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Physical Activity as Intervention Against Age-related Loss of Muscle Mass and Function

Not Applicable
Active, not recruiting
Conditions
Muscle Weakness
Muscle Loss
Physical Activity
Sarcopenia
Interventions
Other: Heavy resistance training
Other: Moderate intensity training
Other: Control
Registration Number
NCT02123641
Lead Sponsor
Bispebjerg Hospital
Brief Summary

A minimum of 450 healthy individuals (62-70 years old) will be recruited.

Each individual will be randomized into one of three groups stratified according to gender (M/F), BMI (≤28/\>28), and 30 sec chair stand (≤11/\>11). The three groups are Heavy resistance training (n=150), moderate intensity training (n=150), and control (n=150, no training).

Assessments will be performed at baseline, after 12 months of intervention. Furthermore, follow up will be performed after 2,4,7, and 10 years.

The primary outcome is change in leg extensor power after the intervention and during follow up.

The primary hypothesis is that by applying the intention-to-treat analysis, the moderate intensity training group will increase leg extensor power just as much as the heavy resistance training group. The two training groups will increase muscle power more than the control group.

Detailed Description

Retirement has been recognized as a critical turning point in determining physical activity behaviours in old age. The literature gives a varying picture regarding change in physical activity level with work retirement but often a reduction in total physical activity has been reported. Retirement typically takes place at a time where the skeletal muscle mass, -strength and -power declines by 1-3% per year.

Interventions to promote physical activity in adults aged 55 to 70 years have been shown to be effective at 12 months but it is very unclear if the effect is maintained thereafter. Both exercise at home or at a center improves health and physical function - but home based programs appear to be superior to center based programs in terms of adherence to exercise especially in the long-term.

In older adults, strength training at 60% of 1RM has been shown to be sufficient for large effect on muscle function and muscle protein synthesis, and potentially lower loads (45-60% 1RM) have effect when adding more repetitions.

The overall objective of the study is to assess the long-term effects of 12 month of supervised high-intensity center based resistance training or "guided" moderate-intensity home-based resistance training relative to a non-exercising control group upon muscle power, -strength and -mass, physical function, physical activity level and health in older people around the time of retirement.

The hypotheses are:

1. Supervised high-intensity center based resistance training over one year results in the best improvement in muscle power and bodily function

2. "Guided" moderate-intensity home-based resistance training will result in a more active lifestyle and thus in sustained elevated activity level after the 1-year intervention period. Thus in the long run (several years) "guided" moderate-intensity home-based resistance training has superior effects compared to supervised high-intensity center based resistance training upon functional ability, health and potentially also cognitive function.

450 participants recruited through advertisements in local newspapers will be included in this three-armed, single-blinded randomized trial. After baseline assessment they will be randomized to one year of 1) supervised, high-intensity progressive, resistance training conducted in machines three times weekly in a local fitness center 2) "guided" moderate-intensity home-based resistance training conducted with elastic bands and body weight three times weekly. "Guided" means that the participants are offered supervised resistance training once weekly in addition to home based resistance training 2 times weekly or 3) various social and cultural activities that do not require physical activity.

All participants complete a wide range of tests before and after the 12 months intervention period and the primary time point for outcome assessment will be at 12 month. The same "test battery" is conducted in the subsequent years (2, 4, 7, and 10 years later) as a follow-up.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
451
Inclusion Criteria
  • Independently living men and women
  • Between 62 and 70 years
Exclusion Criteria
  • Subjects dependent on help/nursing etc.
  • Severe chronic obstructive pulmonary disease, cardiac arrhythmias or known decreased left ventricular ejection fraction, non-treated hyper/hypothyroidism, dementia, active cancer.
  • Surgical diseases: Bone, muscle, tendon or joint injuries compromising participation in exercise regimens.
  • Implanted magnetic devices incompatible with MRi-scanning.
  • >1 hour of exercise weekly, except light activities such as stretching/gymnastics and bike-riding/walking as transportation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Heavy resistance trainingHeavy resistance trainingHeavy resistance training of the lower and upper extremities three times weekly for 52 weeks.
Moderate intensity trainingModerate intensity trainingHome-based moderate intensity training of the lower and upper extremities three times weekly for 52 weeks.
ControlControlNo training
Primary Outcome Measures
NameTimeMethod
Change in leg extensor powerBaseline, 1, 2, 4, 7, and 10 years follow up

Unilateral leg extension power measured in the Leg Extensor Power Rig device (Nottingham). The primary time interval for assessment of the primary outcome measure is from baseline to 12 months intervention. The statistical evaluation of the primary outcome measure is done by applying a two way ANOVA test comparing the three groups before/after the intervention and during follow up (1,2,4,7, and 10 years).

Secondary Outcome Measures
NameTimeMethod
Adherence to training interventions2, 4, 7, 10 years

Questionnaire developped specifically for the LISA study by the authores

Change in Exercise self-efficacyBaseline, 1, 2, 4, 7, and 10 years

Questionnaire: Exercise Self-efficacy Scale.

Change in personalityBaseline, 1, 2, 4, 7, and 10 years

Questionnaire: NEO-FFI

Change in 400 m gait speedBaseline, 1, 2, 4, 7, and 10 years

The time used for walking 400 m (20 m course)

Change in grip strengthBaseline, 1, 2, 4, 7, and 10 years

Isometric hand grip strength (Saehan dynamometer)

Change in cognitive abilityBaseline, 1, 2, 4, 7, and 10 years

Questionnaire: IST 2000-R

Change in quadriceps cross sectional areaBaseline, 1, 2, 4, 7, and 10 years

MRI scanning of thigh muscle composition

Change in blood parameters and anthropometryBaseline, 1, 2, 4, 7, and 10 years

Measuring 1) blood levels of inflammatory markers (CRP, TNFa, and IL-6) and HbA1c, plasma lipids. 2) Weight, abdominal circumference, blood pressure.

Change in mental symptomsBaseline, 1, 2, 4, 7, and 10 years

Questionnaire: SCL-90

Change in maximal isometric quadriceps strengthBaseline, 1, 2, 4, 7, and 10 years

Unilateral maximal isometric quadriceps strength measured in the Good Strength device.

Change in perceived ageBaseline, 1, 2, 4, 7, and 10 years

Determination of perceived age from facial and whole-body photographs

Change in physical activity levelBaseline, 1, 2, 4, 7, and 10 years

Wearing a pedometer device (ActivPal) for 5 continuous days. Questionnaire: PASE (Physical Activity Scale for the Elderly).

Change in 30 s chair stand performanceBaseline, 1, 2, 4, 7, and 10 years

Number of stand-ups from a chair in 30 seconds

Change in whole body composition and bone mineral density as well as lumbar spine and femoral neck bone mineral densityBaseline, 1, 2, 4, 7, and 10 years

Body composition (fat mass, lean mass and bone mass) evaluated by whole-body and regional (lumbar spine and femoral neck) dual energy x-ray absorptiometry (DXA)-scanning.

Change in Health Related Quality of LifeBaseline, 1, 2, 4, 7, and 10 years

Questionnaire: SF36.

Changes in brain structure and functionBaseline, 1, 2, 4, 7, and 10 years

MRI scanning of the regional brain structure and function

Trial Locations

Locations (1)

Bispebjerg Hospital

🇩🇰

Copenhagen NV, Denmark

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