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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2018 Mar 07

DOI: 10.23736/S1973-9087.18.04930-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Strength training increases skeletal muscle quality but not muscle mass in old institutionalized adults: a randomized, multi-arm parallel and controlled intervention study

Eva-Maria STRASSER 1 , Marlene HOFMANN 2, 3, Bernhard FRANZKE 2, 4, Barbara SCHOBER-HALPER 2, 3, Stefan OESEN 2, 3, Waltraud JANDRASITS 2, 4, Alexandra GRAF 5, Markus PRASCHAK 1, Barbara HORVATH-MECHTLER 6, Christine KRAMMER 6, Martin PLODER 7, Norbert BACHL 2, 3, Michael QUITTAN 1, Karl-Heinz WAGNER 2, 4, Barbara WESSNER 2, 3

1 Institute for Physical Medicine and Rehabilitation/Karl Landsteiner Institute for Remobilisation and Functional Health, Kaiser Franz Joseph Hospital, Social Medical Center South, Vienna, Austria; 2 Research Platform Active Ageing, University of Vienna, Vienna, Austria; 3 Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria; 4 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria; 5 Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Vienna, Austria; 6 Institute of Radiology, Kaiser Franz Joseph Hospital, Social Medical Center South, Vienna, Austria; 7 Department of Pediatric Surgery, Social Medical Centre East, Donauspital, Vienna, Austria


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BACKGROUND: Age related loss of skeletal muscle mass is accompanied by changes in muscle quality leading to impairment of functional status.
AIM: This study investigated the effect of resistance training and nutritional supply on muscle mass and muscle quality in very old institutionalized adults.
DESIGN: Prospective, randomized, multi-arm parallel and controlled intervention study.
SETTING: This study was conducted in five retirement care facilities.
POPULATION: This subgroup of the Vienna Active Ageing Study included 54 women and men (82.4 ± 6.0 years) with impaired health status. Participants were randomly assigned either to elastic band resistance training (n=16), training with nutritional supplementation (n=21) or control group (n=17).
METHODS: Health status was assessed at baseline with functional tests, cognitive status, nutritional status, sum of medications as well as sum of diseases. Skeletal muscle mass, determined by dual - energy X-ray absorptiometry, isokinetic knee extension and flexion force and handgrip strength were assessed at baseline and after 6 months. Muscle quality of lower extremities was defined as ratio of the extensor (MQ_LE (Ext.)) or flexor strength (MQ_LE (Flex.)) to lean leg mass. Muscle quality of upper extremity was defined as ratio of handgrip strength to lean arm mass. Follow up examinations were performed after 12 and 18 months of intervention.
RESULTS: Muscle quality, but not muscle mass, showed significant correlations to functional tests at baseline (0.300 - 0.614, p<0.05). Resistance training significantly enhanced muscle quality of lower extremity after 6 months (MQ_LE (Ext.) +19.8 %, MQ_LE (Flex.) +30.8 %, p<0.05). Nutritional supplementation could not further increase the training effect. Participants with lower muscle quality at baseline benefit most from the training intervention. Skeletal muscle mass was not changed by any intervention.
CONCLUSIONS: Resistance training with elastic bands improved muscle quality in very old people. Additional nutritional supplementation was not able to further improve the effects obtained by training alone.
CLINICAL REHABILITATION IMPACT: Elastic band resistance training could be safely used to improve muscle quality even in old people with impaired health status. Weak and chronically ill participants benefit most from this training.


KEY WORDS: Sarcopenia - Muscle quality - Muscle mass - Resistance training - Dietary supplements - Response to training

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Publication History

Article first published online: March 7, 2018
Manuscript accepted: March 6, 2018
Manuscript revised: February 16, 2018
Manuscript received: July 28, 2017

Per citare questo articolo

Strasser EM, Hofmann M, Franzke B, Schober-Halper B, Oesen S, Jandrasits W, et al. Strength training increases skeletal muscle quality but not muscle mass in old institutionalized adults: a randomized, multi-arm parallel and controlled intervention study. Eur J Phys Rehabil Med 2018 Mar 07. DOI: 10.23736/S1973-9087.18.04930-4

Corresponding author e-mail

eva-maria.strasser@wienkav.at