Sarcopenia
Conditions
Keywords
sarcopenia, postmenopausal women, Nordic walking, Strength training, Bungy Pump Exercises
Brief summary
This study explored preventive measures for sarcopenia in apparently healthy postmenopausal women. The investigators implemented a short Nordic walking intervention, Bungy Pumo exercises and strength training, and conducted a 3-month training program as an intervention method. The subjects divided into the NW (Nordic walking) test group, the ST (Strength Training) test group, BP (Bungy Pump exercises) test group and the control group, which engaged in regular daily activities without any additional physical exercise. The collected experimental data then processed and analyzed to objectively assess the benefits and limitations of different interventions.
Detailed description
The tests were conducted twice (before and after the training period). Each test lasted two days and will be preceded by a 7-day measurement of physical activity using sport testers. On the first day, blood tests, microbiota, body composition and a preliminary analysis of diet diaries were performed. On the second day, physical fitness tests were carried out in the Physical Exercise Laboratory of the AWFiS in Gdańsk. Biological material (blood serum and feces) was frozen for testing by the project contractors in the Laboratory of Genetics in Sports of the AWFiS. The subjects were required to keep a diet diary in which they recorded meals during the 3 days preceding the blood and intestinal microbiota test.
Interventions
BEHAVIORALNordic walking
NW training sessions are conducted by a certified NW instructor leading participants in the outdoor forest of Gdansk. Training is about 60 minutes each time, 3 times a week, each interval of 1 or 2 days, a total of 12 weeks. Participants used professional Nordic Pole.
BEHAVIORALStrength training
Strength training was conducted in the gym with progressively increasing resistance from 65% to 75% of the maximum weight (one-repetition maximum (1-RM)). Participants performed 10-13 repetitions of the exercise in one serie. The training was carried out in station form and consisted of 10-13 exercises. There were rest intervals of 60-90 seconds between exercises. As intended, the training was comprehensive, i.e. it affected the muscles of the arms, legs, torso, abdomen and chest.
BEHAVIORALBungy Pump Exercises
Buny Pump training sessions are conducted by a certified BP instructor leading participants in the outdoor forest of Gdansk. Training is about 60 minutes each time, 3 times a week, , a total of 12 weeks. Participants used professional Bungy Pump Pole.
Sponsors
Gdansk University of Physical Education and Sport
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Postmenopausal women over 60 years old (i.e. more than 12 months since their last menstrual cycle). There were no contraindications to exercise after case reports and initial diagnosis. Informed consent must be signed, agreeing to participate in research and physical exercise programs.
Exclusion criteria
Uncontrolled high blood pressure. Coronary artery disease. Rheumatoid arthritis. Type 2 diabetes. Respiratory diseases and lung diseases. Are taking or have used antibiotics and/or antifungal therapy in the past 4 weeks. Unwillingness to stick to a prescribed schedule.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Skeletal muscle index | From enrollment to the end of treatment at 2 weeks | SMI in InBody is calculated as follows: SMI= sum of segmental muscle mass (two arms and two legs) ÷ height 2 |
| Gait Speed | From enrollment to the end of treatment at 2 weeks | In order to harmonize the pace measurement method, the 2019 Asian Sarcopenia Working Group recommends the time it takes to walk 6 meters at a normal pace from moving as a measure of average pace. The test is carried out in an inspection room that is more than 8 meters long. Crutches that participants normally use can also be used. The start and end of the 6-meter distance are clearly marked. Subjects stand with their toes touching the starting line, and after being instructed to move forward at their usual speed, subjects start walking, inspectors start timing, and when subjects fully cross the 6-meter mark with one foot, inspectors stop timing. The test is performed twice, recording the shortest time (in seconds) required to complete each distance. The smaller the value, the faster the walking speed, the better the physical ability. |
| Hand Strength | From enrollment to the end of treatment at 2 weeks | HS was measured to estimate muscle strength and was performed with a hand dynamometer (SAEHAN Digital Hand Dynamometer, SAEHAN, Changwon, Korea). During the HS test, participants had to hold the dynamometer in their hand with the arm stretched parallel to the body while being instructed to stand upright. This measure was performed three times on the dominant hand with a rest interval of 1 min between measurements; finally, the best performance was used as the maximum peak (PK) of HS (in kg). The statistical analysis also included mean peak (mean PK).The higher the grip strength value, the greater the muscle strength, the better the physical ability. |
| Skeletal Muscle Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes.The higher the number, the more muscle the human body has.The ideal skeletal muscle content for men is 47% of standard body weight and 42% of standard body weight for women. A 10% move up or down is considered normal. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| BDNF | From enrollment to the end of treatment at 3 months. | BDNF (brain-derived neurotrophic factor) assay unit is mainly pg/mL. The MAGPIX platform enables multiplex tests, which allow for multi-parameter detection of several to several dozen analytes in a single sample of small volume (\ 40ul). The MAGPIX (xMAP®) system is based on the principles of the ELISA test and uses the technology of paramagnetic microspheres coated with antibodies. One panel allows for simultaneous determination of several to several dozen markers in each sample. ELISA (enzyme-linked immunosorbent assay) is an immunoenzymatic test used to detect and quantify proteins contained in the tested sample, such as antibodies or protein antigens. The ELISA technique is widely used in biomedical research, both scientific and diagnostic. It is a fast, accurate and easy to perform method. Consumables: nitrile gloves, pipette tips 10-200ul, pipette tips 100-1000ul, eppendorff tubes, other (falcon tubes, lignin, etc.). |
| PEAK AWY | From enrollment to the end of treatment at 2 weeks | Peak knee extension muscle strength.Using Biodex System 4 Pro™ dynamometers (Biodex Medical Systems, Inc.) Data collection using Compaq Desk Pro personal computers and Biodex software, using the Biodex standard protocol. After a standardized warm-up, the subject is positioned in the equipment as required by the manufacturer's manual (sitting position, arms hanging down along the body, hands holding the outside handle, torso, buttocks and subject thighs secured by straps, knee flexion to 90°). The test uses the scheme reported by Symons et al., with some modifications. The isometric muscle strength test was performed using three maximum contractions, each lasting 5 seconds with an interval of 30 seconds. Adjust the seat position according to the length of each subject's legs. Data were analyzed using the results of the dominant lower limbs. The greater the value of this index, the stronger the isometric contraction force of the knee extensor muscle. |
| PEAK TWD | From enrollment to the end of treatment at 2 weeks | Peak knee flexor strength. Using Biodex System 4 Pro™ dynamometers (Biodex Medical Systems, Inc.) Data collection using Compaq Desk Pro personal computers and Biodex software, using the Biodex standard protocol. After a standardized warm-up, the subject is positioned in the equipment as required by the manufacturer's manual (sitting position, arms hanging down along the body, hands holding the outside handle, torso, buttocks and subject thighs secured by straps, knee flexion to 90°). The test uses the scheme reported by Symons et al., with some modifications. The isometric muscle strength test was performed using three maximum contractions, each lasting 5 seconds with an interval of 30 seconds. Adjust the seat position according to the length of each subject's legs. Data were analyzed using the results of the dominant lower limbs. The higher the value of this index, the stronger the isometric contraction force of knee flexor muscle. |
| Arm Circumference | From enrollment to the end of treatment at 2 weeks | A tape measure was used to directly measure the circumference of the left and right upper arms of the participants. The larger the value of the index, the larger the arm circumference, but it can only be used as a reference indicator and cannot specifically evaluate the physical function |
| ChairStand | From enrollment to the end of treatment at 2 weeks | The participants stood up as fast as they could on a chair of suitable height for 30 seconds. The greater the value of this test, the more times it is proved to be completed, and the lower limb muscle strength can be indirectly evaluated. |
| ArmCurl | From enrollment to the end of treatment at 2 weeks | Participants were asked to sit in a chair holding a 2KG weight with one arm and complete the maximum number of arm curls within 30 seconds. The greater the number of bends, the better the upper body strength may prove. |
| TUG | From enrollment to the end of treatment at 2 weeks | Time up and go.The TUG test measures the time(s) required for a subject to rise from a chair, walk 3 m, turn around, walk back to the chair, and sit down. It has been shown to be a predictor of sarcopenia in hospitalized patients with a mean age of 70.4±7.7 years.The smaller the value, the shorter the completion time, and the better the physical function. |
| TandemBalance | From enrollment to the end of treatment at 2 weeks | Participants used the toe stick to the heel in a straight line walking way, with the fastest speed to complete 2 meters. The smaller the value, the faster the walking speed, which may represent better balance ability. |
| Muscle Strength Indices | From enrollment to the end of treatment at 2 weeks | The index includes 2 upper limb muscle strength indexes and 2 lower limb muscle strength indexes, and the formula is as follows: 1. HS/BM 2. HS/BMI 3. Knee extensor strength /BM 4. Knee flexor strength /BM A higher value for this indicator may mean greater muscle strength. |
| Myostatin | From enrollment to the end of treatment at 3 months | Myostatin is a protein whose units are the same as those of other proteins, usually expressed in moles (mol/L). The MAGPIX platform enables multiplex tests, which allow for multi-parameter detection of several to several dozen analytes in a single sample of small volume (\ 40ul). The MAGPIX (xMAP®) system is based on the principles of the ELISA test and uses the technology of paramagnetic microspheres coated with antibodies. One panel allows for simultaneous determination of several to several dozen markers in each sample. ELISA (enzyme-linked immunosorbent assay) is an immunoenzymatic test used to detect and quantify proteins contained in the tested sample, such as antibodies or protein antigens. The ELISA technique is widely used in biomedical research, both scientific and diagnostic. It is a fast, accurate and easy to perform method. Consumables: nitrile gloves, pipette tips 10-200ul, pipette tips 100-1000ul, eppendorff tubes, other (falcon tubes, lignin, etc.). |
| Irisin | From enrollment to the end of treatment at 3 months. | The unit of irisin is molecular weight and its value is 298.25. The MAGPIX platform enables multiplex tests, which allow for multi-parameter detection of several to several dozen analytes in a single sample of small volume (\ 40ul). The MAGPIX (xMAP®) system is based on the principles of the ELISA test and uses the technology of paramagnetic microspheres coated with antibodies. One panel allows for simultaneous determination of several to several dozen markers in each sample. ELISA (enzyme-linked immunosorbent assay) is an immunoenzymatic test used to detect and quantify proteins contained in the tested sample, such as antibodies or protein antigens. The ELISA technique is widely used in biomedical research, both scientific and diagnostic. It is a fast, accurate and easy to perform method. Consumables: nitrile gloves, pipette tips 10-200ul, pipette tips 100-1000ul, eppendorff tubes, other (falcon tubes, lignin, etc.). |
| Right Leg Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher number indicates more muscle in the right leg. |
| Right Arm Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher number indicates more muscle in the right arm. |
| Left Arm Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher number indicates more muscle in the left arm. |
| Trunk Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher number indicates more muscle in the trunk. |
| Left Leg Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher number indicates more muscle in the left leg. |
| Skeletal Lean Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The calculation method of SLM is different from that of SMM. The SLM in InBody report paper is the sum of protein, body water, and extracosseous inorganic salts. The ideal SLM for men is 80% of standard body weight and 72% of standard body weight for women. A 10% move up or down is considered normal. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Creatine kinase | From enrollment to the end of treatment at 2 weeks | creatine kinase \[U/l\]. In all measurements, the mean value of the measurement in the tested group and the standard deviation of the results will be reported. After obtaining blood samples from participants in the blood laboratory, investigators performed blood biomarker analysis using the Luminex method. Studies have shown that creatinine and creatine kinase are significantly reduced in patients with sarcopenia. Therefore, they were used as part of the results measurement in this study. |
| Body Fat Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes.The higher the value of this index, the higher the body fat content. |
| Fat-Free Mass | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The higher the value of this index, the heavier the body weight without fat. |
| BMI | From enrollment to the end of treatment at 2 weeks | Using the Octupole Bioimpedance InBody 720 analyzer (Biospace, Seoul, Korea), participants wore light clothing and no shoes. The average person's BMI is usually between 18 and 23. |
| Microbiome analysis | From enrollment to the end of treatment at 3 months | The microbiome test will be performed at the AWFiS Sports Genetics Laboratory. DNA will be isolated using a Bead Ruptor 24 Elite homogenizer and QIAamp PowerFecal Pro DNA Kits (Qiagen) according to the manufacturer's procedure. The quality and quantity of the isolated material will be checked on a NanoDrop 1000 spectrophotometer (Thermo Scientific), Qubit 4.0 fluorometer (ThermoFisher). Sequencing in PE mode (2x150 bp) will be performed on the NovaSeq platform (Illumina). Data analysis will be performed using a specially created pipeline based on several programs such as: MG-RAST, Mothur or CLUSTOM, R program, etc. |
| CRP | From enrollment to the end of treatment at 3 months | CRP is an acute phase reaction protein, the unit of CRP is: mg/L. Blood collection and C-reactive protein assay will be performed by an external company. |
| IL-6 | From enrollment to the end of treatment at 3 months. | The unit of IL-6 (interleukin-6) is (pg/mL). Fasting venous blood samples will be collected after a minimum of 12 hours overnight. Blood will be collected in Sarstedt S-Monovette tubes without anticoagulants but with the addition of coagulation factors to obtain serum. Serum samples will be processed according to standard laboratory procedures, aliquoted and stored at -80°C until analysis. Levels of inflammatory markers CRP, IL-6 and TNF-alpha will be determined using the MAGPIX fluorescence detection system (Luminex Corp., Austin, TX, USA) and the Luminex Human Magnetic Assay 6-Plex according to the manufacturer's protocols. Data acquisition and analysis will be performed using xPONENT software and Quantist Luminex by Bio-Techne (Luminex Corp., Austin, TX, USA). |
| TNF-α | From enrollment to the end of treatment at 3 months. | TNF-α (tumor necrosis factor-α) has two molecular weights: 17kD monomer form and 51kD trimer form . According to the molecular weight, the concentration unit of TNF-α can be converted. For example, in the monomer form of TNF-α, 1ug is approximately equal to 0.06nmol; In trimer form TNF-α, 1ug is equal to approximately 0.02nmol . Serum samples will be processed according to standard laboratory procedures, aliquoted and stored at -80°C until analysis. Levels of inflammatory markers CRP, IL-6 and TNF-alpha will be determined using the MAGPIX fluorescence detection system (Luminex Corp., Austin, TX, USA) and the Luminex Human Magnetic Assay 6-Plex according to the manufacturer's protocols. Data acquisition and analysis will be performed using xPONENT software and Quantist Luminex by Bio-Techne (Luminex Corp., Austin, TX, USA). |
| Nutrition assessment | From enrollment to the end of treatment at 3 months | Nutrition analysis (nutrient and caloric content) based on diet diaries kept by the study participants using diet analysis software. Nutritional analysis in the Nuvero program is based on entering data from diet diaries and assessing the consumption of basic nutrients and caloric content in the context of the nutritional needs of the person being examined. The process begins with collecting detailed information about the products and dishes consumed, which are recorded in the diet diaries kept by the person being examined. This information should include: the type of products consumed, the size of portions and the method of their preparation. The collected data is entered into the Nuvero program, selecting from the available database the products and dishes that most closely correspond to the entries in the diary. If necessary, modifications to the ingredients or methods of preparing dishes should be taken into account to ensure the accuracy of the analysis. |
| Creatinine | From enrollment to the end of treatment at 2 weeks | creatinine \[mg/dl\]. In all measurements, the mean value of the measurement in the tested group and the standard deviation of the results will be reported. After obtaining blood samples from participants in the blood laboratory, investigators performed blood biomarker analysis using the Luminex method. Studies have shown that creatinine and creatine kinase are significantly reduced in patients with sarcopenia. Therefore, they were used as part of the results measurement in this study. |
Countries
Poland
Outcome results
None listed