Jakub Mesinovic, Anoohya Gandham, Mavil May Cervo, Paul Jansons, Costas Glavas, Michael Braude, Juan Pena Rodriguez, Barbora De Courten, Ayse Zengin, Belinda R. Beck, Peter R. Ebeling, David Scott
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Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Sixty older adults (aged ≥ 60 years) with obesity (dual-energy x-ray absorptiometry determined body fat percentage ≥ 30% in men and ≥ 40% in women) and a mobility limitation (Short Physical Performance Battery [SPPB] score ≤ 11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT or self-directed, home-based AT while consuming a hypocaloric diet (750–1000 kcal/day reduction in energy intake). Changes in physical function (primary outcome: gait speed) and body composition were compared between groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 49/60 randomised participants (mean age: 69.6 ± 6 years; 58% women; mean BMI: 32.9 ± 4.1 kg/m<sup>2</sup>) completed the trial. Gait speed increased following HiRIT compared with AT (mean difference: 0.07 m/s [95% CI: 0.01, 0.13]). Chair stand times decreased in both groups (HiRIT: −1.3 s [95% CI: −2.1, −0.4] vs. AT: −0.8 s [95% CI: −1.6, −0.04]) and HiRIT, but not AT, increased handgrip strength (HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI: −0.9, 2.3]) and SPPB scores (HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI: −0.04, 0.8]). Similar decreases in total body mass (HiRIT: −5.1 kg [95% CI: −6.7, −3.4] vs. AT: −4.9 kg [95% CI: −6.5, −3.3]), fat mass (HiRIT: −3.6 kg [95% CI: −5.0, −2.2] vs. AT: −3.3 kg [95% CI: −4.7, −2.0]), visceral fat (HiRIT: −32.1 cm<sup>2</sup> [95% CI: −47.4, −16.8] vs. AT: −31.4 cm<sup>2</sup> [95% CI: −46.1, −16.8]) and appendicular lean mass (HiRIT: −0.8 kg [95% CI: −1.4, −0.2] vs. AT: −1.2 kg [95% CI: −1.8, −0.6]) were observed. HiRIT was well tolerated with only seven minor adverse events compared with five reported in those who completed AT.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>HiRIT appears to be safe and more effective than AT for improving gait speed in older adults with obesity undertaking dietary weight loss. Additional trials with larger sample sizes and longer durations are warranted to explore whether HiRIT can attenuate weight loss–related muscle and bone mass declines. <b>Trial Registration:</b> Australian New Zealand Clinical Trials: ACTRN12618001146280.</p>\n </section>\n </div>","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13789","citationCount":"0","resultStr":"{\"title\":\"Resistance and Impact Training During Weight Loss Improves Physical Function and Body Composition in Older Adults With Obesity\",\"authors\":\"Jakub Mesinovic, Anoohya Gandham, Mavil May Cervo, Paul Jansons, Costas Glavas, Michael Braude, Juan Pena Rodriguez, Barbora De Courten, Ayse Zengin, Belinda R. Beck, Peter R. Ebeling, David Scott\",\"doi\":\"10.1002/jcsm.13789\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Weight loss achieved via energy restriction leads to significant losses in muscle and bone mass, potentially increasing risk for sarcopenia and osteoporosis. High-intensity resistance and impact training (HiRIT) might attenuate weight loss–induced musculoskeletal declines. Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Sixty older adults (aged ≥ 60 years) with obesity (dual-energy x-ray absorptiometry determined body fat percentage ≥ 30% in men and ≥ 40% in women) and a mobility limitation (Short Physical Performance Battery [SPPB] score ≤ 11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT or self-directed, home-based AT while consuming a hypocaloric diet (750–1000 kcal/day reduction in energy intake). Changes in physical function (primary outcome: gait speed) and body composition were compared between groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 49/60 randomised participants (mean age: 69.6 ± 6 years; 58% women; mean BMI: 32.9 ± 4.1 kg/m<sup>2</sup>) completed the trial. Gait speed increased following HiRIT compared with AT (mean difference: 0.07 m/s [95% CI: 0.01, 0.13]). Chair stand times decreased in both groups (HiRIT: −1.3 s [95% CI: −2.1, −0.4] vs. AT: −0.8 s [95% CI: −1.6, −0.04]) and HiRIT, but not AT, increased handgrip strength (HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI: −0.9, 2.3]) and SPPB scores (HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI: −0.04, 0.8]). Similar decreases in total body mass (HiRIT: −5.1 kg [95% CI: −6.7, −3.4] vs. AT: −4.9 kg [95% CI: −6.5, −3.3]), fat mass (HiRIT: −3.6 kg [95% CI: −5.0, −2.2] vs. AT: −3.3 kg [95% CI: −4.7, −2.0]), visceral fat (HiRIT: −32.1 cm<sup>2</sup> [95% CI: −47.4, −16.8] vs. AT: −31.4 cm<sup>2</sup> [95% CI: −46.1, −16.8]) and appendicular lean mass (HiRIT: −0.8 kg [95% CI: −1.4, −0.2] vs. AT: −1.2 kg [95% CI: −1.8, −0.6]) were observed. 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引用次数: 0
摘要
背景：通过能量限制实现的体重减轻会导致肌肉和骨量的显著减少，潜在地增加肌肉减少症和骨质疏松症的风险。高强度阻力和冲击训练（HiRIT）可能会减轻体重减轻引起的肌肉骨骼衰退。我们的目的是比较老年肥胖患者在饮食减肥结合HiRIT或有氧训练（AT）后身体功能和身体成分的变化。方法60名年龄≥60岁的肥胖老年人（双能x线吸收仪测定男性体脂率≥30%，女性体脂率≥40%）和活动受限（短体能性能电池[SPPB]评分≤11）被随机分配到12周的有监督的、以中心为基础的HiRIT或自我指导的、以家庭为基础的AT，同时消耗低热量饮食（750-1000千卡/天减少能量摄入）。比较两组之间身体功能（主要结果：步态速度）和身体成分的变化。结果共49/60名随机受试者(平均年龄：69.6±6岁；58%的女性;平均BMI: 32.9±4.1 kg/m2)完成试验。与AT相比，HiRIT后步态速度增加（平均差值：0.07 m/s [95% CI: 0.01, 0.13]）。两组的站立时间都减少了（HiRIT:−1.3秒[95% CI:−2.1,−0.4]vs. AT:−0.8秒[95% CI:−1.6,−0.04]），HiRIT，但AT，握力增加（HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI:−0.9,2.3]）和SPPB得分（HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI:−0.04,0.8]）。总体质量（HiRIT:−5.1 kg [95% CI:−6.7,−3.4]vs. AT:−4.9 kg [95% CI:−6.5,−3.3]）、脂肪质量（HiRIT:−3.6 kg [95% CI:−5.0,−2.2]vs. AT:−3.3 kg [95% CI:−4.7,−2.0]）、内脏脂肪（HiRIT:−32.1 cm2 [95% CI:−47.4,−16.8]vs. AT:−31.4 cm2 [95% CI:−46.1,−16.8]）和盲肠瘦质量（HiRIT:−0.8 kg [95% CI:−1.4,−0.2]vs. AT:−1.2 kg [95% CI:−1.8,−0.6]）也出现了类似的下降。HiRIT耐受性良好，只有7个轻微不良事件，而完成AT的患者则有5个。结论HiRIT在改善老年肥胖患者饮食减肥的步态速度方面比AT更安全有效。需要更多样本量更大、持续时间更长的试验来探索HiRIT是否能减轻体重减轻相关的肌肉和骨量下降。试验注册：澳大利亚新西兰临床试验：ACTRN12618001146280。
Resistance and Impact Training During Weight Loss Improves Physical Function and Body Composition in Older Adults With Obesity
Background
Weight loss achieved via energy restriction leads to significant losses in muscle and bone mass, potentially increasing risk for sarcopenia and osteoporosis. High-intensity resistance and impact training (HiRIT) might attenuate weight loss–induced musculoskeletal declines. Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).
Methods
Sixty older adults (aged ≥ 60 years) with obesity (dual-energy x-ray absorptiometry determined body fat percentage ≥ 30% in men and ≥ 40% in women) and a mobility limitation (Short Physical Performance Battery [SPPB] score ≤ 11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT or self-directed, home-based AT while consuming a hypocaloric diet (750–1000 kcal/day reduction in energy intake). Changes in physical function (primary outcome: gait speed) and body composition were compared between groups.
Results
A total of 49/60 randomised participants (mean age: 69.6 ± 6 years; 58% women; mean BMI: 32.9 ± 4.1 kg/m2) completed the trial. Gait speed increased following HiRIT compared with AT (mean difference: 0.07 m/s [95% CI: 0.01, 0.13]). Chair stand times decreased in both groups (HiRIT: −1.3 s [95% CI: −2.1, −0.4] vs. AT: −0.8 s [95% CI: −1.6, −0.04]) and HiRIT, but not AT, increased handgrip strength (HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI: −0.9, 2.3]) and SPPB scores (HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI: −0.04, 0.8]). Similar decreases in total body mass (HiRIT: −5.1 kg [95% CI: −6.7, −3.4] vs. AT: −4.9 kg [95% CI: −6.5, −3.3]), fat mass (HiRIT: −3.6 kg [95% CI: −5.0, −2.2] vs. AT: −3.3 kg [95% CI: −4.7, −2.0]), visceral fat (HiRIT: −32.1 cm2 [95% CI: −47.4, −16.8] vs. AT: −31.4 cm2 [95% CI: −46.1, −16.8]) and appendicular lean mass (HiRIT: −0.8 kg [95% CI: −1.4, −0.2] vs. AT: −1.2 kg [95% CI: −1.8, −0.6]) were observed. HiRIT was well tolerated with only seven minor adverse events compared with five reported in those who completed AT.
Conclusion
HiRIT appears to be safe and more effective than AT for improving gait speed in older adults with obesity undertaking dietary weight loss. Additional trials with larger sample sizes and longer durations are warranted to explore whether HiRIT can attenuate weight loss–related muscle and bone mass declines. Trial Registration: Australian New Zealand Clinical Trials: ACTRN12618001146280.
期刊介绍：
The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.
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