4. To determine
• Feasibility
• Physiological consequences
• High-resistance strength training in the
frail elderly
Aims
5. •
•
•
•
•
Long term care facility (“nursing home”)
Ambulatory
Not acutely ill
Follow instructions
No unstable disease
Participants
6. Characteristic
Age (y)
F
Mean±SEM
90.2 (1.1)
6
M
Length of stay (y)
Hx of falls
Use of assistive
device
Chronic dz/person
Daily meds/person
4
3.4(0.8)
8
7
4.5 (0.6)
4.4 (0.8)
Range
86-96
0.7-8.3
2-7
0-9
Participant Characteristics (Table 1.)
7. • Body composition
• Total and regional
• Diet records
• 1RM
• Safety measures
• Functional mobility
Measures
8. •
•
•
•
8 weeks
Con/Ecc leg extension
3 x/wk
3 sets of 8
• 6-9 seconds
• 1-2 min rest
• 80% 1RM
• 2 & 4 weeks of detraining
Training
9. • Level of care
• Excluded
• MI
• Fracture
• Behavioral
• Arthritis
Results: Participants
10. • 40% signs of under nutrition
• FFM higher in men than in women
• SSkFs highly related to BF% (r=0.89,
P<.001)
• Regional muscle area highly related to
total body FFM (r=.98, P<.0001)
Results: Participants
11. • Right leg: 9.0±1.4
• Left leg: 8.9±1.7
• Corr with FFM
(r=.732; P<.01)
• Corr with thigh
muscle area
(r=.752, P<.01)
• Dietary intake
• Chair stand
2.2±0.5 sec
• 6m walk time
22.2±4.6 sec
• Both related to
1RM (how?)
Results: Baseline Muscle Function
12.
13. •
•
•
•
9 of 10 completed protocol
98.8% attendance
No CV complications
Minor joint discomfort
Response to Training
14. • 174 ± 31% increase
• 8.02±1.0 kg to 20.6 ± 2.4 kg (right)
• 7.6±1.3 kg to 19.3±2.2 kg (left)
• No plateau
• Same among men and women
Muscle Strength
15.
16. • No change in gait speed
• Tandem gait improvements (N=5)
• 2 no longer needed canes
• 1 of 3 could rise from chair w/o arms
Clinical Outcomes
17. • Dramatic increases in strength
• 61-374% (!!!)
• Reversal of age-related weakness
• Principle of specificity
• Previous research
• Remarkable findings given potential limitations of
population
• Familiarization??
• Hypertrophy or neural improvements?
• Well tolerated
• Limitations
• Safety of training versus not training (ie, falls)
Discussion
18. • Bassey et al., 1992
• Clinical Science
Leg extensor power and
functional performance
in very old men and
women
19. • Power is the basis for daily activities
• Short time requirement
• Importance of leg extensors in ADLs
….To what extent power output …..predicted performance
in older people
Rationale & Aim
20. • Same location as in Fiatarone et al., 1990
• N=26
• Familiar with procedures (presumably
study staff)
• Ambulatory but often used wheelchairs
• Meds, falls, chronic conditions
• Some cognitive impairment
Participants
21. Men
(N=13)
Age
Wt (kg) Ht (m)
(yrs)
88 (1.6) 64.7
1.58
(2.7)
(0.03)
# of
CCs*
64
# of
Meds
5.2 (2.4)
Women
(N=13)
85 (1.5) 54.7
(2.8)
55
5.2 (2.1)
1.50
(0.03)
* Diabetes, hypertension, heart disease, Parkinson’s,
neurological disease, arthritis, syncope, musculoskeletal defect, cancer, other
Participants
22. • Leg extensor power (<1 sec)
• Right, left, both, best
• Chair rising (1 time)
• Stair climbing (4 steps)
• Walking (6 m)
Measures
23. • All completed
• Leg extensor power
• Walking speed
• Chair rise
• N=1 (man)
• Stair climb
• N=3 (women)
Results
30. •
•
•
•
•
•
Feasibility
Normative data for power?
Power vs strength
Differences between men and women
Performance of participants
Threshold values
• Walking (is this about balance?)
• All
• Cause-effect?
Discussion
31. • Muscle strength
• Muscle power
• Feasibility
• Approach to training?
• Specificity!!
Summary
