Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial

Vasconcelos, Karina S. S.; Dias, João M. D.; Araújo, Marília C.; Pinheiro, Ana C.; Moreira, Bruno S.; Dias, Rosângela C.

doi:10.1590/bjpt-rbf.2014.0174

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Brazilian Journal of Physical Therapy

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Original Articles • Braz. J. Phys. Ther. 20 (05) • Oct 2016 • https://doi.org/10.1590/bjpt-rbf.2014.0174 copy

Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background

Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear.

Objective

To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity.

Method

Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m² and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire.

Results

The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes.

Conclusion

In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity.

Keywords:
physical therapy; obesity; sarcopenia; resistance training; aging; mobility

Period	Exercise
Weeks 1 to 10	Stretching exercises - 1 set of 60 s, resting time of 60 s between each exercise
	Open chain		Closed chain
	In supine position: • Straight leg raise for posterior leg muscles; • Straight leg raise with abduction for medial hip muscles; • Straight leg raise with adduction for lateral hip muscles; • Crossing legs for hip rotator muscles. In prone position: • Knee flexion for anterior leg muscles.		In standing position: • Posterior calf muscles; • Anterior thigh muscles.
Period and loading	Resistance exercises – resting time of 30 s between sets and 60 s between exercises
Weeks 1 to 2 Concentric and eccentric movements at low speeds	Open chain		Closed chain
• 2 x 12 (50% of 1RM) for knee exercises • 2 x 8 (1 kg) for hip exercises • 2 x 10 for mini-squats, against the wall	In supine position: • Hip flexion with straight leg raise. In lateral positions: • Hip adduction; • Hip abduction.	In prone position: • Hip extension; • Knee flexion. In sitting position: • Knee extension.	In upright position: • Mini-squats with hips in neutral position; • Mini-squats with hips in external rotation.
Weeks 3 to 4 Concentric and eccentric movements at low speeds
• 2 x 12 (75% of 1RM) for knee exercises • 2 x 8 (2 kg) for hip exercises • 2 x 10 for mini-squats, resting hands on an examination table
Weeks 5 to 6 Concentric movements at high speeds	Open chain		Closed chain
• 2 x 12 (40% of new 1RM) for knee exercises • 2 x 8 (2 kg) for hip exercises • 2 x 10 for mini-squats (one set at high speed), resting hands on an examination table	In supine position: • Hip adduction. In prone position: • Hip abduction; • Knee flexion. In upright position: • Hip flexion; • Hip extension. In sitting position: • Knee extension.		In upright position: • Mini-squats with hips in neutral position; • Mini-squats with hips in external rotation.
Weeks 7 to 8 Concentric and eccentric movements at high speeds
• 2 x 12 (60% of new 1RM) for knee exercises • 2 x 8 (3 kg) for hip exercises • 2 x 10 for mini-squats at high speed, without external support
Weeks 9 to 10 Concentric and eccentric movements at high speeds
• 3 x 12 (60% of new 1RM) for knee exercises • 3 x 8 (3 kg) for hip exercises • 3 x 10 for mini-squats at high speed, without external support

Characteristics - mean±SD	Exercise Group (n=14)	Control Group (n=14)
Age (yr)	72±4.6	72±3.6
Schooling (yr)	6.8±3.6	6.5±3.8
Weight (kg)	73±6.5	76±6.7
Height (m)	1.5±0.04	1.5±0.05
Body mass index (kg/m²)	32±2.3	33±2.9
Waist circumference (cm)	104±8.2	103±6.7
Comorbidities (number)	5.6±1.9	4.4±1.8
Regular medicine (number)	4.0±1.8	5.9±3.2
Characteristics – n (%)
Physically active	11 (78)	9 (64)
Symptoms of depression	3 (21)	2 (14)

Outcome	Exercise Group (n=14)		Control Group (n=14)		Within-group difference		Between-group difference
Outcome	PRE	POST	PRE	POST	Exercise Group	Control Group	*Interaction grouptime**
Strength (J/kg)	103.38±7.13	105.74±6.63	104.47±6.74	95.77±8.25	2.36±12.0	-8.70±20.0	-6 (-0.90 to 12)
Power (w/kg)	87.55±5.25	103.42±6.84	89.31±5.88	91.38±7.15	15.87±13.8^* * P-value<0.05.	2.07±23.8	13 (-1.4 to 28)
Fatigue (%)	21.16±3.83	27.56±2.94	24.65±3.06	23.69±3.46	6.4±20.0	-0.96±9.0	7.6 (-4.5 to 24)
SPPB (points)	11.00±1.4	11.40±1.0	10.00±1.1	10.57±1.2	0.40±1.3	0.57±1.0	-0.14 (-1.04 to 0.76)
Gait velocity (m/s)	1.09±0.10	1.11±0.16	1.04±0.19	1.09±0.11	0.02±0.01	0.05±0.17	0.09 (0.07 to -0.15)
Physical functioning SF-36 (0 to 100)	81±21	80±23	72±23	78±22	-1.0±12.4	6.0±13.7	-7 (-11 to 3)

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[1] *Correspondence Karina Simone de Souza Vasconcelos Universidade Federal de Minas Gerais Escola de Educação Física, Fisioterapia e Terapia Ocupacional Departamento de Fisioterapia Rua Engenheiro Hermenegildo Campos de Almeida, 260, ap. 31, Vila Japi II CEP 13208-640, Jundiaí, SP, Brazil e-mail: karinasimone@hotmail.com