Resistance Training and Neuroimaging

NCT03982550 | Completed

• 1 other identifier: HS-17-00770
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Aging tends to compromise the ability to solve problems, remember details, and process information. At the extreme level, this normal cognitive decline can interfere with independent living. Because most brain dysfunctions become irreversible before patients show clear signs in the clinic, there is a pressing need to prioritize preventative countermeasures. Exercise is a promising strategy to slow or reverse these losses. While most studies have looked at running or cycling exercise, little is known about the effects of weight lifting exercise. In addition, vascular health is intimately linked with cognitive abilities and risk of stroke, making it a primary target for intervention. Previous weight lifting studies suggest that blood vessels in the brain are a likely site of adaptation. The goal of this research is to understand how weight lifting exercise improves cognitive function in older adults. Specifically, the contribution of blood vessel changes in the brain after 12 weeks of weight lifting exercise 3 days per week. These vascular improvements may provide the link between physical and cognitive health, while simultaneously reducing the risk of cardiovascular disease and stroke. To determine this, advanced brain imaging techniques will be used to measure blood flow/volume changes in the brain non-invasively. Physical capacity (i.e. strength), body composition (i.e. lean mass, fat mass), and blood markers will also be assessed using standard protocols, and each of these variables will be tested for their relationship with cognitive functions. Understanding how weight lifting exercise improves cognitive function will support the development of comprehensive treatments targeting overall brain health. With no current cures for dementia, this information will be vital in prescribing exercise for specific patient needs to reducing the risk of dementia and stroke. In addition, the promise of exercise therapies extends beyond the target disease, having further benefits to the well-being of participants. These types of treatments positively impact fundamental aging processes, and thus reduce the risk of all-cause mortality. Even with moderate benefits to a specific disease like dementia, the global impact on healthcare would be substantial.

Conditions

Cognitive Decline; Cerebrovascular Function

Outcome Measures

Primary Outcomes (4)

• Change in Fluid Cognition Composite Score

  NIH Toolbox Cognition Battery

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Cerebral Blood Flow

  Arterial Spin Labeling Magnetic Resonance Imaging

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Vascular Compliance

  Arterial Spin Labeling Magnetic Resonance Imaging

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Arterial Transit Time

  Arterial Spin Labeling Magnetic Resonance Imaging

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

Secondary Outcomes (13)

• Change in Crystallized Cognition Composite Score

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Total Body Strength

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Body Weight

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Body Fat Percentage

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

• Change in Lower Extremity Power

  Baseline, after the initial 12-week control period, and after the 12-week intervention period.

Study Arms (2)

Control Period

NO INTERVENTION

Participants will serve as their own controls. All 12-week control periods will take place before the RT intervention to ensure that results are not confounded by detraining effects or long-term cognitive benefits of RT. In addition, a control period equal in duration to the intervention allows direct within-subjects statistical comparisons, accounting for each participants' baseline and rate of aging - i.e. age-associated cognitive decline and arterial stiffening. Participants will not be monitored, but may be contacted for scheduling.

Intervention Period

EXPERIMENTAL

Participants will perform a periodized and progressive total-body RT program emphasizing development of lower and upper body strength. All 36 training sessions (3 days per week for 12 weeks) will be performed at the CERC, supervised by an exercise specialist. Participants will be encouraged to continue normal activities of daily living and eating routines outside the RT program of the present study. Because this is a proof-of concept study on normal aging, participants may be contacted for scheduling, but will not be monitored outside of training.

Behavioral: Periodized Resistance Training

Interventions

Periodized Resistance Training BEHAVIORAL

Mesocycle I (weeks 1-4) will emphasize muscular hypertrophy to develop a muscular and metabolic base for more intense training in later phases. Training bouts will consist of 4-6 resistance exercises with 2-4 sets per exercise and 8-10 repetitions per set. Mesocycles II (weeks 5-8) and III (weeks 9-12) will emphasize strength development. Training bouts will consist of 4-6 resistance exercises with 3-5 sets per exercise, 4-6 repetitions per set, and linear increases in intensity over time. These parameters were chosen to maximize performance on 4-6 repetition maximum (RM) testing post-intervention, according to the principle of specificity - i.e. specific adaptation to imposed demands.The training loads used will be individually progressed in a safe and effective manner, in order to employ a progressive overload/challenge to the neuromuscular system and elicit the greatest training-induced neuromuscular adaptations possible.

Intervention Period

Eligibility Criteria

• Age: 60 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Community-dwelling and living independently (without need of assistance).
• Interest and availability for participation in a 12-week planned RT program at the CERC, including pre- and post- testing.
• Competency in English sufficient for assessment and training.
• Able to see and hear sufficiently to participate in RT.
• Not engaged in any structured exercise training outside of this intervention.
• Eligible to undergo MRI.
• Answer NO to all questions on the Physical Activity Readiness Questionnaire (PAR-Q) or receive medical clearance from a physician.

You may not qualify if:

• Possible Dementia (score less than or equal to 23 on MMSE).
• History of known neurological disease (e.g. Epilepsy, Multiple sclerosis, Parkinson disease, Alzheimer's disease), cerebral infarct (e.g. Stroke), or traumatic brain injury.
• History of known cardiovascular or metabolic disease or chronic illness which may compromise the patient's ability to safely perform the RT program (e.g. coronary artery disease, arrhythmia, asthma requiring an inhaler during exercise), or presently uncontrolled hypertension (SBP \> 140 mmHg or DBP \> 90 mmHg). Patient may be required to provide clearance from a physician at the study team's discretion.
• Type 1 or Type 2 Diabetes.
• Changes in chronic pharmacological treatment (e.g. Aspirin, Statins, or ACE inhibitors) or hormone therapy during the intervention period.
• Current treatment for congestive heart failure, angina, uncontrolled arrhythmia, DVT or other cardiovascular event.
• Myocardial infarction, coronary artery bypass grafting, angioplasty or other cardiac condition in the past year.
• Contraindications against MRI (e.g. metal implants, claustrophobia).
• Self-report regular heavy RT in the past 6 months (i.e. "strengthening exercises or lifting weights heavy enough that you could not perform more than 15 repetitions in one set").
• Musculoskeletal injuries interfering with the ability to perform RT or medical conditions for which exercise in contraindicated.

Sponsors & Collaborators

• Todd Schroeder: lead
• Southern California Clinical and Translational Science Institute: collaborator

Study Sites (1)

Clinical Exercise Research Center

Los Angeles, California, 90089, United States

Location

MeSH Terms

Conditions

Cognitive Dysfunction

Condition Hierarchy (Ancestors)

Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor of Clinical Physical Therapy

Model Details: There are two phases in this single-group study: an initial control period and an intervention period. All control periods will take place before the RT intervention to ensure that results are not confounded by detraining effects or long-term cognitive benefits of RT.

Study Record Dates

• First Submitted: June 5, 2019
• First Posted: June 11, 2019
• Study Start: July 17, 2018
• Primary Completion: May 16, 2020
• Study Completion: May 16, 2020
• Last Updated: May 20, 2022

Record last verified: 2022-05

Locations

US (1)