muscle mass and abdominal fat mass, at least for subjects unwilling or unable to exercise conventionally.