High Intensity Resistance Exercise Training to Improve Body Composition and Strength in Older Men With Osteosarcopenia. Results of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

Abstract

Considerably decreased muscle mass and function are subsumed under "sarcopenia," a geriatric syndrome. Dedicated exercise programs maintain muscle mass and function; however, due to the limited enthusiasm of older adults to exercise, it is important to generate low-threshold interventions for this vulnerable cohort. Thus, the primary aim of this study was to determine the effect of low volume/high intensity resistance exercise training (HIT-RT) combined with protein supplementation on body composition and strength in older men with sarcopenia and osteopenia (osteosarcopenia). Forty-three community-dwelling (cdw) older men (78 ± 4 years) with osteosarcopenia were randomly allocated to a consistently supervised HIT-RT (n = 21) or an inactive control group (CG, n = 22). HIT-RT scheduled a single set protocol with high intensity and effort applied twice a week for 36 weeks so far. Both groups were supplemented with Vit-D (800 IE/d), calcium (1,000 mg/d) and whey-protein (CG: 1.2 vs. HIT-RT: 1.5-1.7 g/kg/d). Study endpoints were body composition (dual-energy x-ray absorptiometry) and maximum isokinetic hip/leg-extensor strength (MIES) by leg-press. After 36 weeks, one participant who developed prostate cancer after inclusion in the study (HIT-RT) and two participants who lost interest (CG, HIT-RT) quit the study. Attendance rate for HIT-RT averaged 93 ± 5%. Total and thigh lean body mass (LBM) significantly (p < 0.001) increased in the HIT-RT and was maintained in the CG (p = 0.46 and 0.37). Differences between the groups for changes of total and thigh LBM were pronounced (p < 0.001; SMD d ′ = 1.17 and 1.20). Total and abdominal body fat percentage decreased significantly in the HIT-RT (p < 0.001) and increased in the CG (p = 0.039 and p = 0.097). Intergroup differences were significant (p < 0.001; SMD: d ′ = 1.35 and 1.28). Finally, MIES was maintained in the CG (p = 0.860), and improved significantly (p < 0.001) in the HIT-RT. Differences between the groups were significant (p < 0.001, SMD: d ′ = 2.41). No adverse effects Kemmler et al. HIT-RT in Older Men With Osteosarcopenia of the intervention were observed. In summary, the HIT-RT/protein protocol significantly affected body composition and strength in cdw men 72 years+ with osteosarcopenia. In the absence of negative side effects, the intervention was feasible, attractive and time effective. Thus, we conclude that supervised HIT-RT might be an exercise option for older men.

Effect of high-intensity resistance exercise on cardiometabolic health in older men with osteosarcopenia: the randomised controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

“…However, the continuous scale of this cluster allows a precise, combined analysis of risk factors without generating multiplicity. (3) Monitoring training logs and participant compliance with exercise intensity prescriptions, 17 we estimate that 25%–30% of the RM sets were conducted with too low effort. (4) One may challenge the concept of easy feasibility of a supervised gym-based in general.…”

Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study

“…The study was conducted between February 2018 (start of recruitment) and February 2020 (final data analysis). Two recent interim analyses after 6 and 8 months focus on parameters of sarcopenia [14], muscle mass and strength [15], while the 12-month FrOST analysis [16] addressed skeletal muscle mass index and BMD at the lumbar spine (LS) as determined by quantitative computed tomography (QCT).…”

“…Previous articles [14,15] reported the recruitment process of FrOST in detail, thus only a brief summary will be given here. In essence, 180 cdw men with low muscle mass [17], 72 years and older, living in the area of Erlangen-Nürnberg, Germany were willing to participate in the present study and were checked for eligibility.…”

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

“…The FrOST recruitment procedure took place between March and May 2018 and has been described in detail in previous contributions ( Lichtenberg et al, 2019 ; Kemmler et al, 2020b ). Thus, only a brief summary will be provided here.…”