Effects of Overload Eccentric and Concentric Resistance Training on the Cost of Walking, Muscle-tendon and Jumping Performance in Healthy Older Individuals (EOECORT-COM-JP)

Normal aging leads to a decline in neuromuscular and mobility functions, including a 60% reduction in maximal voluntary force production, a 25% decrease in muscle volume and quality (sarcopenia), and reduced tendon stiffness by age 70. These changes impair walking speed, balance, and increase the metabolic cost of walking by ~20% in older adults compared to younger individuals. While walking training can reduce metabolic costs, no interventions have successfully addressed the 20% age-related difference. Resistance training, particularly eccentric (muscle-lengthening) training, shows promise for improving muscle strength and mass, but its effects on functional, cognitive abilities, and walking economy in older adults remain unexplored.

Study Overview

• Status: Active, not recruiting
• Conditions: Healthy Older Adults
• Intervention / Treatment: Other: Concentric overload resistance training; Other: Eccentric overload resistance training; Other: Active Control

Detailed Description

Normal aging is characterized by a decline in neuromuscular and mobility functions. By the age of 70, maximal voluntary force production decreases by approximately 60%, accompanied by a ~25% reduction in muscle volume and quality, leading to sarcopenia. Alongside changes in muscle protein content, composition, and mitochondrial biochemistry, aging also affects tendon properties. While healthy aging does not significantly alter tendon size, it reduces tendon stiffness, which can delay force transmission. These changes in muscle-tendon function contribute to slower walking speeds and impaired static and dynamic balance.

One of the most significant functional changes with aging is the increased metabolic cost of walking. Older individuals require ~20% more metabolic energy to walk the same distance as younger adults, yet the underlying reasons remain unclear. While walking training has been shown to reduce metabolic costs in older adults, no studies have attempted to reduce this 20% age-related difference using alternative interventions.

Resistance training induces adaptations in muscle-tendon function by requiring participants to overcome external loads. Traditional resistance training combines concentric (muscle shortening) and eccentric (muscle lengthening) contractions, but eccentric training has received increasing attention due to its superior benefits in muscle strength and mass improvement. However, no studies have examined how resistance training, particularly with an eccentric focus, impacts functional and cognitive abilities or walking economy in older adults.

Objectives:

This study aims to:

1. Investigate the effects of resistance training, particularly eccentric-focused training, on muscle-tendon function and walking economy in older adults.
2. Examine whether these changes translate into improved neuromuscular and cognitive functions.
3. Determine if improved tendon stiffness leads to more efficient force transmission, reducing walking energy expenditure.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hungary
  • Budapest
    • Budapest XII., Budapest, Hungary, 1037
      • Hungarian University of Sports Science, Budapest, Hungary

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • Healthy men and women aged 60+ (intervention study).

  • No significant cognitive or cardiovascular impairments.

Exclusion Criteria:

• • Acute injuries or history of severe tendon injuries (Achilles or patellar tendon rupture).

  • Tendinopathy or chronic musculoskeletal disorders.
  • Hypertension, unless controlled with medication.
  • Neurological or psychiatric disorders (dementia, mild cognitive impairment).
  • Metabolic diseases affecting muscle/tendon function,

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Concentric overload resistance training; Receive Concentric overload resistance training	Other: Concentric overload resistance training; Resistance training groups will train 2-3 times per week for 3 months using specialized TechnoGym machines.; Exercises include Concentric leg press, knee extension, and ankle plantarflexion in a progressive loading program following American College of Sports Medicine (ACSM) & National Strength and Conditioning Association (NSCA) guidelines.; Heart rate, blood pressure, and perceived exertion will be monitored during each session.; Other Names: active control
Experimental: Eccentric overload resistance training; Receive Eccentric overload resistance training	Other: Eccentric overload resistance training; Resistance training groups will train 2-3 times per week for 3 months using specialized TechnoGym machines.; Exercises include Eccentric leg press, knee extension, and ankle plantarflexion in a progressive loading program following American College of Sports Medicine (ACSM) & National Strength and Conditioning Association (NSCA) guidelines.; Heart rate, blood pressure, and perceived exertion will be monitored during each session.
Placebo Comparator: Active control group; walking intervention	Other: Active Control; Walking

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Walking metabolic cost	Assessed using spirometry at different speeds (J/kg/m)	Through study completion, an average of 1.5 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximum isometric voluntary contraction	Maximum isometric voluntary force using a dynamometer. (Nm)	Through study completion, an average of 1.5 year
Patella and Achilles tendon stiffness	Stiffness is the slope of the force elongation curve using dynamometer combining with Ultrasound (N/mm)	Through study completion, an average of 1.5 year
Vastus lateralis and Gastrocnemius muscle thickness & tendon thickness	VL, GC, and Achilles tendon & patellar tendon will be assessed using Ultrasound images (mm)	Through study completion, an average of 1.5 year
Whole leg muscle mass	Whole leg muscle mass via DEXA scan.(Kg)	Through study completion, an average of 1.5 year
Jump efficiency	squat jump and Countermovement jump height (cm) jump efficiency (%)	Through study completion, an average of 1.5 year
Cognitive Assessments	Cognitive tests: Executive function, working memory, and processing speed using some questionnaires with score values. Reaction Time (milliseconds, ms) Score (points or errors) - Based on correct/incorrect responses in tasks Number of correct responses per second (responses/sec)	Through study completion, an average of 1.5 year

Collaborators and Investigators

• Sponsor: Hungarian University of Sports Science
• Collaborators: Semmelweis University
• Investigators: Principal Investigator: Prof. DR. Tibor Hortobágyi Hortobágyi, Hungarian University of Sports Science, Department of Kinesioogy, Budapest, Hungary

Publications and helpful links

General Publications

• Malatesta D, Canepa M, Menendez Fernandez A. The effect of treadmill and overground walking on preferred walking speed and gait kinematics in healthy, physically active older adults. Eur J Appl Physiol. 2017 Sep;117(9):1833-1843. doi: 10.1007/s00421-017-3672-3. Epub 2017 Jul 7.
• Thomas EE, De Vito G, Macaluso A. Speed training with body weight unloading improves walking energy cost and maximal speed in 75- to 85-year-old healthy women. J Appl Physiol (1985). 2007 Nov;103(5):1598-603. doi: 10.1152/japplphysiol.00399.2007. Epub 2007 Sep 6.
• Valenti G, Bonomi AG, Westerterp KR. Multicomponent Fitness Training Improves Walking Economy in Older Adults. Med Sci Sports Exerc. 2016 Jul;48(7):1365-70. doi: 10.1249/MSS.0000000000000893.
• Hunter GR, Fisher G, Neumeier WH, Carter SJ, Plaisance EP. Exercise Training and Energy Expenditure following Weight Loss. Med Sci Sports Exerc. 2015 Sep;47(9):1950-7. doi: 10.1249/MSS.0000000000000622.
• Hunter GR, McCarthy JP, Bryan DR, Zuckerman PA, Bamman MM, Byrne NM. Increased strength and decreased flexibility are related to reduced oxygen cost of walking. Eur J Appl Physiol. 2008 Nov;104(5):895-901. doi: 10.1007/s00421-008-0846-z. Epub 2008 Aug 29.
• Godges JJ, MacRae PG, Engelke KA. Effects of exercise on hip range of motion, trunk muscle performance, and gait economy. Phys Ther. 1993 Jul;73(7):468-77. doi: 10.1093/ptj/73.7.468.

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2024
• Primary Completion (Estimated): December 15, 2025
• Study Completion (Estimated): May 15, 2026

Study Registration Dates

• First Submitted: February 9, 2025
• First Submitted That Met QC Criteria: February 17, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 17, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: balance; Resistance training; countermovement jump; SSC; cost of walking; cost of transfer
• Other Study ID Numbers: TE-KEB/No11/2024 (Other Identifier: Hungarian University of sports science)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Time Frame: 15 May 2026
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No