The effect of muscle power training with elastic band on blood glucose, cytokine, and physical function in elderly women with hyperglycemia.

PURPOSE: The purpose of this study was to identify the effects of muscle power training with elastic band on body composition, glucose relation factor, and physical function in elderly women with hyperglycemia.
METHODS: A total of 16 elderly women volunteered to participate in this study as subjects, and they were randomly assigned into one of the following two groups: muscle power training group (MPT: n = 8) and control group (CON: n = 8). The muscle power training group took exercise program using elastic band for 12 weeks, and the other group did not receive any exercise program during the same period. Before and after the experiment, both of the two groups received measurement in body composition (BMI, %Fat, skeletal muscle mass), glucose, cytokine (interleukin 6, adiponectin), and physical function (IPPB, grip strength). With these methods, the following conclusions were achieved.
RESULTS: The results showed significant increases in adiponectin (p = 0.006), interleukin 6 (p = 0.018), SPPB (p = 0.024), and grip strength (P=.014). Blood glucose was significantly decreased in exercise group than contruo group.
CONCLUSION: It shows that the muscle power training with elastic band can give positive effects in elderly women with hyperglycemia.

RCT Entities:   Population Interventions Outcomes

INTRODUCTION

Aging generally refers to the biological, physical, and mental declining of properties and functions; and along with the atrophy of physiological and physical functions, psychological change also occurs, which is the state when the self-sustained function and the social role function of an individual is weakened [1].

Aging brings many changes in the functional aspect of the human body. Among them, the representative ones are the decreases in muscular strength and function. When the decrease in the muscle function occurs due to the aging, strengths such as muscle endurance, agility, and flexibility are decreased [2]. These decreases in the strength can cause negative effect to the everyday life, such as when carrying things, climbing up the stairs, and standing up from a chair. This decrease in muscle function can cause difficulty in independent living; and moreover, it can induce chronic diseases reducing the life span [3]. Especially, the decrease in the muscle function reduces the glucose storage capability, resulting in diabetes [4].

Diabetes is caused by this effect, as well as by the hormones secreted from the pancreas, or by the defect of both; and it is a chronic metabolic disorder featuring hyperglycemia [5]. Chronic hyperglycemia is an important cause increasing the complications of the vascular diseases in the diabetic patient [6]. Hyperglycemia is reported that even without diabetes, when the complications such as cardiovascular disease occur, the patient with temporarily high blood glucose can have a bad prognosis [7]. Therefore, for the prevention and treatment of diabetes and complications, managing the blood glucose is important. The goal of the current diabetes treatment is to control the metabolic disorder and to prevent the occurrences of complications to disable the progress. For the therapeutic methods, there are dietary treatment, exercise therapy, and drug treatment [8]. Among these, the exercise therapy is useful in enhancing the physical strength and preventing complications, which are known to be effective in diabetes treatment [9]. Regular exercise reduces the glucose concentrations in the blood [10], increases the insulin sensitivity of the peripheral tissue including the muscles [11], and also helps to control the weight of obese diabetic patients [12]. Aerobic exercises are generally practiced by diabetic patients until now, but the elderly patients with diabetes have difficulty in performing exercises; this is because they have problems of diabetic complications or retrogression in functional capabilities due to obesity, degenerative arthritis, cardiovascular disease [13]. Therefore, for the patients with difficulty in performing aerobic exercises consisting of sustaining weight for the duration of workout, it is reported that resistance exercise can be a good alternative for these diabetic patients [14].

The resistance exercise increases the amount of muscle for the diabetic patients to improve glucose intolerance and insulin sensitivity. As a result, it brings improvement to glycometabolism and reduction in glycated hemoglobin [14,15]. Also, it is reported to increase the capillary ratio of the muscle fiber and improve the storage capacity of glycogen within the muscle [16]. Therefore, as a diabetic person ages, resistance exercise and muscular reinforcement exercise are required with the general exercise amount, because improving the muscular strength and endurance are helpful for the treatment of diabetes [17]. The traditional resistance exercise is recommended with 50-80% range of weight for 1RM of elders [18]. But, the power training has recently been known to be performed in relatively low intensity of 40% of weight for 1RM in fast speed concentric contraction, which not only increases muscle power and strength but is also effective on improving the functional performance [19,20]. It has been reported that an exercise requiring fast concentric contraction of the muscle is required in order to increase the muscle power [21]. The muscle power training using the band increases muscular strength and improves flexibility, parallelism, and walking; furthermore, it is also reported to have the advantages of minimizing the impact from muscular activation and movements in various angles [22]. Taking these results into account, the muscle power training by using exercise bands is considered to be the appropriate in performing low-intensity, fast-speed concentric contraction exercise in the elderly people.

Therefore, the effect of band exercise will be verified in this study, by applying the protocols of muscle power training to the elderly woman with blood glucose disorder.

METHODS

Subject characteristics

The subjects of this study were elderly women who are studying at Y Elder’s College in Seoul; and the recruited subjects did not have any medical diseases or exercise habit. Among them, 16 people with hyperglycemia met the Impaired Fast -ing Glucose standard provided by the ADA, with the fasting blood glucose level of over 100mg/dl (5.6mmol/liter). These subjects were selected and randomly classified into exercise group (n = 8) and control group (n = 8) for this study. The characteristics of subjects are listed in Table 1.

Table 1.

Characteristics of subjects

Variables	Control group	Exercise group
Age (years)	76.11 ± 2.01	74.27 ± 0.62
Height (cm)	151.81 ± 2.53	151.75 ± 1.17
Weight (kg)	59.56 ± 4.32	58.24 ± 1.28
Body fat (%)	36.53 ± 1.23	37.91 ± 1.56
Muscle mass (kg)	19.35 ± 1.21	19.08 ± 0.61
Blood glucose (mg/dl)	118.13 ± 4.34	122.28 ± 2.45

Test procedure

Physical measurement

For the physical measurement of the study subjects, bio-electrical impedance analysis (Inbody 370, Biospace, Seoul, Korea) was used to measure the height, weight, muscle mass, and body fat (% body fat).

Exercise program

The detail on exercise program of this study is provided in . For the low-intensity muscle power training using the band, the power training program [23] of fast, stop (1 second) in the concentric contraction stage, and 2 second in the extensional contraction stage was used. For the strength of the band color, green (Hygenic Corporation, USA) was used, and subjective exercise strength (RPE) was set as 12-13. The exercise was applied with graded exercise principle, and the strength of the exercise was gradually increased every 4 weeks. According to the ASCM recommendation, the exercise group performed for 60 minutes per session, which included the warm-up (10 minutes), main exercise (40 minutes), and cooling-down (10 minutes); and elastic band exercise was practiced twice a week, and home-based exercise was practiced three times a week, over a total duration of 12 weeks.