Sarcopenia
Conditions
Keywords
muscle, capillary, exercise
Brief summary
Aging is associated with a loss of muscle mass, termed sarcopenia, that reduces mobility, decreases physical function and accelerates progression of other age-related disorders. This study is designed to determine whether increasing skeletal muscle capillarization through aerobic exercise will enhance muscular adaptations to strength training in older adults with sarcopenia.
Detailed description
Sarcopenia, or the aging-related loss of muscle mass, affects a large number of older adults. The presence of sarcopenia is associated with physical disability, poor quality of life, and all-cause mortality, in part because sarcopenic adults have low muscle skeletal muscle capillarization and may lack the adequate perfusion needed to maintain muscle mass and function. This study will test the effects of increasing skeletal muscle capillarization through aerobic exercise training on responses to resistance training in older adults. Eligible participants will be randomized to one of two groups, resistance training preceded by aerobic exercise training (AEX-RT), or resistance training followed by aerobic exercise training (RT-AEX). Participants in the AEX-RT group will undergo 3 months of aerobic exercise training to increase skeletal muscle capillarization, followed by 3 months of resistance training. Participants in the RT-AEX group will undergo 3 months of resistance training, followed by 3 months of aerobic exercise training. Before and after the interventions, participants will undergo assessments of muscle size, strength, and capillarization, as well as assessments of physical function.
Interventions
OTHERAerobic exercise training
3 months of center-based, supervised treadmill exercise
OTHERStrength training
3 months of center-based, supervise strength training
Sponsors
University of Maryland, Baltimore
National Institute on Aging (NIA)
Baltimore VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
The study employs 2 interventions: resistance training and aerobic exercise training. One group of participants will undergo resistance training then aerobic exercise training; the other group will undergo aerobic exercise training then resistance training.
Eligibility
Sex/Gender
ALL
Age
65 Years to 88 Years
Healthy volunteers
Yes
Inclusion criteria
* Body Mass Index = 18-32.5 kg/m2 * Non-smoker * Presence of at least moderate sarcopenia (low muscle mass per unit body height)
Exclusion criteria
* Diagnosis of diabetes, cancer, pulmonary or renal disease * Physical impairment preventing exercise * Recent history of exercise training
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Skeletal Muscle Capillarization | 3 months (post minus pre-resistance training) | Change in the number of capillaries per unit of skeletal muscle tissue after resistance training. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm. |
| Quadriceps Muscle Cross-sectional Area | 3 months (post minus pre-resistance training) | Change in the size of the thigh muscles. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Skeletal Muscle Fiber Size | 3 months (post minus pre-resistance training) | Change in the cross-sectional size of individual thigh skeletal muscle fibers. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm. |
| Muscle Strength | 3 months (post minus pre-resistance training) | Change in the strength/force produced by skeletal muscles of the thigh. Only the resistance training-induced change (post minus pre-resistance training) is reported as this is the primary outcome for each arm. |
Countries
United States
Participant flow
Pre-assignment details
Participants are assigned to groups upon completion of baseline testing.
Participants by arm
| Arm | Count |
|---|---|
| Aerobic Exercise Training Followed by Resistance Training Participants in this arm will undergo 3 months of aerobic exercise training, followed by 3 months of strength training
Aerobic exercise training: 3 months of center-based, supervised treadmill exercise
Strength training: 3 months of center-based, supervise strength training | 7 |
| Resistance Training Followed by Aerobic Exercise Training Participants in this arm will undergo 3 months of strength training, followed by 3 months of aerobic exercise training
Aerobic exercise training: 3 months of center-based, supervised treadmill exercise
Strength training: 3 months of center-based, supervise strength training | 7 |
| Total | 14 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Withdrawal by Subject | 2 | 1 |
Baseline characteristics
| Characteristic | Aerobic Exercise Training Followed by Resistance Training | Total | Resistance Training Followed by Aerobic Exercise Training |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 7 Participants | 14 Participants | 7 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 78 years STANDARD_DEVIATION 4 | 75 years STANDARD_DEVIATION 6 | 73 years STANDARD_DEVIATION 6 |
| Appendicular Lean Mass (kg) | 17.1 kilograms STANDARD_DEVIATION 1.9 | 18.4 kilograms STANDARD_DEVIATION 4.4 | 19.3 kilograms STANDARD_DEVIATION 5.4 |
| Quadriceps muscle strength (Newton*meters) | 91 Newton*meters STANDARD_DEVIATION 15 | 101 Newton*meters STANDARD_DEVIATION 25 | 107 Newton*meters STANDARD_DEVIATION 30 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 5 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) White | 6 Participants | 8 Participants | 2 Participants |
| Region of Enrollment United States | 7 participants | 14 participants | 7 participants |
| Sex: Female, Male Female | 4 Participants | 9 Participants | 5 Participants |
| Sex: Female, Male Male | 3 Participants | 5 Participants | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 7 | 0 / 7 |
| other Total, other adverse events | 0 / 7 | 0 / 7 |
| serious Total, serious adverse events | 0 / 7 | 0 / 7 |
Outcome results
Primary
Quadriceps Muscle Cross-sectional Area
Change in the size of the thigh muscles. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm.
Time frame: 3 months (post minus pre-resistance training)
Population: All participants completing the resistance training portion of the intervention in each arm were analyzed. Only data for the resistance training portion of the study are reported (change post-pre training). Data and analyses are not reported for aerobic exercise as this was not part of the aims/outcomes and was only assessed to gauge responses to only RT.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Aerobic Exercise Training Followed by Resistance Training | Quadriceps Muscle Cross-sectional Area | 2.5 square centimeters | Standard Error 2 |
| Resistance Training Followed by Aerobic Exercise Training | Quadriceps Muscle Cross-sectional Area | 0.7 square centimeters | Standard Error 2.6 |
Comparison: Per the aims of the study, the responses to RT were compared between 2 arms/groups. The change in the outcome (post-RT minus pre-RT) in each arm/group was compared using a t-test. Responses to AEX training itself are not assessed as this was not an aim or hypothesis of the study.~The hypothesis was that the Aerobic exercise training followed by resistance training arm would have greater changes/improvements in study outcomes than the Resistance training followed by aerobic training group.p-value: 0.22t-test, 2 sided
Primary
Skeletal Muscle Capillarization
Change in the number of capillaries per unit of skeletal muscle tissue after resistance training. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm.
Time frame: 3 months (post minus pre-resistance training)
Population: All participants completing the resistance training portion of the intervention in each arm were analyzed. Only data for the resistance training portion of the study are reported (change post-pre training). Data and analyses are not reported for aerobic exercise as this was not part of the aims/outcomes and was only assessed to gauge responses to only RT.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Aerobic Exercise Training Followed by Resistance Training | Skeletal Muscle Capillarization | 0.4 capillaries per muscle fiber | Standard Error 0.1 |
| Resistance Training Followed by Aerobic Exercise Training | Skeletal Muscle Capillarization | 0.2 capillaries per muscle fiber | Standard Error 0.1 |
Comparison: Per the aims of the study, the responses to RT were compared between 2 arms/groups. The change in the outcome (post-RT minus pre-RT) in each arm/group was compared using a t-test. Responses to AEX training itself are not assessed as this was not an aim or hypothesis of the study.~The hypothesis was that the Aerobic exercise training followed by resistance training arm would have greater changes/improvements in study outcomes than the Resistance training followed by aerobic training group.p-value: 0.27t-test, 2 sided
Secondary
Muscle Strength
Change in the strength/force produced by skeletal muscles of the thigh. Only the resistance training-induced change (post minus pre-resistance training) is reported as this is the primary outcome for each arm.
Time frame: 3 months (post minus pre-resistance training)
Population: All participants completing the resistance training portion of the intervention in each arm were analyzed. Only data for the resistance training portion of the study are reported (change post-pre training). Data and analyses are not reported for aerobic exercise as this was not part of the aims/outcomes and was only assessed to gauge responses to only RT.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Aerobic Exercise Training Followed by Resistance Training | Muscle Strength | 12.7 Newton-meters | Standard Error 2.3 |
| Resistance Training Followed by Aerobic Exercise Training | Muscle Strength | 2.0 Newton-meters | Standard Error 5.8 |
Comparison: Per the aims of the study, the responses to RT were compared between 2 arms/groups. The change in the outcome (post-RT minus pre-RT) in each arm/group was compared using a t-test. Responses to AEX training itself are not assessed as this was not an aim or hypothesis of the study.~The hypothesis was that the Aerobic exercise training followed by resistance training arm would have greater changes/improvements in study outcomes than the Resistance training followed by aerobic training group.p-value: 0.28t-test, 2 sided
Secondary
Skeletal Muscle Fiber Size
Change in the cross-sectional size of individual thigh skeletal muscle fibers. The aims of the study were to compare responses to resistance training between arms/groups. Therefore, only the resistance training-induced change (post minus pre-resistance training) is assessed and analyzed as this is the primary outcome for each arm.
Time frame: 3 months (post minus pre-resistance training)
Population: All participants completing the resistance training portion of the intervention in each arm were analyzed. Only data for the resistance training portion of the study are reported (change post-pre training). Data and analyses are not reported for aerobic exercise as this was not part of the aims/outcomes and was only assessed to gauge responses to only RT.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Aerobic Exercise Training Followed by Resistance Training | Skeletal Muscle Fiber Size | 607 square micrometers | Standard Error 108 |
| Resistance Training Followed by Aerobic Exercise Training | Skeletal Muscle Fiber Size | 356 square micrometers | Standard Error 227 |
Comparison: Per the aims of the study, the responses to RT were compared between 2 arms/groups. The change in the outcome (post-RT minus pre-RT) in each arm/group was compared using a t-test. Responses to AEX training itself are not assessed as this was not an aim or hypothesis of the study.~The hypothesis was that the Aerobic exercise training followed by resistance training arm would have greater changes/improvements in study outcomes than the Resistance training followed by aerobic training group.p-value: 0.21t-test, 2 sided