Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

Abstract

To date, there has been no study on the long-term effects of resistance exercise on sarcopenia and obesity indices for people with sarcopenia. The present study thus aimed to determine the effect of 18 months of periodized, high-velocity/intensity/effort progressive resistance training (HIT-RT) on body composition and strength in older men with osteosarcopenia. Using a single-blind, two-group parallel design, 43 community-dwelling men, 72 years and older, with osteopenia and sarcopenia in Erlangen-Nürnberg, Germany, were randomly assigned to two study arms by drawing lots: (1) an exercise group that conducted a consistently supervised periodized high-velocity/intensity/effort protocol (HIT-RT; n = 21) on machines twice a week for 18 months or (2) a control group (CG; n = 22) that maintained their physical activity/exercise habits. Both groups were supplied with protein, cholecalciferol, and calcium according to current recommendations. The study outcomes were lean body mass (LBM), total and abdominal body fat as determined by dual-energy X-ray absorptiometry and maximum hip/leg extensor strength as assessed on an isokinetic leg press at baseline and after 8, 12, and 18 months of follow-up. The intention-to-treat principle and multiple imputation were applied to calculated study outcomes. After 18 months of HIT-RT, altogether five participants were lost to follow up (HIT-RT: n = 2, CG: n = 3). The attendance rates (95%) for HIT-RT were high; relevant adverse effects were not observed. Significant effects (i.e., differences between HIT-RT vs. CG) in favor of HIT-RT were determined for LBM (+1.73 kg, 95% CI: +1.13 to +2.32 kg), total body fat mass (−2.44 kg, 95% CI: −1.28 to 3.60 kg), abdominal body fat percentage (−2.68, 95% CI: −1.70 to −3.66), and maximum hip/leg extensor strength (+533 N, 95% CI: +397 to +670 N; all p < 0.001). Even after adjusting for multiple testing, all effects remained significant. Of note, after 8 months of HIT-RT, only slight (LBM and fat indices) to moderate (maximum strength) ongoing effects were observed. Carefully introduced, continuously supervised HIT-RT is an effective, attractive, feasible, and safe method to improve body composition and muscle strength in older community-dwelling men with sarcopenia. However, even when consequently applying principles of exercise intensity progression within the RT protocol, only slight further positive changes were observed after 8 months of exercise.

Detraining Effects on Muscle Quality in Older Men with Osteosarcopenia. Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

“…The recruitment process has already been published in detail [ 9 , 16 ]. Briefly, inclusion criteria were (a) morphometric sarcopenia (skeletal muscle mass index (SMI) ≤ 7.26 kg/m 2 [ 14 , 15 ]) and (b) osteopenia or osteoporosis at the lumbar spine (LS) or total hip (tHip) [ 17 ]), while exclusion criteria were (a) secondary osteoporosis, (b) skeletal muscle disease or treatment known to affect muscle and bone during the last 2 years, (c) hip fractures, (d) any limitations to intensive exercise training, (e) experience in resistance training during last two years, and (f) alcohol consumption > 60 g/d ethanol.…”

“…Randomization and blinding procedures have been extensively described in previous publications (e.g., [ 9 , 16 ]). Briefly, participants allocated themselves to the HIRT or control group by drawing lots.…”

“…Details of the exercise have been frequently published (e.g., [ 9 , 16 ]). Briefly, we applied a progressive, periodized and consistently supervised HIRT, defined as a single set exercise protocol to repetition maximum [ 18 ] using intensifying strategies [ 19 ].…”

Changes in Body Composition and Cardiometabolic Health After Detraining in Older Men with Osteosarcopenia: 6-Month Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST) Study

“… 3 However, most of the studies focus on the detraining effect on musculoskeletal outcomes after short-term interventions (ie 12–16 weeks), while the effects on body composition and cardiometabolic parameters after resistance training (RT) periods that exceed 6 months were rarely evaluated. This refers particularly to older obese people with low muscle and bone mass, 17 , 18 who can be considered as a high-risk group. In order to close this gap, the aim of this study was to determine the effect of 6 months of detraining after an 18-month HIT-RT intervention on body composition and cardiometabolic risk in older, predominately obese, osteosarcopenic men.…”

Changes in Menopausal Risk Factors in Early Postmenopausal Osteopenic Women After 13 Months of High-Intensity Exercise: The Randomized Controlled ACTLIFE-RCT

“…and speculative "effective") part of the protocol, ie, the last 6 months, being truncated. Although when applying a strictly progressive protocol, one may argue that the majority of the physiological changes occurred during the first year, 74 due to the nature of the remodeling cycle 41 this may be less relevant for changes in BMD.…”