Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance

Creatine monohydrate has become the supplement of choice for many athletes striving to improve sports performance. Recent data indicate that athletes may not be using creatine as a sports performance booster per se but instead use creatine chronically as a training aid to augment intense resistance training workouts. Although several studies have evaluated the combined effects of creatine supplementation and resistance training on muscle strength and weightlifting performance, these data have not been analyzed collectively. The purpose of this review is to evaluate the effects of creatine supplementation on muscle strength and weightlifting performance when ingested concomitant with resistance training. The effects of gender, interindividual variability, training status, and possible mechanisms of action are discussed. Of the 22 studies reviewed, the average increase in muscle strength (1, 3, or 10 repetition maximum [RM]) following creatine supplementation plus resistance training was 8% greater than the average increase in muscle strength following placebo ingestion during resistance training (20 vs. 12%). Similarly, the average increase in weightlifting performance (maximal repetitions at a given percent of maximal strength) following creatine supplementation plus resistance training was 14% greater than the average increase in weightlifting performance following placebo ingestion during resistance training (26 vs. 12%). The increase in bench press 1RM ranged from 3 to 45%, and the improvement in weightlifting performance in the bench press ranged from 16 to 43%. Thus there is substantial evidence to indicate that creatine supplementation during resistance training is more effective at increasing muscle strength and weightlifting performance than resistance training alone, although the response is highly variable.     

Effects of weightlifting vs. kettlebell training on vertical jump, strength, and body composition

Effects of weightlifting vs. kettlebell training on vertical jump, strength, and body composition. J Strength Cond Res 26(5): 1199-1202, 2012-The present study compared the effects of 6 weeks of weightlifting plus traditional heavy resistance training exercises vs. kettlebell training on strength, power, and anthropometric measures. Thirty healthy men were randomly assigned to 1 of 2 groups: (a) weightlifting (n = 13; mean ± SD: age, 22.92 ± 1.98 years; body mass, 80.57 ± 12.99 kg; height, 174.56 ± 5.80 cm) or (b) kettlebell (n = 17; mean ± SD: age, 22.76 ± 1.86 years; body mass, 78.99 ± 10.68 kg; height, 176.79 ± 5.08 cm) and trained 2 times a week for 6 weeks. A linear periodization model was used for training; at weeks 1-3 volume was 3 × 6 (kettlebell swings or high pull), 4 × 4 (accelerated swings or power clean), and 4 × 6 (goblet squats or back squats), respectively, and the volume increased during weeks 4-6 to 4 × 6, 6 × 4, and 4 × 6, respectively. Participants were assessed for height (in centimeters), body mass (in kilograms), and body composition (skinfolds). Strength was assessed by the back squat 1 repetition maximum (1RM), whereas power was assessed by the vertical jump and power clean 1RM. The results of this study indicated that short-term weightlifting and kettlebell training were effective in increasing strength and power. However, the gain in strength using weightlifting movements was greater than that during kettlebell training. Neither method of training led to significant changes in any of the anthropometric measures. In conclusion, 6 weeks of weightlifting induced significantly greater improvements in strength compared with kettlebell training. No between-group differences existed for the vertical jump or body composition.     

举重训练对男子肌比力、肌纤维的影响

安排9名有一定训练的青少年运动员参加10周举重训练。每周6次,每次8小时。训练前后用电子计算机—X线断层扫描技术(CT)测量大腿肌肉横断面积,股外肌针刺活检取样测定Ⅰ、Ⅱ型肌纤维％和面积。测定大腿伸膝肌最大随意等长力量。将结果(实验前、后)与对照组(13名无训练者)和优秀举重运动员(健将3人、一级4人)进行比较。结果表明,有训练人(实验前、后和优秀)与没有训练人(对照)在肌比力上存有差别。短、长期举重训练后,肌比力与Ⅱ型肌纤维％呈正相关。短、长期举重训练不曾改变肌纤维类型分布。举重训练对Ⅱ型肌纤维有选择性作用,且这个作用不受年龄的影响。结果还提示,肌比力的变化及肌比力与肌纤维之间的关系都会受运动项目专项特点的影响。     

Effects of testosterone and exercise on muscle leanness in eugonadal men with AIDS wasting.

Loss of lean body and muscle mass characterizes the acquired immunodeficiency syndrome (AIDS) wasting syndrome (AWS). Testosterone and exercise increase muscle mass in men with AWS, with unclear effects on muscle composition. We examined muscle composition in 54 eugonadal men with AWS who were randomized to 1) testosterone (200 mg im weekly) or placebo and simultaneously to 2) resistance training or no training in a 2 x 2 factorial design. At baseline and after 12 wk, we performed assessments of whole body composition by dual-energy X-ray absorptiometry and single-slice computed tomography for midthigh cross-sectional area and muscle composition. Leaner muscle has greater attenuation. Baseline muscle attenuation correlated inversely with whole body fat mass (r = -0.52, P = 0.0001). This relationship persisted in a model including age, body mass index, testosterone level, viral load, lean body mass, and thigh muscle cross-sectional area (P = 0.02). Testosterone (P = 0.03) and training (P = 0.03) increased muscle attenuation. These data demonstrate that thigh muscle attenuation by computed tomography varies inversely with whole body fat and increases with testosterone and training. Anabolic therapy in these patients increases muscle leanness.     

Large energetic adaptations of elderly muscle to resistance and endurance training.

This study determined the cellular energetic and structural adaptations of elderly muscle to exercise training. Forty male and female subjects (69.2 +/- 0.6 yr) were assigned to a control group or 6 mo of endurance (ET) or resistance training (RT). We used magnetic resonance spectroscopy and imaging to characterize energetic properties and size of the quadriceps femoris muscle. The phosphocreatine and pH changes during exercise yielded the muscle oxidative properties, glycolytic ATP synthesis, and contractile ATP demand. Muscle biopsies taken from the same site as the magnetic resonance measurements were used to determine myosin heavy chain isoforms, metabolite concentrations, and mitochondrial volume densities. The ET group showed changes in all energetic pathways: oxidative capacity (+31%), contractile ATP demand (-21%), and glycolytic ATP supply (-56%). The RT group had a large increase in oxidative capacity (57%). Only the RT group exhibited change in structural properties: a rise in mitochondrial volume density (31%) and muscle size (10%). These results demonstrate large energetic, but smaller structural, adaptations by elderly muscle with exercise training. The rise in oxidative properties with both ET and RT suggests that the aerobic pathway is particularly sensitive to exercise training in elderly muscle. Thus elderly muscle remains adaptable to chronic exercise, with large energetic changes accompanying both ET and RT.     

Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training.

Previous studies have shown that low-intensity resistance training with restricted muscular venous blood flow (Kaatsu) causes muscle hypertrophy and strength gain. To investigate the effects of daily physical activity combined with Kaatsu, we examined the acute and chronic effects of walk training with and without Kaatsu on MRI-measured muscle size and maximum dynamic (one repetition maximum) and isometric strength, along with blood hormonal parameters. Nine men performed Kaatsu-walk training, and nine men performed walk training alone (control-walk). Training was conducted two times a day, 6 days/wk, for 3 wk using five sets of 2-min bouts (treadmill speed at 50 m/min), with a 1-min rest between bouts. Mean oxygen uptake during Kaatsu-walk and control-walk exercise was 19.5 (SD 3.6) and 17.2 % (SD 3.1) of treadmill-determined maximum oxygen uptake, respectively. Serum growth hormone was elevated (P < 0.01) after acute Kaatsu-walk exercise but not in control-walk exercise. MRI-measured thigh muscle cross-sectional area and muscle volume increased by 4-7%, and one repetition maximum and maximum isometric strength increased by 8-10% in the Kaatsu-walk group. There was no change in muscle size and dynamic and isometric strength in the control-walk group. Indicators of muscle damage (creatine kinase and myoglobin) and resting anabolic hormones did not change in both groups. The results suggest that the combination of leg muscle blood flow restriction with slow-walk training induces muscle hypertrophy and strength gain, despite the minimal level of exercise intensity. Kaatsu-walk training may be a potentially useful method for promoting muscle hypertrophy, covering a wide range of the population, including the frail and elderly.     

Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss.

Caloric restriction (CR) results in fat loss; however, it may also result in loss of muscle and thereby reduce strength and aerobic capacity (VO2 max). These effects may not occur with exercise-induced weight loss (EX) because of the anabolic effects of exercise on heart and skeletal muscle. We tested the hypothesis that CR reduces muscle size and strength and VO2 max, whereas EX preserves or improves these parameters. Healthy 50- to 60-yr-old men and women (body mass index of 23.5-29.9 kg/m2) were studied before and after 12 mo of weight loss by CR (n = 18) or EX (n = 16). Lean mass was assessed by dual-energy X-ray absorptiometry, thigh muscle volume by MRI, isometric and isokinetic knee flexor strength by dynamometry, and treadmill VO2 max by indirect calorimetry. Both interventions caused significant decreases in body weight (CR: -10.7 +/- 1.4%, EX: -9.5 +/- 1.5%) and lean mass (CR: -3.5 +/- 0.7%, EX: -2.2 +/- 0.8%), with no significant differences between groups. Significant decreases in thigh muscle volume (-6.9 +/- 0.8%) and composite knee flexion strength (-7.2 +/- 3%) occurred in the CR group only. Absolute VO2 max decreased significantly in the CR group (-6.8 +/- 2.3%), whereas the EX group had significant increases in both absolute (+15.5 +/- 2.4%) and relative (+28.3 +/- 3.0%) VO2 max. These data provide evidence that muscle mass and absolute physical work capacity decrease in response to 12 mo of CR but not in response to a similar weight loss induced by exercise. These findings suggest that, during EX, the body adapts to maintain or even enhance physical performance capacity.     

Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults

Evidence suggests that consumption of over-the-counter cyclooxygenase (COX) inhibitors may interfere with the positive effects that resistance exercise training has on reversing sarcopenia in older adults. This study examined the influence of acetaminophen or ibuprofen consumption on muscle mass and strength during 12 wk of knee extensor progressive resistance exercise training in older adults. Thirty-six individuals were randomly assigned to one of three groups and consumed the COX-inhibiting drugs in double-blind placebo-controlled fashion: placebo (67 ± 2 yr; n = 12), acetaminophen (64 ± 1 yr; n = 11; 4 g/day), and ibuprofen (64 ± 1 yr; n = 13; 1.2 g/day). Compliance with the resistance training program (100%) and drug consumption (via digital video observation, 94%), and resistance training intensity were similar (P > 0.05) for all three groups. Drug consumption unexpectedly increased muscle volume (acetaminophen: 109 ± 14 cm(3), 12.5%; ibuprofen: 84 ± 10 cm(3), 10.9%) and muscle strength (acetaminophen: 19 ± 2 kg; ibuprofen: 19 ± 2 kg) to a greater extent (P < 0.05) than placebo (muscle volume: 69 ± 12 cm(3), 8.6%; muscle strength: 15 ± 2 kg), when controlling for initial muscle size and strength. Follow-up analysis of muscle biopsies taken from the vastus lateralis before and after training showed muscle protein content, muscle water content, and myosin heavy chain distribution were not influenced (P > 0.05) by drug consumption. Similarly, muscle content of the two known enzymes potentially targeted by the drugs, COX-1 and -2, was not influenced (P > 0.05) by drug consumption, although resistance training did result in a drug-independent increase in COX-1 (32 ± 8%; P < 0.05). Drug consumption did not influence the size of the nonresistance-trained hamstring muscles (P > 0.05). Over-the-counter doses of acetaminophen or ibuprofen, when consumed in combination with resistance training, do not inhibit and appear to enhance muscle hypertrophy and strength gains in older adults. The present findings coupled with previous short-term exercise studies provide convincing evidence that the COX pathway(s) are involved in the regulation of muscle protein turnover and muscle mass in humans.     

Hormonal responses to resistance exercise in long-term trained and untrained middle-aged men

This cross-sectional study compared hormonal responses to resistance exercise between trained and untrained men to investigate the adaptations of the endocrine system to long-term strength training in middle-aged men. Twenty-one middle-aged men were recruited for this study and matched into a strength-trained group (SG) (n = 10) and an untrained group (UG) (n = 11). In the SG, the individuals had practiced strength training for hypertrophy for at least 3 years. Upper- and lower-body muscle strength was measured with a 1 repetition maximum (1RM) test. Blood samples were collected at rest and after multiple sets of a superset strength training protocol (SSTP), with an intensity of 75% of 1RM values. With these blood samples, the levels of total testosterone (TT), free testosterone (FT), dehydroepiandrosterone (DHEA), cortisol, and sex hormone-binding globulin (SHBG) were determined. In addition, the TT-to-cortisol ratio and TT-to-SHBG ratio were calculated. There was no difference at rest between groups in hormonal values for TT, FT, DHEA, cortisol, the TT-to-SHBG ratio, and the TT-to-cortisol ratio. There were increases after SSTP in the levels of TT, FT, DHEA, and cortisol and the TT-to-SHBG ratio in the UG, but only FT increased in the SG. The SG demonstrated lower values in the TT-to-SHBG ratio after the training session. These results suggest the presence of alterations in anabolic and catabolic hormonal responses to resistance exercise in long-term trained middle-aged men, with the trained subjects demonstrating lower responsiveness in the hormone values. Long-term trained men seem to require a higher volume of training, at least similar to their daily workout, to stimulate greater hormone responses.     

举重运动员的卫星细胞活化和信号通路对阻力或联合运动的反应

为了考察单一抗阻运动模式和联合运动模式对举重运动员的卫星细胞活化和PI3K/Akt/mTOR信号通路的影响。本研究以30名男性举重运动员为研究对象,将受试者随机分为抗阻运动组和联合运动组,抗阻运动组接受60%最大重复次数(1 RM)的负重蹲起训练,联合运动组接受60%1 RM的负重蹲起和卧推训练。运动前和运动后3 h立即获得肌肉活检样品,采用双重免疫荧光染色检测活化的卫星细胞数(Pax7+/MyoD+)。采用蛋白质印迹法检测肌肉组织中Akt、mTOR、p70S6K和4E-BP1的磷酸化情况。研究发现,运动后,联合运动组活化的卫星细胞数显著高于抗阻运动组(35.14 vs 29.86个,p=0.011)。运动后联合运动组的Akt、mTOR、p70S6K和4E-BP1的磷酸化水平显著高于抗阻运动组(p<0.05)。本研究表明,与单一抗阻运动模式相比,联合运动模式更有助于肌肉卫星细胞的活化和PI3K/Akt/mTOR信号通路的活化,从而改善肌肉功能。     

Heavy resistance exercise training and skeletal muscle androgen receptor expression in younger and older men

Effects of heavy resistance exercise on serum testosterone and skeletal muscle androgen receptor (AR) concentrations were examined before and after a 21-week resistance training period. Seven healthy untrained young adult men (YT) and ten controls (YC) as well as ten older men (OT) and eight controls (OC) volunteered as subjects. Heavy resistance exercise bouts (5 × 10 RM leg presses) were performed before and after the training period. Muscle biopsies were obtained before and 1h and 48 h after the resistance exercise bouts from m.vastus lateralis (VL) to determine cross-sectional area of muscle fibers (fCSA) and AR mRNA expression and protein concentrations. No changes were observed in YC and OC while resistance training led to significant increases in maximal strength of leg extensors (1 RM), fCSA and lean body mass in YT and OT. Acute increases occurred in serum testosterone concentrations due to resistance exercises but basal testosterone remained unaltered. Mean AR mRNA expression and protein concentration remained unchanged after heavy resistance exercise bouts compared to pre-values. The individual pre- to post-training changes in resting (pre-exercise) AR protein concentration correlated with the changes in fCSA and lean body mass in the combined group of YT and OT. Similarly, it correlated with the changes in 1 RM in YT. Although mean AR expression did not changed due to the resistance exercise training, the present findings suggest that the individual changes of AR protein concentration in skeletal muscle following resistance training may have an impact on training-induced muscular adaptations in both younger and older men.     

Growth hormone treatment in growth hormone-deficient adults. II. Effects on exercise performance

Growth hormone (GH) treatment in adults with GH deficiency increases lean body mass and thigh muscle cross-sectional area. The functional significance of this was examined by incremental cycle ergometry in 24 GH-deficient adults treated in a double-blind placebo-controlled trial with recombinant DNA human GH (rhGH) for 6 mo (0.07 U/kg body wt daily). Compared with placebo, the rhGH group increased mean maximal O2 uptake (VO2max) (+406 +/- 71 vs. +133 +/- 84 ml/min; P = 0.016) and maximal power output (+24.6 +/- 4.3 vs. +9.7 +/- 4.8 W; P = 0.047), without differences in maximal heart rate or ventilation. Forced expiratory volume in 1 s, vital capacity, and corrected CO gas transfer were within normal limits and did not change with treatment. Mean predicted VO2max, based on height and age, increased from 78.9 to 96.0% in the rhGH group (compared with 78.5 and 85.0% for placebo; P = 0.036). The anaerobic ventilatory threshold increased in the rhGH group (+159 +/- 39 vs. +1 +/- 51 ml/min; P = 0.02). The improvement in VO2max was noted when expressed per kilogram body weight but not lean body mass or thigh muscle area. We conclude that rhGH treatment in adults with GH deficiency improves and normalizes maximal exercise performance and improves submaximal exercise performance and that these changes are related to increases in lean body mass and muscle mass. Improved cardiac output may also contribute to the effect of rhGH on exercise performance.     

Effect of creatine supplementation during high resistance training on mass,strength, and fatigue resistance in rat skeletal muscle

The aim of this study was to utilize a rodent model of resistance exercise to compare training with creatine supplementation with training alone. We tested the hypothesis that creatine supplementation during high resistance training would result in greater increases in muscle mass, contractile force, and superior resistance to fatigue compared with training alone. Two groups of rats underwent training of the tibialis anterior muscle (TA) for 4 weeks without creatine (NCr group) or with creatine (0.5 g.kg(-1).d(-1)) (CrT group). The relative loads in each animal were held constant during the training protocol. Training resulted in comparable significant increases in muscle contractile force in both the NCr and CrT groups. Creatine supplementation did not result in a significant increase in fatigue resistance and resulted in a significant decrease in postfatigue recovery compared with training alone. Training resulted in a significant increase in muscle dry weight in both groups, whereas muscle wet weight gains in the CrT group were double the gains in the NCr group. The data from this study suggest that for creatine to have a beneficial effect on muscle strength and mass beyond training alone, the workloads need to be adjusted. That is, any potential benefit of creatine to enable a greater lifting volume during resistance training needs to be incorporated into the training regime for creatine to be effective.     

Effects of resistance training and protein plus amino acid supplementation on muscle anabolism,mass, and strength

Summary. This study examined 10 wks of resistance training and the ingestion of supplemental protein and amino acids on muscle performance and markers of muscle anabolism. Nineteen untrained males were randomly assigned to supplement groups containing either 20 g protein (14 g whey and casein protein, 6 g free amino acids) or 20 g dextrose placebo ingested 1 h before and after exercise for a total of 40 g/d. Participants exercised 4 times/wk using 3 sets of 6–8 repetitions at 85–90% of the one repetition maximum. Data were analyzed with two-way ANOVA (p < 0.05). The protein supplement resulted in greater increases in total body mass, fat-free mass, thigh mass, muscle strength, serum IGF-1, IGF-1 mRNA, MHC I and IIa expression, and myofibrillar protein. Ten-wks of resistance training with 20 g protein and amino acids ingested 1 h before and after exercise is more effective than carbohydrate placebo in up-regulating markers of muscle protein synthesis and anabolism along with subsequent improvements in muscle performance.     

Functional properties of human muscle fibers after short-term resistance exercise training

The aim of this study was to assess the relationships between human muscle fiber hypertrophy, protein isoform content, and maximal Ca(2+)-activated contractile function following a short-term period of resistance exercise training. Six male subjects (age 27 +/- 2 yr) participated in a 12-wk progressive resistance exercise training program that increased voluntary lower limb extension strength by >60%. Single chemically skinned fibers were prepared from pre- and posttraining vastus lateralis muscle biopsies. Training increased the cross-sectional area (CSA) and peak Ca(2+)-activated force (P(o)) of fibers containing type I, IIa, or IIa/IIx myosin heavy chain by 30-40% without affecting fiber-specific force (P(o)/CSA) or unloaded shortening velocity (V(o)). Absolute fiber peak power rose as a result of the increase in P(o), whereas power normalized to fiber volume was unchanged. At the level of the cross bridge, the effects of short-term resistance training were quantitative (fiber hypertrophy and proportional increases in fiber P(o) and absolute power) rather than qualitative (no change in P(o)/CSA, V(o), or power/fiber volume).     

Increased muscular dehydroepiandrosterone levels are associated with improved hyperglycemia in obese rats

This study was undertaken to assess the effects of dehydroepiandrosterone (DHEA) administration and exercise training on muscular DHEA and 5α-dihydrotestosterone (DHT) levels and hyperglycemia in diet-induced obese and hyperglycemic rats. After 14 wk of a high-sucrose diet, obese male Wistar rats were assigned randomly to one of three 6-wk regimens: control, DHEA treatment, or exercise training (running at 25 m/min for 1 h, 5 days/wk; n = 10 each group). Results indicate that either 6 wk of DHEA treatment or exercise training significantly attenuated serum insulin and fasting glucose levels compared with the control group. Plasma and muscle concentrations of DHEA and DHT and expression levels of 5α-reductase were significantly higher in the DHEA-treated and exercise-training groups. Moreover, both DHEA administration and exercise training upregulated GLUT4 translocation with concomitant increases in protein kinase B and protein kinase Cζ/λ phosphorylation. Muscle DHEA and DHT concentrations closely correlated with blood glucose levels (DHEA treatment: r = -0.68, P < 0.001; exercise training: r = -0.65, P < 0.001), serum insulin levels, and activation of the GLUT4-regulated signaling pathway. Thus, increased levels of muscle sex steroids may contribute to improved fasting glucose levels via upregulation of GLUT4-regulated signaling in diet-induced obesity and hyperglycemia.     

Acute and chronic testosterone response to blood flow restricted exercise

The American College of Sports Medicine recommends lifting a weight of at least 70% 1RM to achieve muscular hypertrophy as it is believed that anything below this intensity rarely produces substantial muscle growth. At least part of this recommendation is related to elevated systemic hormones following heavy resistance training being associated with skeletal muscle hypertrophy. Despite benefits of high intensity resistance training, many individuals are unable to withstand the high mechanical stresses placed upon the joints during heavy resistance training. Blood flow restricted exercise offers a novel mode of exercise allowing skeletal muscle hypertrophy at low intensities, however the testosterone response to this exercise has yet to be discussed. The acute and chronic testosterone response to blood flow restricted exercise appears to be minimal when examining the current literature. Despite this lack of response, notable increases in both size and strength are observed with this type of exercise, which seems to support that systemic increases of endogenous testosterone are not necessary for muscular hypertrophy to occur. However, definitive conclusions cannot be made without a more thorough analysis of responses of androgen receptor density following blood flow restricted exercise. It may also be that there are differing mechanisms underlying hypertrophy induced by high intensity resistance training and via blood flow restricted exercise.     

A comparison of the effects of 6 weeks of traditional resistance training, plyometric training, and complex training on measures of strength and anthropometrics

Complex training (CT; alternating between heavy and lighter load resistance exercises with similar movement patterns within an exercise session) is a form of training that may potentially bring about a state of postactivation potentiation, resulting in increased dynamic power (Pmax) and rate of force development during the lighter load exercise. Such a method may be more effective than either modality, independently for developing strength. The purpose of this research was to compare the effects of resistance training (RT), plyometric training (PT), and CT on lower body strength and anthropometrics. Thirty recreationally trained college-aged men were trained using 1 of 3 methods: resistance, plyometric, or complex twice weekly for 6 weeks. The participants were tested pre, mid, and post to assess back squat strength, Romanian dead lift (RDL) strength, standing calf raise (SCR) strength, quadriceps girth, triceps surae girth, body mass, and body fat percentage. Diet was not controlled during this study. Statistical measures revealed a significant increase for squat strength (p = 0.000), RDL strength (p = 0.000), and SCR strength (p = 0.000) for all groups pre to post, with no differences between groups. There was also a main effect for time for girth measures of the quadriceps muscle group (p = 0.001), the triceps surae muscle group (p = 0.001), and body mass (p = 0.001; post hoc revealed no significant difference). There were main effects for time and group × time interactions for fat-free mass % (RT: p = 0.031; PT: p = 0.000). The results suggest that CT mirrors benefits seen with traditional RT or PT. Moreover, CT revealed no decrement in strength and anthropometric values and appears to be a viable training modality.     

Use of creatine in the elderly and evidence for effects on cognitive function in young and old

The ingestion of the dietary supplement creatine (about 20 g/day for 5 days or about 2 g/day for 30 days) results in increased skeletal muscle creatine and phosphocreatine. Subsequently, the performance of high-intensity exercise tasks, which rely heavily on the creatine-phosphocreatine energy system, is enhanced. The well documented benefits of creatine supplementation in young adults, including increased lean body mass, increased strength, and enhanced fatigue resistance are particularly important to older adults. With aging and reduced physical activity, there are decreases in muscle creatine, muscle mass, bone density, and strength. However, there is evidence that creatine ingestion may reverse these changes, and subsequently improve activities of daily living. Several groups have demonstrated that in older adults, short-term high-dose creatine supplementation, independent of exercise training, increases body mass, enhances fatigue resistance, increases muscle strength, and improves the performance of activities of daily living. Similarly, in older adults, concurrent creatine supplementation and resistance training increase lean body mass, enhance fatigue resistance, increase muscle strength, and improve performance of activities of daily living to a greater extent than resistance training alone. Additionally, creatine supplementation plus resistance training results in a greater increase in bone mineral density than resistance training alone. Higher brain creatine is associated with improved neuropsychological performance, and recently, creatine supplementation has been shown to increase brain creatine and phosphocreatine. Subsequent studies have demonstrated that cognitive processing, that is either experimentally (following sleep deprivation) or naturally (due to aging) impaired, can be improved with creatine supplementation. Creatine is an inexpensive and safe dietary supplement that has both peripheral and central effects. The benefits afforded to older adults through creatine ingestion are substantial, can improve quality of life, and ultimately may reduce the disease burden associated with sarcopenia and cognitive dysfunction.     

Resistance training induces qualitative changes in muscle morphology, muscle architecture, and muscle function in elderly postoperative patients.

Although the negative effects of bed rest on muscle strength and muscle mass are well established, it still remains a challenge to identify effective methods to restore physical capacity of elderly patients recovering from hospitalization. The present study compared different training regimes with respect to muscle strength, muscle fiber size, muscle architecture, and stair walking power in elderly postoperative patients. Thirty-six patients (60-86 yr) scheduled for unilateral hip replacement surgery due to hip osteoarthritis were randomized to either 1) resistance training (RT: 3/wk x 12 wk), 2) electrical stimulation (ES: 1 h/day x 12 wk), or 3) standard rehabilitation (SR: 1 h/day x 12 wk). All measurements were performed at baseline, at 5 wk and 12 wk postsurgery. After 12 wk of resistance training, maximal dynamic muscle strength increased by 30% at 60 degrees /s (P < 0.05) and by 29% at 180 degrees /s (P < 0.05); muscle fiber area increased for type I (+17%, P < 0.05), type IIa (+37%, P < 0.05), and type IIx muscle fibers (+51%, P < 0.05); and muscle fiber pennation angle increased by 22% and muscle thickness increased by 15% (P < 0.05). Furthermore, stair walking power increased by 35% (P < 0.05) and was related to the increase in type II fiber area (r = 0.729, P < 0.05). In contrast, there was no increase in any measurement outcomes with electrical stimulation and standard rehabilitation. The present study is the first to demonstrate the effectiveness of resistance training to induce beneficial qualitative changes in muscle fiber morphology and muscle architecture in elderly postoperative patients. In contrast, rehabilitation regimes based on functional exercises and neuromuscular electrical stimulation had no effect. The present data emphasize the importance of resistance training in future rehabilitation programs for elderly individuals.