Exercise strategies to protect against the impact of short-term reduced physical activity on muscle function and markers of health in older men: study protocol for a randomised controlled trial

Oliver J Perkin, Rebecca L Travers, Javier T Gonzalez, James E Turner, Fiona Gillison, Cassie Wilson, Polly M McGuigan, Dylan Thompson, Keith A Stokes, Oliver J Perkin, Rebecca L Travers, Javier T Gonzalez, James E Turner, Fiona Gillison, Cassie Wilson, Polly M McGuigan, Dylan Thompson, Keith A Stokes

Abstract

Background: Muscles get smaller and weaker as we age and become more vulnerable to atrophy when physical activity is reduced or removed. This research is designed to investigate the potentially protective effects of two separate exercise strategies against loss in skeletal muscle function and size, and other key indices of health, following 14 days of reduced physical activity in older men.

Methods: Three groups of 10 older men (aged 65-80 years) will undertake 2 weeks of reduced activity by decreasing daily steps from more than 3500 to less than 1500 (using pedometers to record step count). Two of the three groups will then undertake additional exercise interventions, either: 4 weeks of progressive resistance training prior to the step-reduction intervention (PT-group), or home-based 'exercise snacking' three times per day during the step-reduction intervention (ES-group). The third group undertaking only the step-reduction intervention (control) will provide a comparison against which to assess the effectiveness of the protective exercise strategies. Pre and post step-reduction assessments of muscle function, standing balance, anthropometry and muscle architecture will be taken. Pre and post step-reduction in postprandial metabolic control, resting systemic inflammation, adipose inflammation, oxidative stress, immune function, sleep quality, dietary habits, and quality of life will be measured. The stress response to exercise, and signalling protein and gene expression for muscle protein synthesis and breakdown following an acute bout of exercise will also be assessed pre and post step-reduction. Rates of muscle protein synthesis and adipose triglyceride turnover during the step-reduction intervention will be measured using stable isotope methodology. All participants will then undertake 2 weeks of supervised resistance training with the aim of regaining any deficit from baseline in muscle function and size.

Discussion: This study aims to identify exercise strategies that could be implemented to protect against loss of muscle power during 2 weeks of reduced activity in older men, and to improve understanding of the way in which a short-term reduction in physical activity impacts upon muscle function and health.

Trial registration: ClinicalTrials.gov: NCT02495727 (Initial registration: 25 June 2015).

Keywords: Atrophy; Inactivity; Muscle; Recovery; Reduced activity; Resistance exercise; Step-reduction; Strength.

Figures

Fig. 1
Fig. 1
A flow diagram of the study timeline. SPPB, Short Physical Performance Battery; BMI, bodymass index; PT-Group, pre-training group; ES-Group, exercise snacking group
Fig. 2
Fig. 2
A schematic overview of the main trial data collection day; arrows indicate the timing of blood,adipose and muscle samples

References

    1. Mitchell WK, Atherton PJ, Williams J, Larvin M, Lund JN, Narici M. Sarcopenia, dynapenia and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front Physiol. 2012;3:260. doi: 10.3389/fphys.2012.00260.
    1. Seene T, Kaasik P. Muscle weakness in the elderly: role of sarcopenia, dynapenia, and possibilities for rehabilitation. Eur Rev Aging Phys Act. 2012;9(2):109–17. doi: 10.1007/s11556-012-0102-8.
    1. Degens H, Korhonen MT. Factors contributing to the variability in muscle ageing. Maturitas. 2012;73(3):197–201. doi: 10.1016/j.maturitas.2012.07.015.
    1. Lanza IR, Towse TF, Caldwell GE, Wigmore DM, Kent-Braun JA. Effects of age on human muscle torque, velocity, and power in two muscle groups. J Appl Physiol. 2003;95(6):2361–9. doi: 10.1152/japplphysiol.00724.2002.
    1. Cooper C, Fielding R, Visser M, van Loon LJ, Rolland Y, Orwoll E, et al. Tools in the assessment of sarcopenia. Calcif Tissue Int. 2013;93(3):201–10. doi: 10.1007/s00223-013-9757-z.
    1. Bean JF, Kiely DK, Herman S, Leveille SG, Mizer K, Frontera WR, et al. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002;50(3):461–7. doi: 10.1046/j.1532-5415.2002.50111.x.
    1. Faulkner JA, Larkin LM, Claflin DR, Brooks SV. Age-related changes in the structure and function of skeletal muscles. Clin Exp Pharmacol Physiol. 2007;34(11):1091–6. doi: 10.1111/j.1440-1681.2007.04752.x.
    1. Marcell TJ. Sarcopenia: causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci. 2003;58(10):911–6. doi: 10.1093/gerona/58.10.M911.
    1. Ferrando AA, Lane HW, Stuart CA, Davis-Street J, Wolfe RR. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am J Physiol. 1996;270(4):E627–33.
    1. Trappe S, Creer A, Minchev K, Slivka D, Louis E, Luden N, et al. Human soleus single muscle fiber function with exercise or nutrition countermeasures during 60 days of bed rest. Am J Physiol Regul Integr Comp Physiol. 2008;294(3):R939–47. doi: 10.1152/ajpregu.00761.2007.
    1. Urso ML, Clarkson PM, Price TB. Immobilization effects in young and older adults. Eur J Appl Physiol. 2006;96(5):564–71. doi: 10.1007/s00421-005-0109-1.
    1. Wall BT, Dirks ML, van Loon LJ. Skeletal muscle atrophy during short-term disuse: implications for age-related sarcopenia. Ageing Res Rev. 2013;12(4):898–906. doi: 10.1016/j.arr.2013.07.003.
    1. Cohen-Mansfield J, Marx MS, Guralnik JM. Motivators and barriers to exercise in an older community-dwelling population. J Aging Phys Act. 2003;11(2):242–53.
    1. Satariano WA, Haight TJ, Tager IB. Reasons given by older people for limitation or avoidance of leisure time physical activity. J Am Geriatr Soc. 2000;48(5):505–12. doi: 10.1111/j.1532-5415.2000.tb04996.x.
    1. Breen L, Stokes KA, Churchward-Venne TA, Moore DR, Baker SK, Smith K, et al. Two weeks of reduced activity decreases leg lean mass and induces ‘anabolic resistance’ of myofibrillar protein synthesis in healthy elderly. J Clin Endocrinol Metab. 2013;98(6):2604–12. doi: 10.1210/jc.2013-1502.
    1. Clark BC, Manini TM. Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci. 2008;63(8):829–34. doi: 10.1093/gerona/63.8.829.
    1. Ordway NR, Hand N, Briggs G, Ploutz-Snyder LL. Reliability of knee and ankle strength measures in an older adult population. J Strength Cond Res. 2006;20(1):82–7.
    1. Folland JP, Williams AG. The adaptations to strength training – morphological and neurological contributions to increased strength. Sports Med. 2007;37(2):145–68. doi: 10.2165/00007256-200737020-00004.
    1. Butler AA, Lord SR, Rogers MW, Fitzpatrick RC. Muscle weakness impairs the proprioceptive control of human standing. Brain Res. 2008;1242:244–51. doi: 10.1016/j.brainres.2008.03.094.
    1. Cook SB, Kanaley JA, Ploutz-Snyder LL. Neuromuscular function following muscular unloading and blood flow restricted exercise. Eur J Appl Physiol. 2014;114(7):1357–65. doi: 10.1007/s00421-014-2864-3.
    1. Devries MC, Breen L, Von Allmen M, MacDonald MJ, Moore DR, Offord EA, et al. Low‐load resistance training during step‐reduction attenuates declines in muscle mass and strength and enhances anabolic sensitivity in older men. Physiol Rep. 2015;3(8). doi: 10.14814/phy2.12493.
    1. Perkin O, McGuigan P, Thompson D, Stokes K. A reduced activity model: a relevant tool for the study of ageing muscle. Biogerontology. 2015:1-13. doi: 10.1007/s10522-015-9613-9.
    1. Booth FW, Hargreaves M. Understanding multi-organ pathology from insufficient exercise. J Appl Physiol. 2011;111(4):1199–200. doi: 10.1152/japplphysiol.01034.2011.
    1. Tudor-Locke C, Craig CL, Thyfault JP, Spence JC. A step-defined sedentary lifestyle index: <5000 steps/day. Appl Physiol Nutr Metab. 2013;38(2):100–14. doi: 10.1139/apnm-2012-0235.
    1. Walhin J-P, Richardson JD, Betts JA, Thompson D. Exercise counteracts the effects of short-term overfeeding and reduced physical activity independent of energy imbalance in healthy young men. J Physiol. 2013;591(24):6231–43. doi: 10.1113/jphysiol.2013.262709.
    1. Rittweger J, Frost HM, Schiessl H, Ohshima H, Alkner B, Tesch P, et al. Muscle atrophy and bone loss after 90 days’ bed rest and the effects of flywheel resistive exercise and pamidronate: results from the LTBR study. Bone. 2005;36(6):1019–29. doi: 10.1016/j.bone.2004.11.014.
    1. Clegg A, Barber S, Young J, Iliffe S, Forster A. The Home-based Older People’s Exercise (HOPE) trial: a pilot randomised controlled trial of a home-based exercise intervention for older people with frailty. Age Ageing. 2014;43(5):687–95. doi: 10.1093/ageing/afu033.
    1. Francois M, Baldi J, Manning P, Lucas SE, Hawley J, Williams MA, et al. ‘Exercise snacks’ before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Diabetologia. 2014;57(7):1437–45. doi: 10.1007/s00125-014-3244-6.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower-extremity function: association with self-reported disability and prediction of mortality and nursing-home admission. J Gerontol. 1994;49(2):M85–94. doi: 10.1093/geronj/49.2.M85.
    1. Lovell DI, Cuneo R, Gass GC. The effect of strength training and short-term detraining on maximum force and the rate of force development of older men. Eur J Appl Physiol. 2010;109(3):429–35. doi: 10.1007/s00421-010-1375-0.
    1. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the Star Excursion Balance Test. N Am J Sports Phys Ther. 2009;4(2):92–9.
    1. Gilbert KL, Stokes KA, Hall GM, Thompson D. Growth hormone responses to 3 different exercise bouts in 18- to 25- and 40- to 50-year-old men. Appl Physiol Nutr Metab. 2008;33(4):706–12. doi: 10.1139/H08-034.
    1. Thompson D, Williams C, Garcia-Roves P, McGregor SJ, McArdle F, Jackson MJ. Post-exercise vitamin C supplementation and recovery from demanding exercise. Eur J Appl Physiol. 2003;89(3-4):393–400. doi: 10.1007/s00421-003-0816-4.
    1. Thompson D, Williams C, Kingsley M, Nicholas CW, Lakomy HKA, McArdle F, et al. Muscle soreness and damage parameters after prolonged intermittent shuttle-running following acute vitamin C supplementation. Int J Sports Med. 2001;22(1):68–75. doi: 10.1055/s-2001-11358.
    1. Di Fabio RP. One repetition maximum for older persons: is it safe? J Orthop Sports Phys Ther. 2001;31(1):2–3. doi: 10.2519/jospt.2001.31.1.2.
    1. Schroeder ET, Wang Y, Castaneda-Sceppa C, Cloutier G, Vallejo AF, Kawakubo M, et al. Reliability of maximal voluntary muscle strength and power testing in older men. J Gerontol A Biol Sci Med Sci. 2007;62(5):543–9. doi: 10.1093/gerona/62.5.543.
    1. Folland JP, Williams AG. Methodological issues with the interpolated twitch technique. J Electromyogr Kinesiol. 2007;17(3):317–27. doi: .
    1. Bergstrom J. Muscle electrolytes in man – determined by neutron activation analysis on needle biopsy specimens – study on normal subjects, kidney patients, and patients with chronic diarrhoea. Scand J Clin Lab Invest. 1962;14:1. doi: 10.3109/00365516209075148.
    1. Van Thienen R, D’Hulst G, Deldicque L, Hespel P. Biochemical artifacts in experiments involving repeated biopsies in the same muscle. Physiol Rep. 2014;2(5):e00286. doi:10.14814/phy2.286.
    1. Buysse DJ. Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213. doi: 10.1016/0165-1781(89)90047-4.
    1. Skevington SM, Lotfy M, O’Connell KA. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310. doi: 10.1023/B:QURE.0000018486.91360.00.
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2. Hillsdale: Lawrence Earlbaum Associates; 1988.

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