dr richard a. ferguson
Post on 24-Feb-2016
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Dr Richard A. Ferguson
Exercise in older people
Musculo-Skeletal Muscle Biology Research GroupSchool of Sport, Exercise and Health Sciences
Loughborough University
“The biggest issue is loss of function. Not everyone has cancer, not everyone has Alzheimer's, but almost everyone loses function”.
David Muller Dean of Medical EducationMount Sinai School of Medicine in New York City
The background issues …
• Skeletal muscle function
• Aerobic function
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
Resistance / strength exercise
Frontera et al (1988)
Age range 60 – 72 yrs80% 1-RM (progressive)3 sets of 8 reps3 days per week for 12 weeks
Even in VERY old people
Harridge et al (1999)
Age range 85 – 97 yrs80% 1-RM (progressive)3 sets of 8 reps3 days per week for 12 weeks
Resistance / strength exercise
Even in VERY old people
Harridge et al (1999)
Age range 85 – 97 yrs80% 1-RM (progressive)3 sets of 8 reps3 days per week for 12 weeks
Resistance / strength exercise
UK Physical Activity Guidelines
UK Physical Activity Guidelines
Older adults should also undertake physical activity to improve muscle strength on at least two days a week.
UK Physical Activity Guidelines
Effects of strength training on physical function
Physical function – systematic reviews
“…. resistance training increased muscle strength and had a modest significant effect on some measures of physical functioning (e.g., gait speed)”.
Physical function – systematic reviews
“Evidence shows that older people who exercise their muscles against a force or resistance become stronger. They also improve their performance of simple activities such as walking, climbing steps, or standing up from a chair more quickly. The improvement in activities such as getting out of a chair or stair climbing is generally greater than walking speed”
Liu & Latham (2009)
Physical function – systematic reviews
“Evidence shows that older people who exercise their muscles against a force or resistance become stronger. They also improve their performance of simple activities such as walking, climbing steps, or standing up from a chair more quickly. The improvement in activities such as getting out of a chair or stair climbing is generally greater than walking speed”
Liu & Latham (2009)
Alternative interventions
Alternative interventions
Narici et al. (2005)
Muscle power = force x velocity
Alternative interventions
Narici et al. (2005)
Traditional resistance training velocity
Alternative interventions
Narici et al. (2005)
High velocity resistance training
InVEST – Increased Velocity Exercise Specific to Task
Bean et al (2009)
Age ~74 yrs3 days per week for 16 weeks
NIA – National Institute of Aging strength training program (2 sets of 10)
concentric phase performed slowly (3 sec)
InVEST – task specific movement patternconcentric phase performed as quickly as possible
SPPB – short physical performance battery
InVEST – Increased Velocity Exercise Specific to Task
Bean et al (2009)
InVEST – Increased Velocity Exercise Specific to Task
Bean et al (2009)
“human muscle age-related molecular processes appear distinct from the processes directly regulated by those of physical activity”
Marr explained he had fallen into the "terrible" trap of believing what he read in newspapers, which encouraged people to "take very intensive exercise in short bursts - and that's the way to health". He went on: "I went onto a rowing machine and gave it everything I had, and had a strange feeling afterwards - a blinding headache, and flashes of light - served out the family meal, went to bed, woke up the next morning lying on the floor unable to move.
Summary
• Resistance training into later life attenuates the decline in muscle strength
• Does not necessarily enhance functional ability RESEARCH FUNDING OPPORTUNITIES ;-)
• Large variability in “responsiveness” to exercise interventions
• Exercise for older people should be personalised (baseline physiology / genetic screening!!)
RESEARCH FUNDING OPPORTUNITIES ;-)
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