Muscle size responses to strength training in young and older men and women

OBJECTIVES: To examine the possible influences of age and gender on muscle volume responses to strength training (ST). DESIGN: Prospective intervention study. SETTING: University of Maryland Exercise Science and Wellness Research Laboratories. PARTICIPANTS: Eight young men (age 20-30 years), six young women (age 20-30 years), nine older men (age 65-75 years), and ten older women (age 65-75 years). INTERVENTION: A 6-month whole-body ST program that exercised all major muscle groups of the upper and lower body 3 days/week. MEASUREMENTS: Thigh and quadriceps muscle volumes and mid-thigh muscle cross-sectional area (CSA) were assessed by magnetic resonance imaging before and after the ST program. RESULTS: Thigh and quadriceps muscle volume increased significantly in all age and gender groups as a result of ST (P < .001), with no significant differences between the groups. Modest correlations were observed between both the change in quadriceps versus the change in total thigh muscle volume (r = 0.65; P < .001) and the change in thigh muscle volume versus the change in mid-thigh CSA (r = 0.76, P < .001). CONCLUSIONS: The results indicate that neither age nor gender affects muscle volume response to whole-body ST. Muscle volume, rather than muscle CSA, is recommended for studying muscle mass responses to ST.     

Aerobic group training improves exercise capacity and heart rate variability in elderly patients with a recent coronary event. A randomized controlled study.

AIMS: Reduced heart rate variability is associated with an unfavourable prognosis in patients with ischaemic heart disease. Whether physical training can modify this risk factor is not definitely proven. Our hypothesis was that training might increase both physical capacity and heart rate variability in elderly patients recovering from an acute coronary event, i.e. acute myocardial infarction (n=38) or an episode of unstable angina (n=27). METHODS and RESULTS: 24 h ambulatory ECG recordings were obtained from 65 patients randomized to either a 3 months supervised outpatient group training programme 50 min three times a week (n=29) or to a control group (n=36). The two groups were well balanced as regards demographic data and pharmacological treatment at the time of randomization. Body mass index and pharmacological therapy remained unchanged during the study. Heart rate variability was analysed in the time and frequency domains. At the 3 month follow-up, exercise tolerance had increased from 103 to 120 W in the training group (P<0.001), and from 102 to 106 W in the control group (ns). The time-domain heart rate variability measures SDNN (standard deviation of all filtered RR intervals over the analysed time period) and SDANN (standard deviation of the means of all filtered RR intervals for all 5 min epochs of the analysed time period) increased significantly during the daytime in the training group (P<0.01 and P<0.05, respectively), but not in the control group. A significant improvement in night-time heart rate variability was observed among controls. There was a statistically significant correlation (P<0.05) between changes in 24 h overall power (frequency domain measure) and changes in maximal exercise capacity in the training group. CONCLUSION: A regular aerobic group training programme after an acute coronary event can significantly improve exercise capacity and modify heart rate variability in a prognostically favourable direction in elderly low-to-intermediate risk patients, recovering from an acute coronary event.     

维生素D联合阻抗训练对老年肌少症患者骨骼肌质量、日常生活活动能力及血清学指标的影响

目的观察维生素D联合阻抗训练对老年肌少症患者的骨骼肌质量、日常生活活动能力(ADL)及血清单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)水平的影响。方法选取2017年1月至2018年5月河北省人民医院老年病二科收治的112例老年肌少症合并维生素D缺乏患者,根据随机数表法分为对照组(T1组,30例)、阻抗训练组(T2组,41例)及阻抗训练+维生素D组(T3组,41例)。T1组给予肌少症健康宣教;T2组在健康宣教的基础上给予阻抗训练,每周2次,每次30 min;T3组在T2组基础上加用骨化三醇治疗,每次0.25μg,2次/d。3组均持续干预24周,分别于干预前及干预24周后测定3组血清25(OH)D3、MCP-1、IL-1β、CRP水平,并评估握力、步速、ADL及四肢骨骼肌质量指数(SMI);采用Pearson相关分析,分析血清25(OH)D3与SMI、ADL、MCP-1、IL-1β、CRP的关系。结果干预24周后,T2组、T3组血清25(OH)D3、SMI、握力、步速、ADL均较干预前及同期T1组升高(均P0.05),MCP-1、IL-1β、CRP均较干预前及同期T1组降低(均P0.05),其中T3组上述指标的变化幅度较T2组更大(均P0.05);Pearson相关分析结果显示,血清25(OH)D3与SMI、ADL呈正相关(r=0.537、0.439,均P0.05),与MCP-1、IL-1β、CRP呈负相关(r=-0.544、-0.618、-0.496,均P0.05)。结论维生素D联合阻抗训练能够增加老年肌少症患者的肌肉质量,提升其ADL。两者联合治疗的效果较单一阻抗训练效果更好,其作用机制可能与维生素D能降低老年肌少症患者体内MCP-1、IL-1β、CRP炎症因子水平有关。     

Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study.

AIMS: Cardiac rehabilitation including exercise training is of proven value in ischaemic heart disease. However, elderly patients frequently are not encouraged to participate in such programmes. This study evaluates the physiological effects and self-reported quality of life after an aerobic outpatient group-training programme in subjects above the age of 65 years. METHODS AND RESULTS: A consecutive series of 101 patients (males 80%) aged 65-84 (mean 71) years recovering from an acute coronary event were randomized to either a supervised out patient group-training programme (n=50) or to a control group (n=51). The two groups were well balanced as regards clinical characteristics. The compliance in the training group was 87%. Exercise tolerance increased in the trained group from 104 to 122 and 111 W after 3 and 12 months respectively. The corresponding values were 102, 105 and 105 W among controls. Parameters, such as quality of life, self-estimated level of physical activity, fitness and well-being were graded higher by the trained patients than those who served as controls on the two occasions of follow-up. CONCLUSIONS: Aerobic group-training of elderly patients recovering from an acute coronary event beneficially influences physical fitness and several parameters expressing quality of life. Great care has to be taken to preserve the initial effects by continued training.     

老年全膝关节置换术患者术后康复训练依从性观察及其影响因素

目的 探讨老年全膝关节置换术(TKA)患者术后康复训练依从性及其影响因素分析。方法 回顾性分析2022年1月至2023年1月于武汉市第一医院行TKA的244例老年患者的临床资料,且在术后3个月评估所有患者康复训练依从性,并比较不同临床特征老年TKA患者康复训练依从性评分差异。通过多因素logistic回归分析影响老年TKA患者康复训练依从性的危险因素并构建风险预测模型。通过受试者工作特征(ROC)曲线分析风险预测模型预测老年TKA患者康复训练依从性的价值。选用SPSS 22.0统计软件对数据进行处理。根据数据类型,分别采用t、F检验进行组间比较。结果 244例老年TKA患者康复训练依从性评分中身体锻炼依从评分为(13.27±3.09)分、主动寻求锻炼依从评分为(6.88±2.04)分、锻炼监督依从评分为(6.12±1.81)分;康复训练依从性总分为15~32(23.27±6.94)分。女性、年龄≥80岁、合并疾病＞2种、初中文化程度、无配偶、独居、月收入＜500元、有慢性疼痛的老年TKA患者康复训练依从性总分显著低于男性、年龄＜80岁、合并疾病≤2种或无、高中及以上文化程度、有配偶、与配偶或子女同住或其他、月收入≥500元、无慢性疼痛的老年TKA患者,差异有统计学意义(P＜0.05)。经多因素logistic回归分析证实,女性(OR=3.544,95%CI 1.036～12.123)、年龄≥80岁(OR=1.052,95%CI 1.024～1.081)、合并疾病＞2种(OR=4.418,95%CI 1.274～15.321)、初中文化程度(OR=4.274,95%CI 1.542～11.846)、无配偶(OR=3.245,95%CI 1.244～8.465)、独居(OR=1.226,95%CI 1.105～1.360)、月收入＜500元(OR=2.429,95%CI 1.442～4.092)、有慢性疼痛(OR=2.015,95%CI 1.009～4.024)为影响老年TKA患者康复训练依从性的危险因素。经ROC分析证实,风险预测模型预测老年TKA患者康复训练依从性的曲线下面积为0.934,标准误为0.014,95%CI为0.907～0.961,最佳截断点为35.499,灵敏度为0.925,特异度为0.890。结论 老年TKA术后康复训练依从性受到较多因素的影响,同时经ROC分析证实风险预测模型对老年TKA患者康复训练依从性具有较好的预测价值,或可为后续康复训练工作的开展提供帮助。     

A prospective randomized controlled trial to evaluate effect of chewing gum on postoperative ileus in elderly patient after hip fracture

Factors related to developing postoperative ileus (POI) vary from pharmacologic, inflammatory, hormonal, metabolic, gastrointestinal physiology, neurologic, to psychological factors. Although orthopedic-related incidence of postoperative ileus is about 10%, these studies are limited to spine surgery and pelvic surgery. The purpose of this study was to investigate prevalence of POI and to analyze effect of chewing gum on POI and bowel function in elderly patients after hip fracture surgery.A prospective randomized controlled trial was conducted at the Gyeongsang National University Hospital. Elderly patients with hip fracture who underwent surgery from March 2017 to June 2018 were eligible to participate. Patients were excluded if they had a mastication disability, impaired cognitive function, previous history of gastrointestinal disease, respiratory disease and low oxygen saturation, hip arthroplasty with causes other than hip fractures, acetabular fractures, periprosthetic fractures, or pathological fractures. Patients with consciousness problem by excessive anesthesia were also excluded. Patients were classified into 2 groups by randomization. Group I received sugar-free gum and were encouraged to chew 6 hours following surgery until the first intestinal gas is released. Group II was given the same postoperative procedure and encouraged to consume water after 6 hours.After applying exclusion criteria, 74 patients were finally included. Thirty-one patients were classified to Group I and 43 patients were classified to the Group II. Prevalence of POI in all patients with hip fracture was 63.5% (47/74). Prevalence of POI in Group I was statistically significant lower than that in Group II (Group I: 41%, Group II: 79.1%, P = .01)The prevalence of POI in elderly patients with hip fracture was 63.5%. Chewing gum had a significant effect on reduction of POI in elderly patients with hip fractures.     

Coevolutionary phage training leads to greater bacterial suppression and delays the evolution of phage resistance

The evolution of antibiotic-resistant bacteria threatens to become the leading cause of worldwide mortality. This crisis has renewed interest in the practice of phage therapy. Yet, bacteria’s capacity to evolve resistance may debilitate this therapy as well. To combat the evolution of phage resistance and improve treatment outcomes, many suggest leveraging phages’ ability to counter resistance by evolving phages on target hosts before using them in therapy (phage training). We found that in vitro, λtrn, a phage trained for 28 d, suppressed bacteria ∼1,000-fold for three to eight times longer than its untrained ancestor. Prolonged suppression was due to a delay in the evolution of resistance caused by several factors. Mutations that confer resistance to λtrn are ∼100× less common, and while the target bacterium can evolve complete resistance to the untrained phage in a single step, multiple mutations are required to evolve complete resistance to λtrn. Mutations that confer resistance to λtrn are more costly than mutations for untrained phage resistance. Furthermore, when resistance does evolve, λtrn is better able to suppress these forms of resistance. One way that λtrn improved was through recombination with a gene in a defunct prophage in the host genome, which doubled phage fitness. This transfer of information from the host genome is an unexpected but highly efficient mode of training phage. Lastly, we found that many other independently trained λ phages were able to suppress bacterial populations, supporting the important role training could play during phage therapeutic development.

In 30 y, the World Health Organization predicts that antibiotic-resistant bacteria will kill over 10 million people each year—more deaths than are caused by cancer (1). This health crisis, in part caused by the heavy and often inappropriate way we use antibiotic drugs, has led to the spread of resistance genes through clinical, agricultural, and natural environments and to the emergence of multidrug-resistant (MDR) “superbugs” that are untreatable due to their resistance against all available classes of antibiotics (2–4). As bacteria continue to outpace our discovery and development of new drugs, the evolution of resistance threatens to return us to a preantibiotic era of infectious disease (5, 6).This crisis has renewed interest in the century-old practice of phage therapy: the use of phages, viruses that infect bacteria, to treat bacterial infections (7–11). Recently, phage therapy has shown promise in cases where drugs of last resort fail to treat life-threatening MDR bacterial infections (9–13). However, even in successful cases, the evolution of phage resistance poses a considerable threat to the efficacy of treatment (9, 12, 14). For example, in 2016, at the University of California San Diego, a patient with acute pancreatitis complicated by an MDR Acinetobacter baumannii infection was treated with two four-phage mixtures that suppressed the pathogen in vitro (9). Within 8 d, A. baumannii isolated from the patient was resistant to all eight phages used. Fortunately, the infection resolved following delivery of a ninth phage, and the patient survived. This case is representative of numerous phage therapy studies (9–12, 14). A metanalysis in 2018 reported that phage resistance evolved in 82% of animal gut decolonization studies, 50% of meningitis/sepsis models, and 75% of human clinical cases in which the evolution of resistance was monitored (14). These observations of rapid phage resistance evolution in therapy mirror decades of basic research in the laboratory; mutations that confer resistance to phages are often as common as those for antibiotic resistance (15–17). Furthermore, many of these resistance mutations confer cross-resistance to multiple phages (18).Although resistance to phages is as or more common than to antibiotics, potential advantages of using phages as therapeutics have been proposed time and again (7, 8, 19–22). Notably, unlike antibiotics, phages are biological entities that evolve. By reciprocally adapting to changes in their hosts (coevolution), phages have maintained the ability to infect their hosts for millennia. Many have proposed harnessing this inherent evolutionary potential by preemptively coevolving phages with target bacterial prey (22–24). Proponents of this “phage training” approach suggest that, by experiencing the ways their host can evolve resistance, trained phages will evolve to counter host defenses. Then, trained phages “from the future” can be used to trap the ancestral, uncoevolved bacteria “from their past” that are infecting the patient, making their evolution futile.While the idea of phage training is enticing, it has not yet been adopted for therapy. Contrasting theories of bacteria–phage coevolutionary dynamics make the success of phage training uncertain (12, 24, 25). According to some conceptual models of coevolution (e.g., matching alleles), as phages adapt to their evolving host, they lose the ability to infect past hosts (24). In such cases, phage training would not work because trained phages would lose the ability to infect the original target bacterium. Alternatively, other models of coevolution (e.g., gene for gene and arms race dynamics) argue that as phages adapt to their evolving host, they maintain the ability to infect their original host (24). In this scenario, training would expand phage host range to encompass both original and contemporary bacteria. Regardless of how coevolution affects host range, some opponents of phage training contend that the use of trained phages will apply stronger selection on target bacteria which will accelerate the evolution of resistance and loss of therapeutic efficacy (22).In this study, we conducted a coevolution experiment using Escherichia coli and either untrained or trained phages to evaluate the potential of phage training for therapy. By comparing the population dynamics of coevolving bacteria and phages, we find that trained phages suppress the target bacteria more strongly and for longer than untrained phages. Through post hoc analyses on the bacteria and phages that evolved in our experiment, we identify the factors that allowed trained phages to suppress host populations and delay the evolution of resistance.     

Effectiveness of 12‐week inspiratory muscle training with manual therapy in patients with COPD: A randomized controlled study

The benefits of inspiratory muscle training (IMT) in patients with COPD were reported. However, its effects are limited in severe COPD patients. Further researches are required in new and complementary modalities demonstrating IMT efficacy in severe COPD patients. This study aims to investigate effects of manual therapy (MT) additional over IMT on functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue, and quality of life in severe COPD patients. Sixty patients with COPD in GOLD stage III–IV were included in this prospective single‐blind randomized trial. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure (MIP) (n = 30) or only IMT (n = 30) for 12 weeks. MT group received MT during 12 weeks for 30 min additional to IMT. Pulmonary function, respiratory muscle strength, functional capacity, dyspnea, fatigue, and quality of life were evaluated by spirometry, mouth pressure device, six‐minute walk test, Modified Medical Research Council (mMRC) dyspnea scale, fatigue severity scale, and St. George''s Respiratory Questionnaire (SGRQ), respectively. MT group had significantly greater improvement in FEV1%, FVC%, PEF%, respiratory muscle strength, function, dyspnea, fatigue, and quality of life compared with IMT group (p < 0.05). 6MWT (p < 0.001, effect size Cohen''s d: 0.915), MIP (p < 0.001, effect size Cohen''s d: 1.235), and mMRC score (p < 0.001, effect size Cohen''s d: 0.982) were significantly improved in IMT with MT group. This study demonstrated that subjects in IMT with MT group had improved outcomes in functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue perception, and quality of life compared with alone IMT group.     

Exercise therapy in patients with hip osteoarthritis: Effect on hip muscle strength and safety aspects of exercise—results of a randomized controlled trial

Purpose: To evaluate the effect of an exercise therapy concept (the Tübingen exercise therapy approach THüKo) for increasing hip muscle strength (HMS) in patients with hip osteoarthritis (OA), and to investigate whether patients do adhere to the intervention and if there are any adverse events related to the intervention.

Methods: A total of 210 hip OA patients (89 females, 121 males) were randomized into a 12-week exercise intervention (THüKo) including group sessions (1/week) and home exercising (2/week), a placebo ultrasound group (1/week) or a control group (no treatment). HMS was measured as isometric peak torque of hip abduction, adduction, flexion, and extension. Adherence to exercise and safety aspects were monitored as additional outcomes.

Results: Baseline adjusted post intervention HMS of the THüKo group were higher compared to the control group (differences of 0.11–0.27?Nm/kg, p?p?Conclusions: The Tübingen exercise therapy approach has shown to have a significant positive effect on HMS. Its implementation has shown to be feasible and safe according to the percentage of exercise participation and the absence of sustainable adverse events.     

Resistance training improves cardiac output,exercise capacity and tolerance to positive airway pressure in Fontan physiology

Background

Subjects with Fontan-type circulation have no sub-pulmonary ventricle and thus depend exquisitely on the respiratory bellows and peripheral muscle pump for cardiac filling. We hypothesised that resistance training to augment the peripheral muscle pump might improve cardiac filling, reduce inspiratory-dependence of IVC return to the heart and thus improve exercise capacity and cardiac output on constant positive airway pressure (CPAP).

Methods

Eleven Fontan subjects (32 +/− 2 years, mean +/− SEM) had cardiac magnetic resonance imaging (MRI) and exercise testing (CPET); six underwent 20 weeks of high-intensity resistance training; others were non-exercising controls. After training, CPET was repeated. Four trainers had MRI with real-time flow measurement at rest, exercise and on CPAP in the trained state and following a 12-month detrain.

Results

In the trained state, muscle strength increased by 43% (p = 0.002), as did total muscle mass (by 1.94 kg, p = 0.003) and peak VO₂ (by 183 ml/min, p = 0.02). After detraining, calf muscle mass and peak workload had fallen significantly (p < 0.03 for both) as did peak VO₂ (2.72 vs. 2.18 l/min, p < 0.001) and oxygen pulse, a surrogate for SV (16% lower, p = 0.005). Furthermore after detraining, SV on MRI decreased at rest (by 11 ml, p = 0.01) and during moderate-intensity exercise (by 16 ml, p = 0.04); inspiratory-dependent IVC blood return during exercise was 40% higher (p = 0.02). On CPAP, cardiac output was lower in the detrained state (101 vs. 77 ml/s, p = 0.03).

Conclusions

Resistance muscle training improves muscle mass, strength and is associated with improved cardiac filling, stroke volume, exercise capacity and cardiac output on CPAP, in adults with Fontan-type circulation.     

Effects of strength training and detraining on knee extensor strength,muscle volume and muscle quality in elderly women

Strength training seems to be an interesting approach to counteract decreases that affect knee extensor strength, muscle mass and muscle quality (force per unit of muscle mass) associated with ageing. However, there is no consensus regarding the changes in muscle mass and their contribution to strength during periods of training and detraining in the elderly. Therefore, this study aimed at verifying the behaviour of knee extensor muscle strength, muscle volume and muscle quality in elderly women in response to a 12-week strength training programme followed by a similar period of detraining. Statistical analysis showed no effect of time on muscle quality. However, strength and muscle volume increased from baseline to post-training (33 and 26 %, respectively). After detraining, the knee extensor strength remained 12 % superior to the baseline values, while the gains in muscle mass were almost completely lost. In conclusion, strength gains and losses due to strength training and detraining, respectively, could not be exclusively associated with muscle mass increases. Training-induced strength gains were partially maintained after 3 months of detraining in elderly subjects.     

Aerobic training reduces blood pressure and waist circumference and increases HDL-c in metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials

The objective of this study is to estimate the effect of aerobic training (AT) on metabolic syndrome (MetS) outcomes. The Medline, EMBASE, SPORTDiscus, The Cochrane Library, and PEDro databases were searched from inception to May 2017. Two independent reviewers selected the studies and assessed their quality and data. The pooled mean differences between intervention groups and the control group were calculated using a random-effect model. Only randomized controlled trials that compared the effect of AT on MetS with a control group were included. Seventeen published studies were included in the meta-analysis. Systolic and diastolic blood pressure were significantly reduced (?5.11 mmHg [95% confidence interval [CI] ?7.36, ?2.85] and ?2.97 mmHg [?4.99, ?0.94], respectively), following AT. There was also a significant reduction in waist circumference (?2.18 cm [95% CI ?3.75, ?0.62]) and a significant increase in high-density lipoprotein cholesterol (95% CI ?3.15 mg/dL [?5.30, ?1.01]). The pooled effect showed a reduction of ?7.64 mg/dL [95% CI ?17.65, 2.37] in triglycerides and ?1.36 mg/dL [95% CI ?4.11, 1.40] in fasting glucose. This systematic review and meta-analysis provides an overview of the evidence supporting AT as an effective approach to reduce blood pressure levels and waist circumference and increase high-density lipoprotein cholesterol levels. These changes may help to reduce the risk of stroke mortality and mortality from heart disease in people with MetS.     

Effects of functional and traditional training in body composition and muscle strength components in older women: A randomized controlled trial

BackgroundWhile traditional resistance exercises have been widely used to promote muscle strength and hypertrophy in the elderly, few studies have reported the use of a functional approach in which common patterns for daily activities are considered the primary stimulus.ObjectiveInvestigate whether functional training has similar effects the traditional on body composition and muscle strength components in physically active older women.MethodsForty-seven older women completed a randomized and crossover clinical trial, distributed in three groups: Functional or Traditional Training (FUNCT/TRAD: n = 32; 65.28 ± 4.96 years) and Stretching Group (STRETCH: n = 15; 64.40 ± 3.68 years). Maximal dynamic strength was verified with the 1 repetition maximum (RM) test in the leg press and rowing machines. Muscular power was analyzed using 50% of the maximum load, speed was determined using a linear encoder, and isometric strength was analyzed with hand and lumbar dynamometers. ANOVA for repeated measures was applied for comparisons.ResultsThe FUNCT showed a significant decrease in fat percentage (p = 0.015, 3.51%) and the TRAD a significant increase in lean mass (p = 0.008, 2.92%). Both FUNCT and TRAD generated significant increases in all components of muscle strength compared to baseline whereas STRETCH showed declines in these variables. No statistically significant differences were observed between the experimental groups in body composition.ConclusionFunctional and traditional training are equally efficient in improving strength components in physically active older women and, therefore, they may be complementary to combat some of the deleterious effects of senescence. This trial was registered at Brazilian Registry of Clinical Trials (RBR-9Y8KJQ).     

Effects of aerobic and resistance exercise training on insulin action in the elderly

Background:   Aging is associated with a declining glucose tolerance, which is primarily caused by peripheral insulin resistance, and with a decline in physical activity. The aim of this study was to assess the effect of aerobic and resistance exercise training on insulin action in the elderly.
Methods:   Fourteen healthy male subjects (age: 65–73 years) were enrolled and divided into two exercise groups: resistance training (RT) or a combined aerobic and resistance training (CT). Subjects participated in each training program three times a week for 12 weeks. Before and after the training program, insulin action was determined using the euglycemic clamp technique at insulin infusion rates of 40 (low) or 400 (high) mU/m² per min. Body composition was measured by dual-energy X-ray absorptiometry (DXA).
Results:   Percent fat decreased significantly in both groups. Fat-free mass (FFM) tended to increase in the RT group ( P  = 0.054), but not in the CT group. In the CT group, the glucose infusion rate (GIR) increased 16.6% ( P  < 0.05) at the low insulin infusion rate and 21.7% ( P  < 0.01) at the high rate. In the RT group, GIR tended to increase at the low insulin infusion rate, but was not statistically significant ( P  = 0.052) and increased 9.9% ( P  < 0.05) at the high rate. When calculated per FFM, the increased insulin action persisted in the CT group ( P  < 0.01), but not in the RT group.
Conclusion:   The combination of aerobic and resistance training is more effective for improving the decreased insulin action in the elderly than resistance training alone.