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This study aims to evlauate the effect os a 32-week multicomponent training (MT) program on muscle architecture and muscle quality (assessed by ultrasound) in womer over 60 years. The study will also analyze concurrent changes in muscle strength, physical performance, and body composition. The hypothesis is that the training will induce positive architectural adaptations, such as reduced echogenicity and increased thickness in the rectus femoris and rectus abdominis muscles, correlating with improved functional independence.
Population aging emphasizes the need for "healthy aging", where muscle quality (MQ) is a vital metric. However, there is a lack of robust longitudinal protocols integrating ultrasound-assessed MQ with functional performance in older women. This randomized controlled trial involves community-dwelling women aged 60+ from the Geriatric Revitalization Program in Salamanca. Participants will be randomized (1:1) into an experimental group (multicomponent training) or a control group. The intervention is a 32-week supervised program (3 sessions/week, 50 min/session) combining aerobic, strength, balance, and coordination exercises. Primary outcomes focus on muscle architecture (echo intensity and thickness) in the rectus femoris and rectus abdominis muscles. Secondary outcomes include functional capacity (SPPB, TUG, 5-time sit-to-stand), handgrip strength, and body composition.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group (Multicomponent training) | Experimental | Participants in this group will follow the multi-component exercise programme. The load progression will be based on individual perceived exertion. At the beginning of the intervention, participants will be taught how to interpret the modified Borg scale. At the end of each week, each person's perception of exertion will be recorded in relation to the three sessions completed. The aim will be to maintain a constant level of between 5 and 7 on the scale, which corresponds to 'hard' and 'very hard'. If the perceived exertion is greater than 7, it will be reduced, and conversely, if it is less than 5, the intensity will be increased. |
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| Control Group | No Intervention | Participants in this group will maintain their usual diet and physical activity, without changing their habits during the intervention period. They will not participate in other physical exercise programs, nor will they engage in frequent and systematic physical exercise. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multicomponent training | Other | The exercise battery includes lower body work (squats, deadlifts, front and sagittal plane lunges, hip abduction/extension, and plantar flexion) and upper body work (wall flexion-extensions, shoulder raises, and elbow flexion-extensions). In addition to the strength exercises mentioned above, balance exercises such as walking in tandem, standing on one leg, side steps, and weight transfer will also be performed. Aerobic capacity will be worked on by walking at a moderate intensity, and flexibility will be improved through stretching the main muscle groups. |
| Measure | Description | Time Frame |
|---|---|---|
| Echo intensity | Echo intensity (gray scale analysis), using ImageJ software, proposed by the SARCUS consensus and Nutritional Ultrasound ®. | Baseline and 32 weeks |
| Muscle thickness (mm) | Linear measurement of the distance between the superficial and deep aponeuroses of a target muscle belly. | Baseline and 32 weeks |
| Cross-sectional area | The total area of the muscle (measured in cm^2) in a plane perpendicular to its longitudinal axis | Baseline and 32 weeks |
| Subcutaneous adipose tissue thickness | Measurement of the distance between the dermis and the superficial muscle fascia. This variable quantifies the thickness of the fat layer located directly beneath the skin. | Baseline and 32 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Handgrip strength (kg) | Handgrip strength will be assessed using dynamometry due to its association with various outcomes of aging, being a key component in sarcopenia and frailty. Measurements will be taken using the Hydraulic Jamar device with the subject standing and the elbow flexed at 90º. | Baseline and 32 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Sociodemographic variables | Personal data, medical history, presence of comorbidities, use of medications will be collected in a personal interview, and finally, blood pressure will be taken. | Baseline and 32 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Luis Polo Ferrero, PhD | Contact | 689919744 | pfluis@usal.es |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Salamanca | Salamanca | Salamanca | 37006 | Spain |
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| ID | Term |
|---|---|
| D055948 | Sarcopenia |
| ID | Term |
|---|---|
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Short Physical Performance Battery (SPPB) |
The Short Physical Performance Battery (SPPB) will be used, a quick and objective three-part physical function test with excellent test-retest reliability, predictive validity, and clinical applicability, mainly used for fall risk stratification. |
| Baseline and 32 weeks |
| Timed Up and Go (TUG) | The Timed Up and Go (TUG) test will be used as it is a valid tool for detecting balance deficits, which are associated with an increased risk of falls in older adults. | Baseline and 32 weeks |
| 5-time sit-to-stand (5STS) | The 5-time sit-to-stand (5STS) test will be used, a functional test serves to assess lower limb strength. | Baseline and 32 weeks |
| Body Mass Index (BMI) | alculated as weight in kilograms divided by the square of height in meters (kg/m²). It is used to assess changes in body mass relative to height. | Baseline and 32 weeks |
| Body Fat Percentage | Total body fat percentage measured through electrical bioimpedance (BIA) using the TANITA BC-418 device (%). | Baseline and 32 weeks |
| Abdominal Circumference | Measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest using a flexible tape measure. | Baseline and 32 weeks |
| Waist-to-Hip Ratio | Calculated by dividing the waist circumference by the hip circumference. Used as an indicator of abdominal fat distribution. | Baseline and 32 weeks. |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |