Strength Training for Aging

Overseen By Sarah Lessila

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Marquette University

Must not be taking: NSAIDs, Glucocorticoids, Testosterone, others

Disqualifiers: Diabetes, Hypertension, Cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 8 weeks

120 Participants Needed

Trial Summary

What is the purpose of this trial?

The proposed studies will assess 1) the mechanisms for the age-related increase in fatigability during dynamic exercise (Aims 1 and 2) and 2) the effectiveness of high-velocity resistance training coupled with blood flow restriction (BFR) in improving muscle power output and fatigability in older adults (Aim 3). The first two aims are cross-sectional studies comparing young (18-35 years old) and older adults (≥60 yrs old) to test our central hypothesis that the greater accumulation of metabolites and increase in fatigability in older adults is due to either age-related impairments in skeletal muscle bioenergetics (Aim 1) and/or vascular dysfunction (Aim 2). These two aims will integrate techniques to assess whole-muscle bioenergetics (31P-MRS) and in vivo vascular function (near infrared spectroscopy; NIRS and doppler ultrasonography) with in vitro assessment of single fiber bioenergetics (epifluorescence microscopy) and vasoreactivity of isolated skeletal muscle arterioles (video microscopy). We will then determine whether bioenergetics, vascular function and fatigability are altered in older men and women in response to 8 weeks of resistance exercise training of the lower limb both with and without blood flow restriction (Aim 3).

Will I have to stop taking my current medications?

The trial does not specify if you must stop taking your current medications, but it excludes those who have taken medications known to influence muscle mass or neuromuscular function in the past year. Common medications for older adults, like statins, are allowed and will be considered in the study's analysis.

What data supports the effectiveness of the treatment Exercise, Physical Activity, Workout, Fitness Training for aging?

Research shows that regular exercise, including strength training, can improve muscle strength, reduce the risk of diseases like heart disease and diabetes, and enhance overall quality of life in older adults. It also helps maintain independence by improving functional capacity and reducing the risk of falls. ^{1 2 3 4 5}

Is strength training safe for older adults?

Strength training is generally safe for older adults and can improve health by increasing muscle strength and bone density. While adverse events (unwanted effects) can occur, they are not common, and the benefits of strength training usually outweigh the risks. ^{6 7 8 9 10}

How does strength training differ from other treatments for aging?

Strength training is unique because it directly targets muscle strength and mass, which can reverse age-related muscle loss (sarcopenia) and improve overall health in older adults. Unlike other treatments, it enhances physical function, reduces fall risk, and can be beneficial even for those with chronic conditions like hypertension and osteoarthritis. ^{7 11 12 13 14}

Eligibility Criteria

This trial is for men and women aged 18-40 or over 65, without severe health issues like uncontrolled high blood pressure, diabetes, recent cancer treatment, extreme obesity (BMI ≥40), or conditions limiting exercise. Pregnant women and those on certain muscle-affecting drugs can't join.

Inclusion Criteria

I am between 18 and 40 years old.

I am older than 65 years.

Exclusion Criteria

I am currently pregnant or might be pregnant.

I haven't taken medications in the past year that affect muscle mass or nerve function.

My high blood pressure is not under control.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Cross-sectional Study

Assessment of age-related increase in fatigability and mechanisms in young and older adults

4 weeks

Multiple sessions for bioenergetics and vascular function assessments

Treatment

8 weeks of resistance exercise training with and without blood flow restriction

8 weeks

Regular training sessions

Follow-up

Participants are monitored for changes in muscle metabolism, oxygenation, volume, and vascular function

2 weeks

One session before and after training

Treatment Details

Interventions

• Exercise

Trial Overview The study tests how aging affects muscle tiredness during dynamic exercises and if strength training with blood flow restriction improves muscle power in older adults. It compares younger individuals to seniors using advanced techniques to measure muscle and vascular function.

Participant Groups

Group I: Resistance Training Only Experimental Treatment 1 Intervention

This leg will then perform low-load resistance training (30% of 1-RM) including 3 sets of 15 knee extensions performed as fast as possible while seated upright in a knee extension weight machine. Sets will be interspersed with 30 seconds rest. This leg will always perform the training without blood flow restriction.

Group II: Blood Flow Restriction Training Experimental Treatment 1 Intervention

This leg will then perform low-load resistance training (30% of 1-RM) including 3 sets of 15 knee extensions performed as fast as possible while seated upright in a knee extension weight machine. Sets will be interspersed with 30 seconds rest. This leg will always perform the training with blood flow restriction.

Who Is Running the Clinical Trial?

Marquette University

Lead Sponsor

Trials

68

Recruited

202,000+

Medical College of Wisconsin

Collaborator

Trials

645

Recruited

1,180,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

In a study involving 71 older hospitalized patients, those who participated in progressive resistance strength training showed significant improvements in walking speed and mobility tasks compared to the control group, indicating potential benefits of this training method.

While both groups improved in various functional measures, the treatment group demonstrated greater overall improvements, suggesting that adding strength training to standard care may enhance rehabilitation outcomes for older patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial. Tibaek, S., Andersen, CW., Pedersen, SF., et al.[2019]

Improving physical fitness through exercise significantly reduces the risk of death from all causes and cardiovascular disease in sedentary older adults, highlighting the importance of physical activity for longevity.

Exercise offers numerous benefits for the geriatric population, including improved body composition, increased strength, reduced depression and arthritis pain, and lower risks of diabetes and coronary artery disease, yet many healthcare professionals feel unprepared to create effective exercise programs for their patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and older patients: guidelines for the clinician. Christmas, C., Andersen, RA.[2022]

Moderate- to high-quality evidence indicates that exercise significantly improves walking speed and physical performance in older adults with sarcopenia, supporting its role as an effective intervention.

While exercise may enhance muscle strength, particularly in grip strength, the improvements may not be substantial enough to meet patient-important differences, highlighting the need for further research on quality of life outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Exercise on Patients Important Outcomes in Older People With Sarcopenia: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. Shen, Y., Liu, D., Li, S., et al.[2022]

Resistance training significantly improves functional status, health, and quality of life in older adults by increasing muscle strength and mass, which are crucial for combating sarcopenia, a common age-related condition.

The review suggests that resistance training enhances muscle quality and power, promotes better body composition, and encourages physical activity, while cautioning that excessive aerobic training alongside resistance training may hinder strength gains if not managed properly.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of resistance training on older adults. Hunter, GR., McCarthy, JP., Bamman, MM.[2022]

Regular participation in cardiovascular and resistance-training programs significantly reduces the risk of chronic diseases like coronary heart disease and diabetes in elderly individuals, while also improving bone density, muscle mass, and overall functional capacity.

To maximize health benefits, tailored exercise prescriptions are necessary, but the challenge remains in effectively educating and encouraging elderly individuals to engage in and adhere to regular exercise regimens.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise prescription for the elderly: current recommendations. Mazzeo, RS., Tanaka, H.[2018]

In a review of 121 trials involving 6700 older adults, most adverse events related to progressive resistance strength training were musculoskeletal issues like muscle strains and joint pain, particularly in participants with pre-existing health conditions or those engaging in high-intensity training.

Adverse events were often underreported, highlighting the need for clearer definitions and consistent reporting in future studies to better inform practitioners about the risks and benefits of strength training in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. Liu, CJ., Latham, N.[2010]

Strength training is crucial for older adults (65 years and older) as it enhances health by improving muscular strength, endurance, and bone density, while also reducing the risk of falls and fractures.

Only about 12% of adults aged 65-74 and 10% of those aged 75 and older engage in strength training at least twice a week, highlighting the need for programs to promote strength training among older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strength training among adults aged >/=65 years--United States, 2001. [2008]

Participants with chronic health conditions expressed that adverse events (AEs) from resistance training (RT) significantly impact their willingness to engage in future exercise, highlighting the importance of understanding both the risks and benefits of RT.

The study identified that personal experiences, health conditions, and the environment in which RT occurs influence perceptions of safety and participation, suggesting that better communication about the risks of AEs is essential to encourage RT among individuals with chronic health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring participants' perspectives on adverse events due to resistance training: a qualitative study. El-Kotob, R., Pagcanlungan, JR., Craven, BC., et al.[2023]

Researchers in resistance training studies often lack clear guidance and motivation for thorough adverse event (AE) reporting, which can lead to inconsistent practices.

There is a need for exercise-specific guidelines for AE reporting, as current standards are perceived as not applicable to exercise trials, highlighting the importance of tailored strategies to improve reporting consistency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study. El-Kotob, R., Pagcanlungan, JR., Craven, BC., et al.[2022]

Resistance training (RT) significantly reduces all-cause mortality and the incidence of cardiovascular disease while improving physical functioning in adults, based on an analysis of 11 systematic reviews involving over 382,000 participants.

Although adverse events were not consistently reported, serious adverse events related to RT were uncommon, suggesting that the benefits of resistance training outweigh the potential harms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training and health in adults: an overview of systematic reviews. El-Kotob, R., Ponzano, M., Chaput, JP., et al.[2021]

Resistance training significantly enhances muscular strength and endurance in older adults, contributing to improved functional independence and quality of life, even in the oldest individuals.

The combination of strength training and aerobic exercise in circuit training not only increases muscle strength but also improves balance, coordination, and cardiovascular health, reducing disability risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of strength and resistance training on cardiovascular disease risk factors and outcomes in older adults. Williams, MA., Stewart, KJ.[2013]

Resistance training is highly effective in preserving or increasing skeletal muscle mass and strength in older adults, combating age-related sarcopenia.

In addition to muscle benefits, resistance training also enhances energy requirements, protein retention, bone mass, and overall physical activity levels in both healthy and frail elderly individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise, nutrition, and aging. Evans, WJ.[2008]

Strength training (ST) is highly effective for older adults, significantly increasing muscle strength, mass, and power, which helps combat sarcopenia and improves overall functional abilities.

In addition to enhancing muscle health, ST also contributes to better endurance, normalizes blood pressure, reduces insulin resistance, decreases body fat, and helps maintain bone mineral density, making it a comprehensive intervention for aging-related health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strength training in the elderly: effects on risk factors for age-related diseases. Hurley, BF., Roth, SM.[2022]

Older adults can significantly improve their muscle strength through strength training, despite age-related declines and periods of inactivity.

Carefully supervised strength training is safe and beneficial for elderly individuals, including those with chronic conditions like hypertension and osteoarthritis, and is particularly important for rehabilitation after orthopedic surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Muscle strength training in old age]. Ehrsam, R., Aeschlimann, A.[2006]

References

1. England pubmed.ncbi.nlm.nih.gov

Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Exercise and older patients: guidelines for the clinician. [2022]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of Exercise on Patients Important Outcomes in Older People With Sarcopenia: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. [2022]

4. New Zealand pubmed.ncbi.nlm.nih.gov

Effects of resistance training on older adults. [2022]

5. New Zealand pubmed.ncbi.nlm.nih.gov

Exercise prescription for the elderly: current recommendations. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. [2010]

7. United States pubmed.ncbi.nlm.nih.gov

Strength training among adults aged >/=65 years--United States, 2001. [2008]

8. Canada pubmed.ncbi.nlm.nih.gov

Exploring participants' perspectives on adverse events due to resistance training: a qualitative study. [2023]

9. Canada pubmed.ncbi.nlm.nih.gov

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study. [2022]

10. Canada pubmed.ncbi.nlm.nih.gov

Resistance training and health in adults: an overview of systematic reviews. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Impact of strength and resistance training on cardiovascular disease risk factors and outcomes in older adults. [2013]

12. United States pubmed.ncbi.nlm.nih.gov

Exercise, nutrition, and aging. [2008]

13. New Zealand pubmed.ncbi.nlm.nih.gov

Strength training in the elderly: effects on risk factors for age-related diseases. [2022]

14. Germany pubmed.ncbi.nlm.nih.gov

[Muscle strength training in old age]. [2006]