Introduction:Reduced-Exertion High-Intensity Interval Training (REHIT) is a 10-min cycling regimen that has improved glucose tolerance in adults with metabolic dysfunction. However, the ecological relevance of REHIT for application in healthy, middle-aged men as a prevention tool to improve glucose control remains unknown. This study aimed to investigate the effects of a single bout of REHIT following a mixed meal on 3h post-prandial and 24h blood glucose measures in physically active, middle-aged men compared to a non-exercise control condition (Non-EX). Methods:Twenty physically active men (Age: 52 ± 8 years; VO2max: 44.5 ± 6.0 mL min-1·kg-1; BMI: 24.3 ± 1.7 kg m-2) completed a randomized crossover study comparing REHIT to Non-EX. All participants completed both interventions 30 min after consuming a standardized breakfast. Each study condition was separated by 48 h. Continuous glucose monitors (CGMs) measured interstitial glucose continuously throughout the study. CGM data were analyzed to assess post-prandial, 24h mean glucose, and 24h glucose variability (standard deviation; mean amplitude of glycemic excursions, MAGE; coefficient of variation, CV). Results:REHIT led to a significantly shorter glucose peak-to-nadir (p = 0.014). While a significant condition × time interaction was observed (p < 0.001), there was no significant effect of condition (p = 0.725). REHIT vs. Non-EX did not lower 3h post-breakfast glucose responses (113 ± 22 vs. 114 ± 19 mg dL-1, p = 0.809), 24h mean glucose (119 ± 14 vs. 117 ± 13 mg dL-1, p = 0.453) or measures of glucose variability including 24h standard deviation of blood glucose (17 ± 5 vs. 18 ± 6 mg dL, p = 0.173), 24h MAGE (2.5 ± 0.9 vs. 2.6 ± 0.9 mmol L-1, p = 0.474), and 24h CV (14.6 ± 4.0 vs. 14.9 ± 4.6 %, p = 0.746), respectively. Conclusion:While REHIT led to transient reductions in post-prandial glucose in active middle-aged men, there was no clinically meaningful reduction in 3h post-prandial or 24h glucose control.

Background: Older adults age 65+ with obesity are a growing population with marked clinical complexity, which is exacerbated by comorbid conditions as they age. Objectives: To assess clinical heterogeneity in participants in a weight loss intervention to help understanding treatment outcomes. Methods: We previously conducted a single-arm, pre/post, 24-wk, telemedicine-delivered diet and exercise intervention in older adults with obesity. Heterogeneity in treatment outcomes was evaluated between baseline and follow-up weight, 30-s sit-to-stand (30STS), 6-min walking test (6MWT), oxygen consumption at rest (resting VO2), and total energy expenditure (TEE). Distributions of differences in physical function before and after the weight loss intervention were evaluated based on participants’ weight loss response status. Results: Of the 53 enrolled participants, 44 completed the study, but 31 had full follow-up measures. The mean ± standard deviation age was 72.9 ± 3.9 y (72.7% female). Across all participants, weight decreased from 97.8 ± 16.3 kg to 93.2 ± 15.8 kg, and BMI (in kg/m2) dropped from 36.5 ± 5.2 to 34.7 ± 5.4. Twenty-two individuals were classified as responders to the weight loss intervention, having achieved >5% weight loss. Both groups exhibited significant improvements in physical function, though the magnitude of differences was nonsignificant, other than 6MWT (P = 0.04) at 24-wk. There was variability observed in correlation coefficients (r) between percent weight loss and 30STS (r = ‒0.23), 6MWT (r = ‒0.10), resting VO2 (r = ‒0.16), and TEE (r = 0.058). The coefficient of variation for changes from baseline in physical function measures demonstrated marked variability: 134%, 299%, 260%, and 2310% for 30STS, 6MWT, resting VO2, and TEE, respectively. Conclusions: Although older adults can improve outcomes in weight, body mass, and waist circumference through diet and physical activity interventions, there was marked heterogeneity observed in physical function outcomes.

AbstractBlood flow restriction (BFR) combined with low work rate exercise can enhance muscular and cardiovascular fitness. However, whether neural mechanisms mediate these enhancements remains unknown. This study examined changes in corticospinal excitability and motor cortical inhibition following arm cycle ergometry with and without BFR. Twelve healthy males (24 ± 4 years) completed four, randomized 15‐min arm cycling conditions: high work rate (HW: 60% maximal power output), low work rate (LW: 30% maximal power output), low work rate with BFR (LW‐BFR) and BFR without exercise (BFR‐only). For BFR conditions, cuffs were applied around the upper arm and inflated to 70% of arterial occlusion pressure continuously during exercise. Single‐pulse transcranial magnetic stimulation was delivered to left primary motor cortex (M1) to elicit motor‐evoked potentials (MEP) in the right biceps brachii during a low‐level isometric contraction. MEP amplitude and cortical silent period (cSP) duration were measured before and 1, 10 and 15 min post‐exercise. MEP amplitude increased significantly from baseline to Post‐10 and Post‐15 for both the HW (both z < −7.07, both P < 0.001) and LW‐BFR conditions (both z < −5.56, both P < 0.001). For the LW condition without BFR, MEP amplitude increased significantly from baseline to Post‐10 (z = −3.53, P = 0.003) but not Post‐15 (z = −1.85, P = 0.388). The current findings show that HW arm cycling and LW‐BFR led to longer‐lasting increases in corticospinal excitability than LW arm cycling alone. Future research should examine whether the increased corticospinal excitability is associated with the improvements in muscle strength observed with BFR exercise. A mechanistic understanding of BFR exercise improvement could guide BFR interventions in clinical populations.

Background/objective:This study assessed the influence of rest interval duration after tuck jumps on 10-s Wingate outcomes and countermovement jump height. Methods:Eighteen resistance trained individuals (males: n = 10, 21.3 ± 3.6 years; females: n = 8, 22.1 ± 2.2 years) volunteered to participate in four sessions: familiarization, 3-min rest interval with no jumps (CON), and two randomized experimental sessions with a rest interval of either 1-min (ER1) or 5-min (ER5) after a series of tuck jumps. Countermovement jump (CMJ) height was assessed at baseline (PRE) and after (POST) the CON, ER1, and ER5 conditions, and 10-s Wingate cycling testing. Wingate relative peak power (RPP) and mean peak power (RMP) were measured. Separate mixed-factorial repeated measures analyses of variance assessed changes across conditions and sex for the Wingate variables and conditions, sex, and time for CMJ height at an alpha of p ≤ 0.05. Results:RPP and RMP were significantly greater than CON for ER1 by 0.92 ± 0.23 W kg-1 and 0.41 ± 0.14 W kg-1, respectively, and ER5 by 0.77 ± 0.23 W kg-1 and 0.36 ± 0.10 W kg-1, respectively. ER1 and ER5 RPP and RMP were similar (p > 0.05). For CMJ height, there was only a main effect for sex as males jumped higher than females by 31.3 % (p = 0.002). Conclusion:Performing tuck jumps prior to anaerobic exercise may increase performance for up to 5-min.

Weight loss may benefit older adults with obesity. However, it is unknown whether individuals with different frailty phenotypes have different outcomes following weight loss. Community-dwelling adults aged ≥65 (n = 53) with a body mass index ≥30 kg/m2 were recruited for a six-month, single-arm, technology-based weight loss study. A 45-item frailty index identified frailty status using subjective and objective measures from a baseline geriatric assessment. At baseline, n = 22 participants were classified as pre-frail (41.5%) and n = 31 were frail (58.5%), with no differences in demographic characteristics. While weight decreased significantly in both groups (pre-frail: 90.8 ± 2.7 kg to 85.5 ± 2.4 kg (p < 0.001); frail: 102.7 ± 3.4 kg to 98.5 ± 3.3 kg (p < 0.001), no differences were observed between groups for changes in weight (p = 0.30), appendicular lean mass/height2 (p = 0.47), or fat-free mass (p = 0.06). Older adults with obesity can safely lose weight irrespective of frailty status using a technology-based approach. Further investigation is needed to determine whether the impact of specific lifestyle interventions differ by frailty status.

Rauseo, ML, Feairheller, DL, LaRoche, DP, and Cook, SB. Acute effect of dynamic and gluteal resistance exercise warm-up protocols on lower-extremity jump landing mechanics in college-aged females. J Strength Cond Res 38(2): 259-265, 2024-Inadequate neuromuscular control of the femur by the gluteal musculature is associated with noncontact and overuse injuries to the knee. Acute bouts of resistance exercises targeting the gluteal musculature can be prescribed as part of a warm-up protocol with the goal of improving subsequent neuromuscular control and performance. The purpose of this study was to determine the effect that a warm-up protocol including moderate-intensity gluteal resistance exercises (GRE) has on single leg jump landing biomechanics. Seventeen healthy, college-aged, recreationally active females (mean +/- SD; age = 21.4 +/- 1.9 years; height = 166.9 +/- 5.7 cm; body mass = 62.5 +/- 7.4 kg) performed 3 single leg hop trials per leg after completing no warm-up (CON), a dynamic warm-up (DWU), and a dynamic warm-up with gluteal resistance exercises (DWU + GRE) across 3 laboratory visits. Lower extremity kinetic and kinematic variables were assessed during single leg hops from the point of initial foot contact to deepest knee flexion. Biomechanical differences between dominant and nondominant limb landings were also assessed. Dominant limb hip internal rotation angle after DWU + GRE (2.03 +/- 9.92 degrees) was significantly greater (p <= 0.05) compared with CON (-3.36 +/- 7.74 degrees). Peak knee adduction moment (56.8%), peak knee flexion angle (5.7%), and peak knee external rotation angle (17.0%) were significantly greater (p <= 0.017) in the dominant limb, compared with the nondominant limb, across warm-up protocols. The combined DWU + GRE warm-up protocol did not have a substantial impact on landing biomechanics. Clinicians prescribing GRE before activity should not expect significant changes in movement patterns after a single bout.

When low muscle mass and impaired strength and physical function coexist with excess adiposity, it is termed sarcopenic obesity (SO). Handgrip strength (HGS) is a predictor of disability and mortality. Asymmetry in HGS, particularly ≥ 10% strength differences between hands, may indicate neuromuscular dysfunction observable prior to declines in maximal strength are detectedand therefore could be incorporated to identify those at risk of physical limitations and SO. This study compares HGS values and asymmetry in older adults with excess adiposity and evaluates their relationships with physical function. Baseline data from two previous pilot weight loss studies in 85 older adults with body mass index values ≥ 30 kg m-2 are included with measures of body composition, walking speed, and chair stand ability. Sixty-three participants met the criteria for SO. HGS correlated to gait speed (r = 0.22), distance walked (r = 0.40), chair stand time for 5 repetitions (r = 0.42) and during 30 s (r = 0.31). HGS asymmetry is only correlated to gait speed (r = 0.31) and there are no differences in physical function between those with and without asymmetry. Maximal HGS tests should continue to be used to screen for functional decline and disability.

Tactical populations face increased risk on the job, and it is known that firefighters have high levels of cardiac-related death. Aerobic fitness is a modifiable cardiac risk factor, but many fire stations lack the proper equipment to easily assess aerobic fitness levels of their firefighters. Additionally, many fire stations lack wellness programs to hold firefighters accountable for maintaining their fitness levels.Purpose:We assessed the validity of the submaximal 6-minute walk test (6MWT) as a measure of aerobic capacity compared to a maximal treadmill test and the submaximal Gerkin protocol.Methods:Twenty-four firefighters (19 male, 5 female, 34.8 ± 9.7 years; 38.1 ± 3.6 kg·m-2) completed the 6MWT, the submaximal Gerkin protocol, and a maximal treadmill test. Data were analyzed with Bland-Altman plots and correlation analysis.Results:We found equivalence between the 6MWT and directly measured VO2max and between the 6MWT and Gerkin protocol using Bland-Altman plots. In our cohort, the 6MWT underestimated VO2max (31.57 ml·kg-1·min-1) compared to directly measured VO2max (38.1 ml·kg-1·min-1) by 17% and to the Gerkin (40.48 ml·kg-1·min-1) by 22%.Conclusion:Considering its equivalence, using the 6MWT could be a more accessible way to quantify aerobic capacity in firefighters. Despite underestimation, having an easy to administer protocol may encourage more fire stations to assess pre- and post- fitness levels regularly.

Low-intensity exercise with a blood flow restriction (BFR) has been shown to be an effective alternative to high-intensity (HI) training. This study evaluated heart rate (HR), oxygen consumption (Vo(2)), blood lactate (BLa), and ratings of perceived exertion (RPE) during blood flow restricted running and HI running in competitive female runners. Fifteen female distance runners (23 +/- 4 years, 1.67 +/- 0.50 m, 57.6 +/- 5.7 kg) completed 3 randomized 12-minute running conditions: low-intensity (LI) control at 40% Vo(2)max, HI at 80% Vo(2)max, and low-intensity with a BFR (LI-BFR) at 40% Vo(2)max. Vo(2), HR, RPE (6-20 scale), and BLa were measured before, during, and after exercise. Significance was set at p < 0.05. Vo(2) differed between the conditions (p < 0.001), because HI (39.4 +/- 3.9 ml center dot kg(-1)center dot min(-1)) was greater than LI-BFR (25.3 +/- 2.6 ml center dot kg(-1)center dot min(-1)) and both were higher than LI (22.5 +/- 3.1 ml center dot kg(-1)center dot min(-1)). Heart rate differed between the 3 conditions (p < 0.001) and averaged 166 +/- 8, 142 +/- 13, and 124 +/- 11 b center dot min(-1) for HI, LI-BFR, and LI, respectively. Average BLa across conditions was similar in HI and LI-BFR conditions (1.76 +/- 0.48 and 1.82 +/- 0.48 mmol, respectively; p > 0.05), and both were higher than LI (1.06 +/- 0.18 mmol; p < 0.017). Ratings of perceived exertion in the HI (11 +/- 2) and LI-BFR (12 +/- 2) conditions were similar (p = 0.236), while LI (9 +/- 1) was lower (p < 0.001). High-intensity running elicits the greatest responses in HR and Vo(2) compared with LI and LI-BFR, suggesting more robust and effective long-term training responses could occur. Low-intensity with a BFR has more pronounced cardiovascular and metabolic effects than LI running but generated the greatest RPE values creating concerns about acceptability and compliance.

CONTEXT:Soccer players often have a dominant (D) leg, which could influence the relative strength between the quadriceps and hamstrings. The hamstring-to-quadriceps (H:Q) ratio can be assessed on a dynamometer at various velocities to provide information on injury risk.OBJECTIVE:To assess the concentric hamstrings and concentric quadriceps strength ratio (conventional H:Q ratio) assessed in D and nondominant (ND) legs at various speeds in male soccer players.DATA SOURCES:A systematic literature search was completed from inception to 2020 in PubMed, Academic Search Ultimate, CINAHL, and SPORTDiscus.STUDY SELECTION:Keywords associated with the H:Q ratio were connected with terms for soccer players. Titles and abstracts were screened by 2 reviewers based on inclusion and exclusion criteria related to sex, playing level, language, and measurement. A total of 81 studies were reviewed and 17 studies (21%) were used.STUDY DESIGN:A meta-analysis with random effects modeling generated standardized mean differences with 95% CIs between legs and speeds.LEVEL OF EVIDENCE:Level 3.DATA EXTRACTION:A total of 38 cohorts were identified, with 14, 13, and 11 cohorts assessed at low, intermediate, and high velocities, respectively. The Quality Assessment Tool for Observational Cohort and Cross-sectional Studies from the National Institutes of Health was used.RESULTS:The mean H:Q ratio at low velocities was 59.8 ± 9.5% in D leg and 58.6 ± 9.9% in ND leg, 64.2 ± 10.7% (D) and 63.6 ± 11.3% (ND) at the intermediate velocity, and 71.9 ± 12.7% (D) and 72.8 ± 12.7% (ND) at the high velocity. Low, intermediate, and high velocities had small effects of 0.13, 0.10, and -0.06, respectively.CONCLUSION:Conventional H:Q ratios vary across velocities but did not differ between D and ND limbs in male soccer players. This study may provide the foundation to establish norms and clinically meaningful differences.

Background: The role of protein in glucose homeostasis has demonstrated conflicting results. However, little research exists on its impact following weight loss. This study examined the impact of protein supplementation on glucose homeostasis in older adults >65 years with obesity seeking to lose weight. Methods: A 12-week, nonrandomized, parallel group intervention of protein (PG) and nonprotein (NPG) arms for 28 older rural adults (body mass index (BMI) ≥ 30 kg/m2) was conducted at a community aging center. Both groups received twice weekly physical therapist-led group strength training classes. The PG consumed a whey protein supplement three times per week, post-strength training. Primary outcomes included pre/post-fasting glucose, insulin, inflammatory markers, and homeostasis model assessment of insulin resistance (HOMA-IR). Results: Mean age and baseline BMI were 72.9 ± 4.4 years and 37.6 ± 6.9 kg/m2 in the PG and 73.0 ± 6.3 and 36.6 ± 5.5 kg/m2 in the NPG, respectively. Mean weight loss was −3.45 ± 2.86 kg in the PG and −5.79 ± 3.08 kg in the NPG (p < 0.001). There was a smaller decrease in pre- vs. post-fasting glucose levels (PG: −4 mg ± 13.9 vs. NPG: −12.2 ± 25.8 mg/dL; p = 0.10), insulin (−7.92 ± 28.08 vs. −46.7 ± 60.8 pmol/L; p = 0.01), and HOMA-IR (−0.18 ± 0.64 vs. −1.08 ± 1.50; p = 0.02) in the PG compared to the NPG. Conclusions: Protein supplementation during weight loss demonstrated a smaller decrease in insulin resistance compared to the NPG, suggesting protein may potentially mitigate beneficial effects of exercise on glucose homeostasis.

Abstract Background Higher dietary intake of protein has also been associated with increased risk of type 2 diabetes, yet losing weight improves glucose metabolism and homeostasis. We evaluated whether a multicomponent weight loss intervention in older persons with obesity aged 65+ years augmented with protein supplementation impacts glucose homeostasis. Methods A 12-week, non-randomized, parallel group intervention in 28 older rural adults with obesity (body mass index (BMI)≥30kg/m2) was conducted at a community aging center of a protein and non-protein arms. Both received individualized, weekly dietitian visits with twice weekly physical therapist-led group strength training classes; aerobic exercise was prescribed outside the classes. The protein group was provided with whey protein supplementation three times weekly post-strength training. Pre/post fasting glucose, insulin, and c-peptide levels were assessed with HOMA-IR and HOMA beta-cell function calculated. Results Mean age was 72.9±4.4 (86% female) and 73.0±6.3 (79% female), p=0.94, with baseline BMI of 37.6±6.9 and 36.6±5.5, in the protein and non-protein groups, respectively. Mean weight-loss was -3.45±2.86kg and -5.79±3.08kg (both p< 0.001; Δ p=0.047). Visceral fat decreased less in the protein group (-0.02mL vs. -1.02ml;p=0.007), while appendicular lean mass did not (p=0.44). There was lower fasting glucose (protein:-4mg±13.9mg/dL vs. non-protein: 12.2±25.8, effect size:-0.40;p=.10), insulin (-1.32±4.68 vs. -7.79±10.14, ES:0.82;p=0.01), and higher c-peptide (-0.02±0.67 vs. -0.69±1.25,ES:0.66;p=0.06) at follow-up. HOMA-IR also decreased less (-0.18±0.64 vs. -1.08±1.50, ES:0.78; p=0.02) and b-cell function (-3.94±22.61 vs. -16.81±33.85; ES:0.45; p=0.09]). Conclusions A multicomponent obesity intervention incorporating protein supplementation led to lower degree of weight loss and mitigated the benefit on glucose homeostasis.

We conducted a post-hoc analysis of a pre/post, single-arm, nonrandomized, multicomponent weight loss intervention in older adults. Fifty-three older adults aged ≥65 with a body mass index ≥ 30 kg/m2 were recruited to participate in a six-month, remote monitoring and video-conferencing delivered, prescriptive intervention consisting of individual and group-led registered dietitian nutrition and physical therapy sessions. We assessed weight, height, and body composition using a SECA 514 bioelectrical impedance analyzer. Mean age was 72.9±3.9 years (70% female) and all had ≥2 chronic conditions. Of those with complete data (n=30), we observed a 4.6±3.5kg loss in weight, 6.1±14.3kg (1.9%) loss in fat mass, and 0.78±1.69L loss in visceral fat (all p<0.05). Fat-free mass (−3.4kg±6.8, p=0.19), appendicular lean mass (−0.25±1.83, p=0.22), and grip strength (+3.46±7.89, p=0.56) did not significantly change. These variables were preserved after stratifying by 5% weight loss. Our intervention led to significant body and visceral fat loss while maintaining fat-free and appendicular lean muscle mass.

To compare heart rate (HR), oxygen consumption (VO2), blood lactate (BL), and ratings of perceived exertion (RPE) during arm cycling with and without a blood flow restriction (BFR). Twelve healthy males (age: 23.9 ± 3.75 years) completed four, randomized, 15-min arm cycling conditions: high-workload (HW: 60

Objectives: Pre-operative exercise may improve functional outcomes for lung cancer patients, but barriers associated with cost, resources, and burden make it challenging to deliver pre-operative exercise programs. The goal of this proof-of-concept study was to determine level of moderate-vigorous physical activity (MVPA) and change in aerobic capacity after participation in a home-based pre-operative exercise intervention. Materials and methods: Eighteen patients scheduled for surgery for suspected stage I-III lung cancer received an exercise prescription from their surgeon and wore a commercially-available device that tracked their daily MVPA throughout the pre-operative period. Descriptive statistics were used to calculate adherence to the exercise prescription. A one-sample t-test was used to explore change in aerobic capacity from baseline to the day of surgery. Results: Participants exhibited a mean of 20.4 (sd = 46.2) minutes of MVPA per day during the pre-operative period. On average, the sample met the goal of 30 min of MVPA on 16.4% of the days during the preoperative period. The mean distance achieved at baseline for the 6-min walk test was 456.7 m (sd = 72.9), which increased to 471.1 m (sd = 88.4) on the day of surgery. This equates to a mean improvement of 13.8 m (sd = 37.0), but this difference was not statistically different from zero (p = 0.14). Eight of the 17 participants (47%) demonstrated a clinically significant improvement of 14 m or more. Conclusion: A surgeon-delivered exercise prescription plus an activity tracker may promote clinically significant improvement in aerobic capacity and MVPA engagement among patients with lung cancer during the preoperative period, but may need to be augmented with more contact with and support from practitioners over time to maximize benefits. Trial registration: The study protocol was registered with ClinicalTrials.gov prior to initiating participant recruitment (NCT03162718).

In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.

Weight-loss interventions for older adults with obesity are controversial as the age-related loss of muscle mass may be exacerbated during caloric restriction. However, the addition of aerobic and resistance exercise may preserve lean mass and lead to enhanced physical function. PURPOSE: To evaluate physical function after a nutrition and exercise intervention at a community aging center in older adults with obesity (body mass index [BMI] > 30 kg·m2). METHODS: Twenty-five older adults (7 males and 18 females, 72.6 + 6.4 yr, 164.4 + 9.2 cm, 97.4 + 14.2 kg) participated in a 3-month intervention consisting of weekly dietitian sessions, twice weekly physical therapist-led strength training classes and individualized at-home aerobic training programs. Physical function was assessed before, monthly, and after the intervention using the 6-minute walk test, 5-chairstands test, gait speed and grip strength. Appendicular Skeletal Mass Index (ASMI) in a subsample (n = 14) was measured using bioelectrical impedance and normalized to height. Variables were evaluated using ANOVA with repeated measures and correlations between percent weight loss and percent changes in physical function were conducted. RESULTS: Participants lost an average of 6.0 + 4.9 kg over the 3-months and experienced consistent losses of 2 kg per month (P < 0.01). ASMI remained constant throughout the intervention (4.91 + 0.87 vs 4.85 + 0.88 kg·m2, P = 0.31). BMI decreased from 36.1 + 4.8 to 34.0 + 5.0 (P < 0.001). All measures of physical function improved throughout the intervention. Gait speed rose from 1.23 + 0.17 to 1.36 + 0.20 m·s-1 (P < 0.001) and 6-min walk distance increased from 423 + 77 to 465 + 99 m (P < 0.001). Time to complete 5-chairstands decreased by 1.67 + 2.15 s (P < 0.01) and grip strength of the left and right hands increased by 8 and 9%, respectively (P < 0.01). Percent change in body weight did not correlate to changes in physical function (P > 0.05) but improvements in 6-min walk distance was correlated to faster completion of 5-chairstands (r = -0.44, P = 0.03). CONCLUSIONS: A diet and exercise intervention can decrease body weight while preserving muscle mass and enhancing physical function. Changes in body weight do not appear to be related to physical function suggesting other factors, like enhanced strength and aerobic capacity may play a role.

Background: Older persons with obesity aged 65+ residing in rural areas have reduced access to weight management programs due to geographic isolation. The ability to integrate technology into health promotion interventions shows a potential to reach this underserved population. Methods: A 12-week pilot in 28 older rural adults with obesity (body mass index [BMI] >= 30 kg/m(2)) was conducted at a community aging center. The intervention consisted of individualized, weekly dietitian visits focusing on behavior therapy and caloric restriction with twice weekly physical therapist-led group strengthening training classes in a community-based aging center. All participants were provided a Fitbit Flex 2. An aerobic activity prescription outside the strength training classes was provided. Results: Mean age was 72.9 5.3 years (82% female). Baseline BMI was 37.1 kg/m(2), and waist circumference was 120.0 +/- 33.0 cm. Mean weight loss (pre/post) was 4.6 +/- 3.2 kg (4.9 +/- 3.4%; p < .001). Of the 40 eligible participants, 33 (75%) enrolled, and the completion rate was high (84.8%). Objective measures of physical function improved at follow-up: 6-minute walk test improved: 35.7 +/- 41.2 m (p < .001); gait speed improved: 0.10 +/- 0.24 m/s (p = .04); and five-times sit-to-stand improved by 2.1 seconds (p < .001). Subjective measures of late-life function improved (5.2 +/- 7.1 points, p = .003), as did Patient-Reported Outcome Measurement Information Systems mental and physical health scores (5.0 +/- 5.7 and 4.4 +/- 5.0, both p < .001). Participants wore their Fitbit 93.9% of all intervention days, and were overall satisfied with the trial (4.5/5.0, 1-5 low-high) and with Fitbit (4.0/5.0). Conclusions: A multicomponent obesity intervention incorporating a wearable device is feasible and acceptable to older adults with obesity, and potentially holds promise in enhancing health.

Quinn, TJ, Dempsey, SL, LaRoche, DP, Mackenzie, AM, and Cook, SB. Step frequency training improves running economy in well-trained female runners. J Strength Cond Res 35(9): 2511-2517, 2021-The purpose was to determine whether a short training program (15 minutes for 10 days) to increase step frequency to 180 steps per min would elicit improvements in running economy (RE). Experimental (n = 11) and control (n = 11) female subjects reported to the laboratory for 12 consecutive days and completed 2 RE tests at 3.4 and 3.8 m center dot s(-1) (day 1 and 12), followed by a maximal oxygen uptake test (day 1 only), and experimental subjects completed a 10-day training program to increase step frequency (days 2-11). Control subjects completed the same runs without step frequency training. The training program consisted of running at 180 steps per minutes for 15 minutes at a self-selected velocity. A repeated-measures multivariate analysis of variance was used to test for differences. Oxygen consumption was significantly lower at each testing velocity for experimental but not control after the 10-day training program. The average drop in oxygen consumption across both speeds was approximately 11.0% (p < 0.05; mean eta(2)(p) = 0.28). These lower oxygen consumptions were achieved at greater (7.0%) self-selected step frequencies (p < 0.01; mean eta(2)(p) = 0.78), shorter (3.7%) step lengths (p < 0.05; mean eta(2)(p) = 0.74), and lower (5.1%) heart rates (p < 0.05; mean eta(2)(p) = 0.31) for experimental but not control. Training to run at a faster step cadence may be a viable technique to improve RE.