The effects of a muscle resistance program on the functional capacity, knee extensor muscle strength and plasma levels of IL-6 and TNF-alpha in pre-frail elderly women: a randomized crossover clinical trial--a study protocol.
BACKGROUND
With the increase in the elderly population, a growing number of chronic degenerative diseases and a greater dependency on caregivers have been observed. Elderly persons in states of frailty remain more susceptible to significant health complications. There is evidence of an inverse relationship between plasma levels of inflammatory mediators and levels of functionality and muscle strength, suggesting that muscle-strengthening measures can aid in inflammatory conditions. The purpose of this study will be verified the effect of a muscle-strengthening program with load during a ten-week period in pre-frail elderly women with attention to the following outcomes: (1) plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), (2) functional capacity and (3) knee extensor muscle strength.


METHODS
The study design is a randomized crossover clinical trial evaluating 26 elderly women (regardless of their race and/or social condition) who are community residents, older than 65, and classified as pre-frail according to the criteria previously described by Fried et al. (2004). All subjects will be assessed using the Timed up and go and 10-Meter Walk Test functional tests. The plasma levels of IL-6 and TNF-alpha will be assessed by ELISA (enzyme-linked immunosorbent assay) with high sensitivity kits (QuantikineHS, R&D Systems Minneapolis, MN, U.S.). Knee extensor muscle strength will be assessed using the Byodex System 3 Pro(R) isokinetic dynamometer at angular speeds of 60 and 180 degrees/s. The intervention will consist of strengthening exercises of the lower extremities at 50 to 70% of 1RM (maximal resistance) three times per week for ten weeks. The volunteers will be randomized into two groups: group E, the intervention group, and group C, the control group that did not initiate any new activities during the initial study period (ten weeks). After the initial period, group C will begin the intervention and group E will maintain everyday activities without exercising. At the end of the total study period, all volunteers will be reassessed.


CONCLUSIONS
To demonstrate and discuss possible influences of load-bearing exercises on the modification of plasma levels of IL-6 and TNF-alpha and in the functional performance of pre-frail elderly women.


BACKGROUND
ISRCTN62824599.
Lustosa
Lygia P
LP
Centro Universitário de Belo Horizonte, Centro Universitário Newton Paiva, Belo Horizonte, MG, Brazil.
Coelho
Fernanda M
FM
Silva
Juscelio P
JP
Pereira
Daniele S
DS
Parentoni
Adriana N
AN
Dias
João M D
JM
Dias
Rosangela C
RC
Pereira
Leani S M
LS
D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007719:Knee Joint / Q000502:physiology*; D007866:Leg / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D018401:Sample Size; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D016474:Weight-Bearing
C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha