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“我们想要更多”:肌少症老年女性对高强度渐进性抗阻运动及乳清蛋白营养干预可行性的看法

"We want more": perspectives of sarcopenic older women on the feasibility of high-intensity progressive resistance exercises and a whey-protein nutrition intervention.

作者信息

Vijayakumaran Reena K, Daly Robin M, Tan Vina P S

机构信息

Department of Rehabilitation and Sports Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom.

Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.

出版信息

Front Nutr. 2023 Sep 7;10:1176523. doi: 10.3389/fnut.2023.1176523. eCollection 2023.

Abstract

This qualitative study is nested within a 12-week pilot randomized-controlled, two-arm trial involving high-intensity progressive resistance training (PRT) or PRT with a multi-nutrient, whey-protein supplementation (PRT+WP) in sarcopenic older adults (trial registration no: TCTR20230703001). The aim was to investigate sarcopenic participants' perceptions and barriers to this multi-modal intervention strategy that may accelerate "real-world" implementation. Eighteen older adults (one man) with possible sarcopenia were invited to join the study, of whom 16 women were randomized to a thrice-weekly PRT ( = 8) program (80% of 1-repetitive maximum, six resistance band exercises) only or PRT plus daily weekday milk-based WP supplementation (PRT+WP, = 8). Muscle strength (handgrip and 5-times sit-to-stand), mass (dual-energy X-ray absorptiometry), performance (Short Physical Performance Battery and stair ascent-descent), and nutrition status (Mini Nutritional Assessment) were assessed for changes. We randomly selected eight women for the semi-structured interview. Post-intervention, eight (50%) women were sarcopenia-free, six (38%) remained in possible sarcopenia, one (6%) improved to sarcopenia, and one (6%) deteriorated from possible to severe sarcopenia. There were no significant between-group differences, but significant within-group improvements ( < 0.05) were detected for handgrip strength (PRT+WP 5.0 kg, = 0.93; PRT 6.1 kg, = 0.55), 5-times sit-to-stand time (PRT 2.0 s, = 1.04), nutrition score (PRT+WP 3.44, = 0.52; PRT 1.80, = 0.44), and stair ascent time (PRT+WP 0.97 s, = 0.77; PRT 0.75 s, = 0.97). Our thematic analyses identified four main themes, namely, (1) perceived benefits, (2) sustaining behavior changes, (3) challenges in participating, and (4) improved wellbeing. Participants expressed how they initially were skeptical and doubted that they could complete the exercises or tolerate the milk-based WP supplements. However, they reported positive experiences and benefits felt from strength gains, increased confidence, and better physical abilities. Participants were surprised by the zero adverse effects of WP supplements. The women wanted more nutritional information and structured, guided exercise programs and suggested a community-based implementation. In conclusion, our findings showed PRT was well received and may support reduced risks of sarcopenia. No added benefits were seen with the addition of WP supplementation, but a larger sample is required to address this question. Overall, older (previously sarcopenic) Malay women indicated that they want more multi-modal programs embedded in their community.

摘要

这项定性研究嵌套在一项为期12周的试点随机对照双臂试验中,该试验涉及对肌肉减少症的老年成年人进行高强度渐进性阻力训练(PRT)或补充多种营养的乳清蛋白的PRT(PRT+WP)(试验注册号:TCTR20230703001)。目的是调查肌肉减少症参与者对这种可能加速“现实世界”实施的多模式干预策略的看法和障碍。邀请了18名可能患有肌肉减少症的老年人(1名男性)参加该研究,其中16名女性被随机分配到仅每周三次的PRT(n = 8)计划(1次重复最大值的80%,六项弹力带练习)或PRT加工作日每天补充乳基WP(PRT+WP,n = 8)。评估肌肉力量(握力和5次坐立试验)、质量(双能X线吸收法)、表现(简短体能测试和上下楼梯)和营养状况(微型营养评定法)的变化。我们随机选择了8名女性进行半结构化访谈。干预后,8名(50%)女性没有肌肉减少症,6名(38%)仍可能患有肌肉减少症,1名(6%)改善为肌肉减少症,1名(6%)从可能患有肌肉减少症恶化为严重肌肉减少症。组间没有显著差异,但握力(PRT+WP为5.0 kg,标准差 = 0.93;PRT为6.1 kg,标准差 = 0.55)、5次坐立时间(PRT为2.0 s,标准差 = 1.04)、营养评分(PRT+WP为3.44,标准差 = 0.52;PRT为1.80,标准差 = 0.44)和上楼梯时间(PRT+WP为0.97 s,标准差 = 0.77;PRT为0.75 s,标准差 = 0.97)在组内有显著改善(P < 0.05)。我们的主题分析确定了四个主要主题,即(1)感知到的益处,(2)维持行为改变,(3)参与的挑战,以及(4)幸福感改善。参与者表示,他们最初持怀疑态度,怀疑自己能否完成锻炼或耐受乳基WP补充剂。然而,他们报告了因力量增加、信心增强和身体能力提高而感受到的积极体验和益处。参与者对WP补充剂的零不良反应感到惊讶。这些女性想要更多的营养信息和结构化、有指导的锻炼计划,并建议在社区实施。总之,我们的研究结果表明PRT很受欢迎,可能有助于降低肌肉减少症的风险。添加WP补充剂没有看到额外的益处,但需要更大的样本量来解决这个问题。总体而言,年长的(以前患有肌肉减少症的)马来女性表示,她们希望在自己的社区中有更多的多模式项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1de/10513027/bdf5e70165f7/fnut-10-1176523-g0001.jpg

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