Government guidelines suggest that we should all take part in approximately two and a half hours each week of moderate-intensity aerobic exercise. Older adults are particularly important as their overall health may decline as they get older. Therefore, exercising is important especially for older adults to improve heart and muscle health and functioning in carrying out tasks of daily living. The overall effects of aging on the body can make people less likely to withstand challenges to the body - this is termed 'resilience'. Although aerobic exercise is not super easy and requires continuity, it is not extremely difficult to get used to. However, we still do not know if some types of aerobic exercise are better for you than others at improving resilience. Therefore, this study will look at cycling vs walking to see if one is better at improving resilience in older adults who are 60-80 years old. You will be trained on either a treadmill or cycle ergometer and these exercise sessions will be done over 5 weeks, 3 days a week. Each session will last 40 minutes, start with warm-up and end with cool-down sessions. Assessments will include heart, lung, muscle, and memory and thinking measurements, all of which will be taken before and after the intervention period. This work will help us to better understand how we can improve exercise prescriptions for older adults to sustain their health and functioning in their daily life.
Physiological resilience refers to the capacity to retain or regain physical function in the presence of diseases or age-related impairments. Poor resilience may increase vulnerability to stress, which could lead to negative functional and clinical consequences like a prolonged course of illness/hospitalization, reduced physical activity, an elevated risk of frailty, and even mortality. Physiological resilience is particularly crucial because it declines, and the likelihood of many stresses rises with age. Therefore, it is important to promote older populations' physiological resilience reserves and resources (increase their readiness levels against potential future stressors that are more likely to be seen when an individual gets older). Since risk of having stressors increases with advanced age, there is a relationship between aging and reduced readiness to stressors (low physiological resilience). The scientific data establishing the beneficial effects of exercise is undeniable, and the advantages of exercise considerably outweigh the hazards in most adults. Although the existing evidence supports that exercise interventions are a potent tool to foster resilience in older adults, there is still a need of future studies regarding this information. Aerobic exercise (AE), one of the most recommended exercise types by the literature, has also been stated as a beneficial tool to promote physiological resilience at all stages of life through increased growth factor expression and neuroplasticity, which lower the destructive effects of chronic stress. Also, aerobic fitness has been shown to be one of the best predictors of resilience. Government guidelines recommend performing moderate-intensity AE 150 minutes per week. However, the literature does not elaborate on the details of AE interventions on physiological resilience and there is a lack of information on which AE modality is better for this purpose. Although the literature supports the idea of AE being a beneficial tool to improve health and physical fitness goals as well as resilience, it can clearly be seen that there is a need for future research regarding both the comparison of AE modalities in older adults and the effects of AE intervention to promote physiological resilience. Thus, this study will be the first to compare the effects of moderate intensity time-matched AE modalities (cycle ergometer versus treadmill training versus control group) on the parameters associated with physiological resilience (muscle mass/strength, cognition, dexterity, functional ability, cardiorespiratory fitness, and neuromuscular function) in older adults. The intervention period will last 5 weeks, 3 days a week, with 40-minute sessions. The research question will be 'Which AE modality is better in improving determinants of physiological resilience?'. This work will allow us to understand the relationship between AE and physiological resilience in a more detailed way and to prescribe better exercise prescriptions in the future.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
36
Intervention consists of exercises only. Participants in this group will walk on a treadmill. The heart rates of the participants will be monitored with a heart rate monitor while exercising in order to maintain moderate-intensity.
Intervention consists of exercises only. Participants in this group will cycle on an ergometer. The heart rates of the participants will be monitored with a heart rate monitor while exercising in order to maintain moderate-intensity.
The University of Nottingham/Medical School
Derby, Derbyshire, United Kingdom
RECRUITINGThe change in vastus lateralis mass
Bioelectrical impedance analysis (BIA) and ultrasound will be used for this. Muscle thickness, fascicle length, and pennation angle will be measured on ultrasound. BIA is simple to use, places a minimal burden on individuals, uses lightweight and inexpensive equipment, and, most significantly, provides no radiation risk compared to many other methods. It is also found feasible and reliable for the measurement of muscle mass for adults in clinical settings. Ultrasonography is also a technology that is portable, safe, and clearly distinguishes between muscle and subcutaneous fat tissues as well as a valid and novel tool for muscle mass assessment.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The changes of muscle strength with maximum voluntary contraction of knee extension
Maximum voluntary contraction is a standardized technique for assessing muscle strength in healthy older adults. Knee extension strength will be measured with an isometric dynamometer.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The change in cardiorespiratory fitness (CRF) capacity via the Ekblom-bak (EB) test
The EB-test consists of exercise at one standardized, low work rate followed by a higher, individually set work rate. Both work rates are performed for 4 minutes at a cadence of 60rpm on a cycle ergometer. The individual higher work rate is chosen by the researcher according to the participants' gender, age, and training background. The higher work rate aims to reach the Borg rate of perceived exertion (RPE) 12-16. Heart rate is measured during the last minute of each work rate (at 3:15, 3:30, 3:45, and 4:00). Then, VO2max is estimated with a formula.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The difference in neuromuscular function via force accuracy task
Force accuracy is an important parameter since most daily activities are conducted at submaximal levels, where force fluctuation can be observed and reduce the ability to create an intended movement. Force accuracy will be measured on OTBiolab+ application.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The changes in functional ability via the Timed Up and Go test (TUG)
The TUG is a tool for assessing lower limb functional ability and its use has been recommended by the literature. The time required to finish the test is commonly utilised as the primary outcome of the evaluation. This test has previously been used in several studies to assess functional ability.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The difference between upper limb dexterity time before and after the intervention via 9-hole peg task
The 9-hole peg test has been shown to be a valid and reliable tool to measure upper extremity dexterity in various groups including healthy older adults. The number of seconds it takes for the participant to complete the test is used for scoring. A shorter completion time is a better value.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The changes in cognitive function via Mini-ACE
The Mini-ACE is a brief cognitive screening test that evaluates four main cognitive areas (orientation, memory, language and visuospatial function). Higher value on this scale means better cognition.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The changes of muscle strength with handgrip strength
Isometric hand grip strength is closely correlated with the strength of the muscles in the lower extremities, and the torque of the knee, and poor mobility is clinically indicated by low handgrip strength. Higher values mean better results.
Time frame: at Baseline (pre-assessment) and at the week 5 (post-assessment)
The change in cardiorespiratory fitness (CRF) capacity via 6-minute walking test (6MWT)
In the 6MWT, participants walk as much as they can for six minutes along a continuous, interior track that is 30 metres long and has a hard surface. It is a simple, cost-effective, and validated tool in several populations, and it has been frequently used to measure CRF as a field test. The distance covered on this test is reported. A higher distance covered means a better result.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The difference in neuromuscular function via balance time in The Short Physical Performance Battery (SPPB) on motion platform
Balance will be measured on FootScan (centre of pressure, distance travelled, ellipse area).
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
The changes in functional ability via Short Physical Performance Battery Test
Short Physical Performance Battery test includes the chair rise, balance, walk and gait speed assessments for functional mobility. An overall score is determined on a scale from 0 to 12, with lower scores representing a more severe level of disability and higher scores representing more functionally normal levels.
Time frame: at baseline (pre-intervention) and at the week 5 (post-intervention)
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