Influence of Strength Training on the Physical Condition of Elderly, Obese and Sarcopenic People

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Participants were physically inactive and obese older adults (65 years, BMI 30 kg/m2), with no serious illness. They were divided into a group with sarcopenia (SAR, n = 28) and a group with no or sarcopenia (NSAR, n = 20). Sarcopenia was evaluated using the Short Physical Performance Battery (SPPB), hand-grip strength and skeletal muscle mass index (IMS). The participants developed a progressive strength training, which was carried out on machines (Cybex EAGLE, SANIMED Nordic line).

Before they were allowed to begin training, they had to undergo a medical examination, particularly a check-up of the cardiovascular system. The training lasted 16 weeks with 2 sessions of 60 minutes per week. Previous studies showed increases in muscle, hypertrophy in older and/or obese adults after only 4 months of training. The conditions of resistance training (e.g., duration, frequency, intensity) were adopted from the American College of Sports Medicine recommendations for elderly, healthy adults and adults with type 2 diabetes.

During the first 3 weeks, participants trained at 60% of maximum strength and performed 2 sets of 12 to 15 repetitions for each muscle group. During weeks 4 to 16, participants gradually increased the intensity to 80% to 85% of maximum strength and performed 3 sets of 8 to 12 repetitions. The key points for the progression of the loads were generated by the Westcott and Baechle recommendations. group. Sarcopenia was evaluated using the Short Physical Performance Battery (SPPB), hand-grip strength and skeletal muscle mass index (IMS).

The participants developed a progressive strength training, which was carried out on machines (Cybex EAGLE, SANIMED Nordic line). Before they were allowed to begin training, they had to undergo a medical examination, particularly a check-up of the cardiovascular system. The training lasted 16 weeks with 2 sessions of 60 minutes per week. Previous studies showed increases in muscle hypertrophy in older and/or obese adults after only 4 months of training. The conditions of resistance training (e.g., duration, frequency, intensity) were adopted from the American College of Sports Medicine recommendations for elderly, healthy adults and adults with type 2 diabetes.

During the first 3 weeks, participants trained at 60% of maximum strength and performed 2 sets of 12 to 15 repetitions for each muscle group. During weeks 4 to 16, participants gradually increased the intensity to 80% to 85% of maximum strength and performed 3 sets of 8 to 12 repetitions. The key points for the progression of the loads were generated by the Westcott and Baechle recommendations. They recommended increasing weights by 5% or less (depending on the muscle group) for healthy older people. One session consisted of a 10-minute warm-up on a bicycle ergometer. Then followed the main training, which contained 7 exercises for the main muscle groups in general (knee extensors, elbow flexors and chest muscles, hip adductors and abductors, abdominal muscles, back muscles). For the return to calm, the participants carried out about 5 minutes of work with a cycling ergometer.

Participants classified with sarcopenic were able to increase their initial performance in all fitness parameters, i.e., manual grip force, walking speed, Short Physical Performance Battery and modified Physical Performance Test score. In the last two tests, they were able to reach the reference performance values of the NSAR group. In contrast, no changes in muscle mass were found after training. The Short Physical Performance Battery is often used in older adults living in the community to predict the risk of loss of the ability to live independently and is also identified as a standard measure for research and clinical practice. Previous studies showed that older adults with the lowest Short Physical Performance Battery scores were more likely to experience disability in daily life compared to those with the highest scores. Both groups were even able to increase their scores after training. Our participants were able to increase their scores by 0.95 (NSAR group) and 1.17 (SAR group).

Gait speed is also an important assessment tool when examining older adults. Abellan van Kan and colleagues found that walking at a usual rate is a consistent risk factor for disability, cognitive impairment, institutionalization, falls, and/or mortality. In addition, they specified that older adult who walks faster than 1.0 m/s generally have a lower risk of disease and a better survival rate. In addition, they considered that the cut-off point could be 0.8 m/s for the risk of adverse outcomes when using a 4 m duration cycle. Our participants walked more than 1 m/s even before the training. But the members of the SAR group were able to increase their walking speed after training by 5% or 0.5 m/s. The NSAR group kept its constant walking speed at a high level after training and increased its walking speed by 2.8%.

In conclusion, participants in both groups were able to increase their performance in several parameters after strength training. The SAR group was partially able to reach the initial condition of the NSAR group. Therefore, these results showed that older people with obesity and sarcopenia may also develop substantial improvements due to strength training. These improvements in muscle function can help them live a functionally independent life and can reduce the risk of disability and falls.

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