Einfluss von hochintensivem Krafttraining und Detraining auf die Fettinfiltration und Muskelqualität bei Männern mit Osteosarkopenie

Hintergrund und Ziele Hochintensives Krafttraining ist eine effektive Therapie zur Verbesserung der Muskelkraft und zur Reduzierung des Frakturrisikos bei älteren Erwachsenen. Es ist auch als effektive Methode bekannt, um Muskelkraft, Gleichgewicht und Muskelmasse zu erhöhen. Die im MRT gemessene Fettinfiltration, gilt als Marker für eine gesunde Muskulatur und Funktion. Das Ziel dieser Studie ist es, die Wirkung von HIRT auf der Fettinfiltration bei Männern mit Osteosarkopie zu untersuchen. Unser sekundäres Ziel war es, den Effekt eines 6-monatigen Detrainings nach 18 Monaten HIRT auf die Muskelqualität im Vergleich zu einer passiven Kontrollgruppe zu untersuchen. Material und Methoden Dreiundvierzig Männer, die in den letzten 2 Jahren nicht an einem Krafttraining teilgenommen hatten, wurden als geeignet erachtet und wurden nach dem Zufallsprinzip einer – Training Gruppe (EG, n=21) oder Kontrollgruppe (CG, n= 22) zugewiesen. Die EG besuchte 16 Monate lang zwei Trainingseinheiten pro Woche, diese fanden an Geräten statt und waren stets überwacht. Die CG durfte in dieser Zeit an keinem regelmäßigen Training teilnehmen. Die MR-Bildgebung wurde zur Bestimmung des Muskel- und Fettgewebsvolumens und des Fettanteils des Oberschenkels bei Studienbeginn und nach 16 Monaten angewendet. In der Detrainingsphase, Zwei Teilnehmer, die das Interesse verloren, und ein Teilnehmer mit Prostatakrebs brachen jedoch während der Interventionsphase ab. Drei Teilnehmer besuchten die 6-monatige Nachuntersuchung nicht, da sie Angst vor einer Covid-19 Ansteckung während der Untersuchungen hatten. Ergebnisse Nach 16 Monaten nahmen Oberschenkel- (-2,8 %) und Intrafaszienvolumen (-2,0 %) in der EG signifikant ab, während für diese Parameter in der CG keine signifikanten Veränderungen festgestellt werden konnten. Im Gegensatz dazu nahm bei der CG das IMAT-Volumen (10,3 %) signifikant zu und das Muskelgewebevolumen (-2,6 %) signifikant ab, während bei der EG keine signifikanten Veränderungen festgestellt werden konnten. Der intrafasziale Fettanteil nahm in der CG signifikant zu und war in der EG stabil, während sich der Fettanteil im Muskelgewebe (CG: 6,5 %; EG 3,0 %) in beiden Gruppen nach 16 Monaten signifikant erhöhte. Während in der CG keine weiteren relevanten Veränderungen in der Muskelqualität festgestellt wurden, wurde in der EG eine Verschlechterung (p<.001) während der Detrainingszeit beobachtet. Der Gesamteffekt (nach 18 Monaten Training und 6 Monaten Detraining) war in der EG jedoch immer noch signifikant besser als in der CG (p=.004). Schlussfolgerung Das HIRT verhinderte eine weitere Zunahme der Muskelfettinfiltration des Oberschenkels, bei älteren Männern mit Osteosarkopenie. In der CG ging der Anstieg des IMAT mit Muskelschwund einher. Sechs Monate Detraining machen die Effekte auf Muskelqualität und -kraft nach 18-monatigem HIRT bei Männern mit Osteosarkopenie teilweise rückgängig. Obwohl die Anpassungen im Vergleich zum Baseline-Wert nicht vollständig verschwunden sind, ist ein regelmäßiges Training notwendig, um alle Anpassungen zu erhalten

The effect of ageing on fat infiltration of thigh and paraspinal muscles in men

Background Myosteatosis, skeletal muscle fat infiltration, is associated with inflammation and fibrosis. The age-related increase of myosteatosis is an important characteristic of sarcopenia and contributes to fragility. Aims To investigate the impact of healthy aging on intermuscular adipose tissue (IMAT) and muscle fat fraction (FF) in the thigh and the paraspinal muscles in males. Methods In 54 healthy males (age 20–70), all active hobby golfers, magnetic resonance imaging was performed to determine volume of IMAT, volume of muscle tissue (MT) and of percentage of FF. Results Between ages 20–70, at the thigh, IMAT/MT volume and MT FF increased annually by 2.9% and 1.3%, respectively. At the psoas IMAT/Psoas volume did not change with age. MT FF increased by 1.5% annually. At the erector spinae IMAT/Erector volume decreased by 0.3% and MT FF increased by 2.8% annually. Discussion With increasing age, in males, thigh muscle atrophied, muscle tissue was partly replaced by adipose tissue and remaining muscle tissue also contained more fat. Similar effects were observed in the erector spinae. The psoas muscle did not atrophy, although MT FF also increased with age. Overall correlations with age were weak to moderate with higher correlations observed in the paraspinal muscles. Conclusions Age-related increases of muscle fat infiltration were observed in the thigh and in the spine. Muscle atrophy did not occur in the psoas. In cross-sectional studies, an adjustment of volumetric parameters by muscle volume is advisable when comparing age-dependent results.Open Access funding enabled and organized by Projekt DEAL.Friedrich-Alexander-Universität Erlangen-Nürnberg (1041

Detraining Effects on Muscle Quality in Older Men with Osteosarcopenia. Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

The present study aimed to determine the effect of detraining on muscle quality (MQ) in older men with osteosarcopenia. Forty-three community-dwelling older men (78 ± 4 years) were randomly allocated to a consistently supervised high-intensity resistance exercise training (HIRT) group (n = 21) or a control group (CG, n = 22). The HIRT scheduled a periodized single set protocol twice weekly. After the intervention, the men were subjected to six months of detraining. Muscle quality (MQ), defined as maximum isokinetic hip/leg extensor strength per unit of mid-thigh intra-fascia volume, was determined by magnetic resonance imaging (MRI) or per unit of thigh muscle mass assessed by dual-energy X-ray absorptiometry (DXA). Intention-to-treat analysis with multiple imputations was applied. We observed significant exercise effects for MQ (p = 0.001). During detraining, the HIRT group lost about one-third of the intervention-induced gain and displayed significantly (p = 0.001) higher MQ reductions compared to the CG. Nevertheless, after training and detraining, the overall intervention effect on MQ remained significant (p ≤ 0.004). In summary, six months of absence from HIRT induce a significant deleterious effect on MQ in older osteosarcopenic men. We conclude that intermitted training programs with training breaks of six months and longer should be replaced by largely continuous exercise programs, at least when addressing MQ parameters

Once Weekly Whole-Body Electromyostimulation Enhances Muscle Quality in Men: Data of the Randomized Controlled Franconian Electromyostimulation and Golf Study

Whole-body electromyostimulation (WB-EMS) is commercially advertised as a time-efficient resistance-type exercise technology. Indeed, the commercial, non-medical setting applies 20 min of WB-EMS only once a week. However, this setting conflicts with the approved scientific approach of higher training frequencies. Using data from an ongoing study on WB-EMS and golf performance as a vehicle, we evaluate the effect of once weekly WB-EMS on changes of fatty muscle infiltration, as a crucial parameter of muscle quality. Fifty-four moderately physically active male amateur golfers 18–70 years old were randomly allocated to a WB-EMS (n = 27) with a standard setting of once weekly 20 min and a non-WB-EMS control group (CG, n = 27). Intermuscular adipose tissue (IMAT) volume and intrafascial muscle tissue (MT) volume per unit of intrafascial volume as determined by magnetic resonance imaging were used to characterize muscle quality. Intention to treat analysis with multiple imputation was applied. WB-EMS was conducted at the participants’ homes; thus, the attendance rate was close to 100%. After 16 weeks of intervention, we observed increases in volume-adjusted IMAT (p = 0.040) and decreases in MT (p = 0.206) in the CG. IMAT decreased in the WB-EMS group (p = 0.215), while MT increased significantly (p = 0.032). Of importance, group difference (i.e., “effects”) for intra-group changes in volume-adjusted IMAT (effect size: d´ = 0.66; p = 0.028) and MT (d´ = 0.70; p = 0.020) was significant for both parameters. Once weekly WB-EMS application significantly affects muscle quality of the mid-thigh in moderately active, healthy men 18–70 years old

Effects of High-Intensity Aerobic Exercise and Resistance Training on Cardiometabolic Risk in Early-Postmenopausal Women

Purpose: The menopausal transition is a critical period in wo-men’s lives. The central aim of the present study was to evaluate the effect of a multimodal exercise protocol on the cardiometa-bolic risk factor potentially related to menopausal transition in early postmenopausal women.›Methods: Fifty-four (54) early-postmenopausal women (54.0±1.8 years) were randomly assigned to two groups: (1) exer-cise group (EG: n=27) which conducted a high intensity aerobic and resistance training three times/week and (2) active control group (CG: n=27) exercising once a week w ith low exercise inten-sity. Besides bone density, the main variable of this project, the outcome variable in this thesis was also cardiometabolic risk, as summarized by the Metabolic Syndrome (MetS) Z-Score. We applied Intention-to-Treat (ITT) and Per Protocol Analyses (PPA) w ith multiple imputation and used standardized mean differen-ces to illustrate the effects.›Results: After 16 weeks of exercise two participants (EG: n=1; CG: n=1) were lost to follow-up. Effects for the MetS Z-Score were moderate (EG: -0.36±1.36 vs. CG: 0.51±2.28; SMD: 0.47, 95% CI: -0.08 to 1.03), albeit borderline non-significant (ITT: p=.089; PPA: p =.0 6 0). ›Conclusion: The present multimodal exercise protocol just fai-led to affect the MetS Z-Score and its underlying cardiometabolic risk factors. Whether this result can be generalized to the entire cohort of early-postmenopausal women or whether it has to be attributed to the only moderately high exercise intensity during the early weeks of the intervention along w ith a relatively short intervention period remains to be evaluated

Effects of High Intensity Exercise during Early Postmenopause-the Randomized Controlled ACTLIFE-Study

The aim of the study was to determine the effect of a dedicated exercise program on important menopausal risk factors and complaints in osteopenic early-postmenopausal women. Fifty-four women, 1-5 years postmenopause with osteopenia were randomly assigned (a) to a high impact weight bearing/high intensity, high velocity resistance training group (EG: n=27) exercising three times a week or (b) to an attention control group (CG: n=27). Study endpoints were body composition including Bone Mineral Density (BMD) at the Lumbar Spine (LS) as determined by Dual-Energy X-Ray Absorptiometry (DXA), menopausal symptoms, low back pain, lower extremity strength and power. After 28 weeks of intervention, significant effects were determined for free fat mass (EG: 0.48±0.68 kg vs CG: -0.15±0.88 kg, standardized mean differences (SMD): 0.80, p=.005), total body fat mass (EG: -1.19±1.26 kg vs CG: 0.36±1.59 kg,SMD: 1.08, p=.001), abdominal body fat rate (-1.26±1.99% vs 0.54± 1.53%, SMD: 1.02, p=.001), low back pain frequency (SMD: 0.55, p=.049) and severity (SMS: 0.66, p=.018), lower extremity strength (SMD: 1.46, p<.001) and jumping height (SMD: 0.92, p<.001) in the EG compared with the CG. Menopausal complaints improved in both groups, but changes were only significant in the EG (SMD: 0.33, p=.232). We did not determine significant exercise effects on LS-BMD (SMD: 0.26, p=.351). In conclusion, we demonstrate the general effectiveness of a multipurpose exercise protocol on various risk factors and complaints related to the menopausal transition. Future assessments have to determine the exercise effects on BMD, possibly the most challenging physiologic outcome of this ongoing project