Effects of low-intensity bodyweight training with slow movement on motor function in frail elderly patients: a prospective observational study
Kanda et al. Environmental Health and Preventive Medicine
Effects of low-intensity bodyweight training with slow movement on motor function in frail elderly patients: a prospective observational study
Kanae Kanda 0
Takeshi Yoda 0
Hiromi Suzuki 0
Yugo Okabe 0
Yutaka Mori 1
Kunihisa Yamasaki 1
Hiroko Kitano 1
Aya Kanda 1
Tomohiro Hirao 0
0 Department of Public Health, Kagawa University Faculty of Medicine , 1750-1 Ikenobe, Miki-cho Kita-gun, Kagawa 761-0793 , Japan
1 Sin Cire Co., Ltd , 14-29 Ogi-machi Daito, Osaka 574-0033 , Japan
Background: Slow-motion training, an exercise marked by extremely slow movements, yields a training effect like that of a highly intense training, even when the applied load is small. This study evaluated the effects of low-intensity bodyweight training with slow movement on motor function in frail, elderly patients. Methods: Ninety-seven elderly men and women aged 65 years or older, whose level of nursing care was classified as either support required (1 and 2) or long-term care required (care level 1 and 2), volunteered to participate. Two facilities were used. Participants in the first facility used low-intensity bodyweight training with slow movement (the LST group, n = 65), and participants in another facility used machine training (the control group, n = 31). Exercises were conducted for 3 months, once or twice a week, depending on the required level of nursing care. Changes in motor function were examined. Results: Post-exercise measurements showed significant improvements from the pre-exercise levels after 3 months, based on the results of the Timed Up and Go test (p = 0.0263) and chair-stand test (p = 0.0016) in the low-intensity exercise with slow movement and tonic force generation (LST) group. Although the ability to stand on one leg with eyes open tended to improve, no significant change was found (p = 0.0964). Conclusions: We confirmed that carrying out LST bodyweight training for 3 months led to improvements in ambulatory function and lower-limb muscle strength. In this way, it is possible that LST training performed by holding a bar or by staying seated on a chair contributes to improved motor function in elderly patients within a short time. Trial registration: UMIN000030853. Registered 17 January 2018. (retrospectively registered).
Bodyweight training; frail elderly; LST; Motor function
Background
Resistance training, which consists of applying resistance
to muscles, is effective for the prevention of muscle
weakness and muscle atrophy associated with aging [
1, 2
].
However, in conventional resistance training, no apparent
muscle hypertrophy can be achieved unless high load
intensity equivalent to approximately 80% of the maximum
muscle strength is used [3]. Notably, high-load resistance
training is associated with small, but real, risks of muscle
or joint injuries and cardiovascular events [
4
]; therefore,
muscle training methods for elderly subjects need to be
safe to perform under a relatively low load.
Recently, low-intensity exercise with slow movement
and tonic force generation (LST) [
5
], involving
movements while maintaining muscle tension that allows for
the obtainment of a substantial muscle hypertrophy
effect using a relatively light load, has been developed,
and evidence of its effects continue to be accumulated.
LST training is a collective term, which refers to a
practice of muscle training in which the load is increased
and decreased extremely slowly. LST training has a
positive effect on muscle hypertrophy and demonstrates an
enhancing effect on muscle strength, even with load
strength equivalent to 50% or less of the maximum
muscle strength [
5–9
]. However, studies on this method
of training conducted on elderly subjects are in their
accumulation stage and have predominantly been
conducted on healthy elderly subjects, with the use of
muscle training machines. Accordingly, a slow-motion
bodyweight training program that can be easily
performed by frail elderly subjects at home is needed.
Therefore, the purpose of this study was to evaluate
the effects of LST bodyweight training on motor
function in frail elderly patients.
Methods
Participants
The study included elderly men and women aged
65 years or older who were using nursing care facilities
in Osaka from March to August 2016 as well as those
who required a level of nursing care classified as either
support required (1 and 2) or long-term care required
(care level 1 and 2). Two facilities were involved. The
participants in the first facility started receiving an
exercise rehabilitation therapy using LST bodyweight
training (the LST group), and the participants in the
other facility started receiving an exercise rehabilitation
therapy using machine training (the control group). The
study flowchart is shown in Fig. 1. Exclusion criteria for
the participants were as follows: (1) those who had
difficulty participating in the exercise program due to
apparent cognitive symptoms and (...truncated)