Mechanisms and Functional Outcomes of Exercise Progression Models in the Elderly

Not Applicable

Completed

Interventions: Other: Regional Specific Training Stimulus (RSTS)
Other: Aerobic Exercise Regimen (AE)

Brief Summary: The aim of this study is to devise a sufficiently high intensity training program that provided an optimal stimulus to remove the peripheral factors known to reduce functional capacity, and can be cardiovascular and orthopedically well tolerated by the elderly. Findings from study laboratories have suggested that a regional specific training stimulus (RSTS) results in rapid improvements in both vascular and muscular function. RSTS is a novel combination of resistance training and aerobic training applied simultaneously, and in a serial manner, to specific regions of the body. It involves high-intensity and frequency muscle contractions, generating a targeted exercise stimulus, without producing excessive cardiovascular or orthopedic stress. The hypothesis is that initiating training with RSTS at multiple, strategically selected peripheral sites, in a serial manner will elicit local vascular and muscular changes, thereby preparing individuals at elevated risk of losing independence, to respond and progress more favorably to whole-body exercise.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Regional Specific Training (RSTS)	Regional Specific Training Stimulus (RSTS)	The RSTS protocol was designed to focus on specific peripheral muscle groups without imposing a significant cardiorespiratory strain. Each exercise involved contractions with moderate load but with an extended duration of up to six minutes. Eight specific exercises were performed to target all major muscle groups and enable the routine to be completed within 60 minutes including warm-up, rest periods and stretching between exercises, and cool down exercises.
Aerobic Exercise (AE)	Aerobic Exercise Regimen (AE)	Whole-body aerobic exercise at \>50% of heart rate reserve (HRR) for 45 minutes, three days per week.

Primary Outcome Measures

Name	Time	Method
Change In Exercise Capacity	Baseline, 4 weeks, and 12 weeks	Exercise capacity was assessed using a maximal cardiopulmonary exercise (CPX) test with expired gas analysis, for determination of peak oxygen consumption and peak walking time.
Change in Maximal Strength	Baseline, 4 weeks, and 12 weeks	Skeletal muscle strength was assessed using a one repetition maximum (1RM) measurement obtained for the seated row, chest press, leg press and handgrip.

Secondary Outcome Measures

Name	Time	Method
Change in Skeletal Muscle Physiology	Baseline, 4 weeks, and 12 weeks	Capillary density (mm2) and capillary to fiber ratio will be evaluated. Fiber type will be also determined to identify for types I, IIa and IIb muscle fibers.
Change in Functional Ability	Baseline, 4 weeks and 12 Weeks	The Senior Fitness Test is a previously validated battery of 6 physical tasks of daily living used to assess strength, flexibility and endurance in order to detect and predict future limitations in functional capacity. The test is designed to evaluate physical fitness domains including upper-body strength (Arm Curl), lower-body strength (Chair Sit-Stand), upper and lower body flexibility (Back Scratch and Chair Sit and Reach), balance and coordination (8 foot Up and Go), and endurance (Six Minute Walk).
Change In Vascular Function	Baseline, 4 weeks, and 12 weeks	Ankle-brachial Index (ABI), Brachial artery flow-mediated dilation (BAFMD), and arterial stiffness (pulse wave velocity and pulse wave reflection).

Locations (2): Duke Center for Living; Wallace Clinic
🇺🇸
Durham, North Carolina, United States
Pennington Biomedical Center
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Baton Rouge, Louisiana, United States