THE EFFECTS OF DIFFERENT EXERCISE-BASED INTERVENTIONS ON FUNCTIONAL FITNESS OF OLDER ADULTS
Abstract
Ageing is a multifactorial process associated with several irreversible functional and cognitive alterations of human body and determined by genetic and environmental factors. We aimed to investigate the effects of three physical activity interventions of 40 independently living older adults before and after a 3-month training period. Thirty female (69.6 ± 5.3 years) and ten male (70.6 ± 5.4 years) participants were randomly assigned into a physical exercise group (PEG; N = 9), a concurrent physical and cognitive exercise group (PEG + COG; N = 10), a physical exercise with additional 10 g of BCAA daily supplementation group (PEG+BCAA; N = 11), and a control group (CG; N = 10). All three groups performed the same physical exercise program for 12 weeks, three days a week for 45 − 60 minutes per session. Pre- and post-measurements were performed using a standardized functional fitness assessment tool for older adults i.e. Senior Fitness Test battery, upgraded with the Four Square Step Test (FSST) and Grip Strength Test (GST). When intervention groups were pooled, we found moderate to low improvements in the Chair Stand Up, Timed Up and Go, FSST and Six-minute Walk Tests (all P < .001). However, those improvements were intervention-specific with highest improvements found in the PEG for the FSST (P = .004) and Six-minute Walk Test (P = .004); in the PEG + COG for the Timed Up and Go Test (P < .001); and in the PEG+BCAA for body mass (P = .012) and the Chair Stand Up Test (P < .001). Although the sample size was low, our study provides further evidence of different interventional exercise-based programs that can benefit the population of independently living older adults.
References
Atkinson H. H., et al. (2007). Cognitive function, gait speed decline, and comorbidities: The Health, Aging and Body Composition Study. Journals of gerontology. Series A, Biological sciences and medical sciences, 62(8), 844–850.
Ball, K., Berch, D., & Helmers, K. (2002). Effects of cognitive training interventions with older adults. JAMA : Journal of the American Medical Association, 288(18), 2271–2281.
Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E., et al. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. Journal of the american Medical Directors association, 14(8), 542-559.
Baum, J. I., Kim, I.-Y., & Wolfe, R. R. (2016). Protein consumption and the elderly: what is the optimal level of intake? Nutrients, 8(6), 359
Baumgartner, R. N. (2000). Body composition in healthy aging. Annals of the New York Academy of Sciences, 904, 437–448.
Blair, S. N., Kohl, H. W., Paffenbarger, R. S., Clark, D. G., Cooper, K. H., & Gibbons, L. W. (1989). Physical fitness and all-cause mortality. JAMA: Journal of the American Medical Association, 262(17), 2395–2401.
Buchman, A. S., Boyle, P. A., Yu, L., Shah, R. C., Wilson, R. S., & Bennett, D. A. (2012). Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology, 78(17), 1323–1329.
Cermak, N. M., de Groot, L. C., Saris, W. H., & van Loon, L. J. (2012). Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. The American journal of clinical nutrition, 96(6), 1454-1464.
Chalé, A., Cloutier, G. J., Hau, C., Phillips, E. M., Dallal, G. E., & Fielding, R. A. (2012). Efficacy of whey protein supplementation on resistance exercise–induced changes in lean mass, muscle strength, and physical function in mobility-limited older adults. Journals of gerontology. Series A, Biological sciences and medical sciences, 68(6), 682-690.
Chang, T. J., Morton, C. S., Rubenstein, Z. L., Mojica, A. W., Maglione, M., Suttorp, J. M., et al. (2004). Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials, BMJ, 328(March), 1–7.
Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009). Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7), 1510–1530.
Choudry, H. A., Pan, M., Karinch, A. M., & Souba, W. W. (2006). Branched-chain amino acid-enriched nutritional support in surgical and cancer patients. The Journal of nutrition, 136(1), 314S-318S.
Clark, B. C., & Manini, T. M. (2008). Sarcopenia ≠ Dynapenia. Journals of gerontology. Series A, Biological sciences and medical sciences, 63(8), 829–834.
Coombes, J. S., & McNaughton, L. S. (2000). Effects of branched-chain amino acid supplementation on serum creatine kinase and lactate dehydrogenase after prolonged exercise. Journal of sports medicine and physical fitness, 40(3), 240-246.
Cruz-Jentoft, A. J., Landi, F., Schneider, S. M., Zúñiga, C., Arai, H., Boirie, Y., et al. (2014). Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age and ageing, 43(6), 748-759.
Cyarto, E. V., Brown, W. J., Marshall, A. L., & Trost, S. G. (2008). Comparison of the effects of a home-based and group-based resistance training program on functional ability in older adults. American Journal of Health Promotion, 23(1), 13–17.
Dite, W., & Temple, V. A. (2002). A clinical test of stepping and change of direction to identify multiple falling older adults. Archives of Physical Medicine Rehabilitation, 83(11), 1566–1571.
Edwards, J. D., Wadley, V. G., Vance D. E., Wood K., Roenker, D. L., Ball, K. K. (2005). The impact of speed of processing training on cognitive and everyday performance. Aging & Mental Health, 9(3), 262–271.
Fiatarone, A. M., O’Neill, F. E., Ryan, N., Clements, K., Solares, G., Nelson, M., et al. (1994). Exercise training and nutritional supplementation for physical fraility in very elderly people. The New England Journal of Medicine, 330(25), 1769–1775.
Finger, D., Goltz, F. R., Umpierre, D., Meyer, E., Rosa, L. H. T., & Schneider, C. D. (2015). Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports medicine, 45(2), 245-255.
Flansbjer, U. B., Miller, M., Downham, D., & Lexell, J. (2008). Progressive resistance training after stroke: Effects on muscle strength, muscle tone, gait performance and perceived participation. Journal of Rehabilitation Medicine, 40(1), 42–48.
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004). Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. Journals of gerontology. Series A, Biological sciences and medical sciences, 59(3), 255–263.
Fujita, S., & Volpi, E. (2006). Amino acids and muscle loss with aging. The Journal of nutrition, 136(1), 277S-280S.
Goodpaster, B. H., Park, S. W., Harris, T. B., Kritchevsky, S. B., Nevitt, M., Schwartz, A. V, et al. (2006). The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. Journals of gerontology. Series A, Biological sciences and medical sciences, 61(10), 1059–1064.
Grimby, G., & Saltin, B. (1983). The ageing muscle. Clinical Physiology, 3(3), 209–218.
Hallage, T., Krause, M. P., Haile, L., Miculis, C. P., Nagle, E. F., Reis, R. S., & Da Silva, S. G. (2010). The Effects of 12 weeks of step aerobics training on functional fitness of elderly women. Journal of Strength and Conditioning Research, 24(8), 2261–2266.
Hanson, E. D., Srivatsan, S. R., Agrawal, S., Menon, K. S., Delmonico, M. J., Wang, M. Q., & Hurley, B. F. (2009). Effects of strength training on physical function: influence of power, strength, and body composition. Journal of strength and conditioning research, 23(9), 2627–2637.
Haramizu, S., Ota, N., Hase, T., & Murase, T. (2011). Aging-associated changes in physical performance and energy metabolism in the senescence-accelerated mouse. Journals of gerontology. Series A, Biological sciences and medical sciences, 66(6), 646–655.
Harman, D. (1981). The aging process. Proceedings of the National Academy of Sciences of the United States of America, 78(11), 7124–7128.
Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1423–1434.
Heyn, P., Abreu, B. C., & Ottenbacher, K. J. (2004). The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 85(10), 1694–1704.
Holtzer, R., Verghese, J., Xue, X., & Lipton, R. B. (2006). Cognitive processes related to gait velocity: results from the Einstein Aging Study. Neuropsychology, 20(2), 215–223.
Hupin, D., Roche, F., Gremeaux, V., Chatard, J.-C., Oriol, M., Gaspoz, J.-M., et al. (2015). Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis. British Journal of Sports Medicine, 49(19), 1262-1267.
Kallman, D. A., Plato, C. C., & Tobin, J. D. (1990). The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. Journal of Gerontology, 45(3), M82–M88.
Kampert, J. B., Blair, S. N., Barlow, C. E., & Kohl, H. W. (1996). Physical activity, physical fitness, and all-cause and cancer mortality: A prospective study of men and women. Annals of Epidemiology, 6(5), 452–457.
Karavirta, L., Häkkinen, K., Kauhanen, A., Arija-Blázquez, A., Sillanpää, E., Rinkinen, N., & Ḧkkinen, A. (2011). Individual responses to combined endurance and strength training in older adults. Medicine and Science in Sports and Exercise, 43(3), 484–490.
Katsanos, C. S., Kobayashi, H., Sheffield-Moore, M., Aarsland, A., & Wolfe, R. R. (2006). A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. American Journal of Physiology: Endocrinology and Metabolism, 291(2), E381–E387.
Kim, H. K., Suzuki, T., Saito, K., Yoshida, H., Kobayashi, H., Kato, H., & Katayama, M. (2012). Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: A randomized controlled trial. Journal of the American Geriatrics Society, 60(1), 16–23.
Klenk, J., Rapp, K., Büchele, G., Keil, U., & Weiland, S. K. (2007). Increasing life expectancy in Germany: Quantitative contributions from changes in age- and disease-specific mortality. European Journal of Public Health, 17(6), 587–592.
Kokkinos, P. (2012). Physical activity, health benefits, and mortality risk. ISRN Cardiology, 2012(718789), 1–14.
Koopman, R., Verdijk, L., Manders, R. J., Gijsen, A. P., Gorselink, M., Pijpers, E., et al. (2006). Co-ingestion of protein and leucine stimulates muscle protein synthesis rates to the same extent in young and elderly lean men. The American journal of clinical nutrition, 84(3), 623-632.
Layman, D. K. (2003). The role of leucine in weight loss diets and glucose homeostasis. The Journal of nutrition, 133(1), 261S-267S.
MacLean, D. A., Graham, T. E., & Saltin, B. (1994). Branched-chain amino acids augment ammonia metabolism while attenuating protein breakdown during exercise. American Journal of Physiology-Endocrinology And Metabolism, 267(6), E1010-E1022.
Marusic, U., Kavcic, V., Giordani, B., Gerževič, M., Meeusen, R., & Pišot, R. (2015). Computerized spatial navigation training during 14 days of bed rest in healthy older adult men: Effect on gait performance. Psychology and Aging, 30(2), 334-340.
Marusic, U., Giordani, B., Moffat, S. D., Petrič, M., Dolenc, P., Pišot, R., & Kavcic, V. (in press). Computerized cognitive training during physical inactivity improves executive functioning in older adults. Aging, Neuropsychology, and Cognition. A Journal on Normal and Dysfunctional Development, 1–21.
Marušič, U., Taube, W., Morrison, S., Šimunič, B., Paravlić, A., Biasutti, L., et al. (2016). Mental simulation of locomotor tasks improves rehabilitation outcome in elderly adults after hip surgery. In A. Baca ... [et al.] (Eds.), Crossing borders through sport science: book of abstracts, 21st Annual Congress of the European College of Sport Science (p 84), Vienna: European College of Sport Science
Meador, K. J. (1994). Cognitive side effects of antiepileptic drugs. The Canadian Journal of Neurological Sciences, 21(3), S12-16.
Messier, S. P., Loeser, R. F., Miller, G. D., Morgan, T. M., Rejeski, W. J., Sevick, M. A., et al.. (2004). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the arthritis, diet, and activity promotion trial. Arthritis and Rheumatology, 50(5), 1501–1510.
Milanović, Z., Pantelić, S., Trajković, N., Sporiš, G., Kostić, R., & James, N. (2013). Age-related decrease in physical activity and functional fitness among elderly men and women. Clinical Interventions in Aging, 2013(8), 549–556.
Milman, U., Atias, H., Weiss, A., Mirelman, A., & Hausdorff, J. M. (2014). Can cognitive remediation improve mobility in patients with Parkinson's disease? Findings from a 12 week pilot study. Journal of Parkinson's Disease, 4(1), 37-44.
Morley, J. E., Argiles, J. M., Evans, W. J., Bhasin, S., Cella, D., Deutz, N. E., et al. (2010). Nutritional recommendations for the management of sarcopenia. Journal of the american Medical Directors association, 11(6), 391-396.
Morris, S. L., Dodd, K. J., & Morris, M. E. (2004). Outcomes of progressive resistance strength training following stroke: a systematic review. Clinical Rehabilitation, 18(1), 27–39.
Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., et al. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1094–1105.
Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., et al. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet, 385(9984), 2255-2263.
Nosaka, K. (2003). Muscle soreness and amino acids. Training journal, 289, 24-28.
Nowson, C., & O'Connell, S. (2015). Protein requirements and recommendations for older people: A review. Nutrients, 7(8), 6874-6899.
Onder, G., Penninx, B. W., Lapuerta, P., Fried, L. P., Ostir, G. V, Guralnik, J. M., & Oswald, W. D., Gunzelmann, T., Rupprecht, R., & Hagen, B. (2006). Differential effects of single versus combined cognitive and physical training with older adults: The SimA study in a 5-year perspective. European Journal of Ageing, 2006(3), 179–192.
Oswald, W. D., Gunzelmann, T., Rupprecht, R., & Hagen, B. (2006). Differential effects of single versus combined cognitive and physical training with older adults: The SimA study in a 5-year perspective. European Journal of Ageing, 2006(3), 179–192.
Paddon-Jones, D., & van Loon, L. (2012). Nutritional approaches to treating sarcopenia. In A. J. Cruz-Jentoft & J. E. Morley (Eds.), Sarcopenia (pp 275-295). Chichester, UK: John Wiley & Sons, Ltd.
Paffenbarger, R. S., Hyde, R., Wing, A. L., & Hsieh, C.-C. (1986). Physical Activity, All-Cause Mortality, and Longevity of College Alumni. The New England Journal of Medicine, 314(10), 605–613.
Pišot, R., Marusic, U., Biolo, G., Mazzucco, S., Lazzer, S., Grassi, B., et al. (2016). Greater loss in muscle mass and function but smaller metabolic alterations in older compared to younger men following two weeks of bed rest and recovery. Journal of Applied Physiology, 120(8), 922-929.
Pišot, R., Paravlić, A., Marušič, U., Plevnik, M., Zerbo Šporin, D., Pišot, S., & Šimunič, B. (2015). Physical activity vs inactivity, muscle vs fat mass in elderly. In M. Zvonař (Ed.). Sport and quality of life: 10th International Conference on Kinanthropology (pp. 348–365). Brno: Masaryk University.
Power, G. A., Dalton, B. H., & Rice, C. L. (2013). Human neuromuscular structure and function in old age: A brief review. Journal of Sport and Health Science, 2(4), 215–226.
Rennie, M. J. (1996). Influence of exercise on protein and amino acid metabolism. Comprehensive Physiology.
Rikli, R. E., & Jones, C. J. (1999). Development and validation of a functional fitness test for community-residing older adults. Journal of Aging and Physical Activity, 7(2), 129-161.
Rikli, R. E., & Jones, C. J. (2001). Senior Fitness Test Manual. Champaign, IL: Human Kinetics.
Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4), 433–440.
Saczynski, J. S., Willis, S. L., & Schaie, K. W. (2002). Strategy use in reasoning training with older adults. Aging, Neuropsychology, and Cognition, A Journal on Normal and Dysfunctional Development, 9(1), 48–60.
Salthouse, A. T. (2009). When does age-related cognitive decline begin? Neurobiology of Aging, 30(4), 507–514.
Sawilowsky, S. S. (2009). New effect size rules of thumb. Journal of Modern Applied Statistical Methods, 8(2), 597–599.
Smith-Ray, R. L., Makowski-Woidan, B., & Hughes, S. L. (2014). A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact Black older adults. Health Education & Behavior, 41(1 Suppl), 62S-69S.
Taylor, A. H., Cable, N. T., Faulkner, G., Hillsdon, M., Narici, M., & Van Der Bij, A. K. (2004). Physical activity and older adults: a review of health benefits and the effectiveness of interventions. Journal of Sports Sciences, 22(8), 703–725.
Theill, N., Schumacher, V., Adelsberger, R., Martin, M., & Jäncke, L. (2013). Effects of simultaneously performed cognitive and physical training in older adults. BMC Neuroscience, 14(103) 1-14.
Tieland, M., Dirks, M. L., van der Zwaluw, N., Verdijk, L. B., van de Rest, O., de Groot, L. C., & van Loon, L. J. (2012). Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Journal of the American Medical Directors Association, 13(8), 713-719.
Topinková, E. (2008). Aging, disability and frailty. Annals of Nutrition and Metabolism, 52(Suppl. 1), 6–11.
Turjanski, N., & Lloyd, G. G. (2005). Psychiatric side-effects of medications: recent developments. Advances in Psychiatric Treatment, 11(1), 58–70.
Vandervoort, A. A. (2002). Aging of the human neuromuscular system. Muscle and Nerve, 25(1), 17–25.
Verdijk, L. B., Jonkers, R. a, Gleeson, B. G., Beelen, M., Meijer, K., Savelberg, H. H., et al. (2009). Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. The American Journal of Clinical Nutrition, 89(2), 608–616.
Verhaeghen, P., Steitz, D. W., Sliwinski, M. J., & Cerella, J. (2003). Aging and dual-task performance: a meta-analysis. Psychology and Aging, 18(3), 443–460.
Volpi, E., Ferrando, A. A., Yeckel, C. W., Tipton, K. D., & Wolfe, R. R. (1998). Exogenous amino acids stimulate net muscle protein synthesis in the elderly. Journal of Clinical Investigation, 101(9), 2000-2007.
Volpi, E., Kobayashi, H., Sheffield-Moore, M., Mittendorfer, B., & Wolfe, R. R. (2003). Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. The American journal of clinical nutrition, 78(2), 250-258.
Weinert, B. T., & Timiras, P. S. (2003). Physiology of aging. Invited review: Theories of aging. Journal of Applied Physiology, 95(4), 1706–1716.
Wertz, R. T., & Dronkers, N. F. (1990). Effects of age on aphasia. In E. Cherow (Ed.), Proceedings of the research symposium on communication sciences and disorders of aging (pp. 88–98). Rockville, MD: ASHA.
WHO. (2007). Protein and amino acid requirements in human nutrition: report of a joint FAO/WHO/UNU expert consultation. Geneva: WHO Press, Report 935, 284.
Willis, S. L., Tennstedt, S. L., Marsiske, M., & et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA : Journal of the American Medical Association, 296(23), 2805–2814.
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