Aging Research at Tufts UniversityFiatarone et al., 1990

Bassey et al., 1992

High-Intensity Strength Training in Nonagenarians

• Effects on Skeletal Muscle• JAMA, 1990

Rationale

• Biologic aging (??)• Disease• Sedentary lifestyle• Nutritional inadequacies• All related to type II fiber atrophy

• Intervention?• Weakness Falls

Aims

To determine• Feasibility• Physiological consequences• High-resistance strength training in the

frail elderly

Participants

• Long term care facility (“nursing home”)• Ambulatory• Not acutely ill• Follow instructions• No unstable disease

Participant Characteristics (Table 1.)

Characteristic Mean±SEM Range

Age (y) 90.2 (1.1) 86-96

F 6

M 4

Length of stay (y) 3.4(0.8) 0.7-8.3

Hx of falls 8

Use of assistive device

7

Chronic dz/person 4.5 (0.6) 2-7

Daily meds/person 4.4 (0.8) 0-9

Measures

• Body composition• Total and regional

• Diet records• 1RM • Safety measures

• Functional mobility

Training

• 8 weeks• Con/Ecc leg extension• 3 x/wk• 3 sets of 8• 6-9 seconds• 1-2 min rest• 80% 1RM

• 2 & 4 weeks of detraining

Results: Participants

• Level of care• Excluded• MI• Fracture• Behavioral• Arthritis

Results: Participants

• 40% signs of under nutrition• FFM higher in men than in women• SSkFs highly related to BF% (r=0.89,

P<.001)• Regional muscle area highly related to

total body FFM (r=.98, P<.0001)

Results: Baseline Muscle Function

• Right leg: 9.0±1.4• Left leg: 8.9±1.7• Corr with FFM

(r=.732; P<.01)• Corr with thigh

muscle area (r=.752, P<.01)

• Dietary intake• Chair stand

2.2±0.5 sec• 6m walk time

22.2±4.6 sec• Both related to

1RM (how?)

Response to Training

• 9 of 10 completed protocol• 98.8% attendance• No CV complications• Minor joint discomfort

Muscle Strength

• 174 ± 31% increase • 8.02±1.0 kg to 20.6 ± 2.4 kg (right)• 7.6±1.3 kg to 19.3±2.2 kg (left)• No plateau• Same among men and women

Clinical Outcomes

• No change in gait speed• Tandem gait improvements (N=5)• 2 no longer needed canes• 1 of 3 could rise from chair w/o arms

Discussion

• Dramatic increases in strength• 61-374% (!!!)

• Reversal of age-related weakness• Principle of specificity

• Previous research• Remarkable findings given potential limitations of

population• Familiarization??• Hypertrophy or neural improvements?• Well tolerated• Limitations• Safety of training versus not training (ie, falls)

Leg extensor power and functional performance in very old men and women

• Bassey et al., 1992• Clinical Science

Rationale & Aim

• Power is the basis for daily activities• Short time requirement• Importance of leg extensors in ADLs

….To what extent power output …..predicted performance in older people

Participants

• Same location as in Fiatarone et al., 1990• N=26• Familiar with procedures (presumably

study staff)• Ambulatory but often used wheelchairs• Meds, falls, chronic conditions• Some cognitive impairment

Participants

Age (yrs)

Wt (kg) Ht (m) # of CCs*

# of Meds

Men (N=13)

88 (1.6) 64.7 (2.7)

1.58 (0.03)

64 5.2 (2.4)

Women (N=13)

85 (1.5) 54.7 (2.8)

1.50 (0.03)

55 5.2 (2.1)

* Diabetes, hypertension, heart disease, Parkinson’s, neurological disease, arthritis, syncope, musculo-skeletal defect, cancer, other

Measures

• Leg extensor power (<1 sec)• Right, left, both, best

•Chair rising (1 time)• Stair climbing (4 steps)•Walking (6 m)

Results

• All completed • Leg extensor power• Walking speed

• Chair rise• N=1 (man)

• Stair climb• N=3 (women)

Results

• Good reliability (test-retest)• Neurological & musculo-skeletal disease• Gender or sex??• Use of aids (ie, cane, walker, arms to rise)• 1.1 vs 1.9 W/kg• 0.86 vs 1.87 W/kg

Discussion

• Feasibility• Normative data for power?• Power vs strength• Differences between men and women• Performance of participants• Threshold values• Walking (is this about balance?)• All

• Cause-effect?

Summary

•Muscle strength•Muscle power• Feasibility•Approach to training?• Specificity!!