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J Nutr Health Aging. 2019;23(6):564-570. doi: 10.1007/s12603-019-1208-8.

Twenty-Four Months' Resistance and Endurance Training Improves Muscle Size and Physical Functions but Not Muscle Quality in Older Adults Requiring Long-Term Care.

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Akito Yoshiko, Ph.D. School of International Liberal Studies, Chukyo University, 101 Tokodachi, Kaizu, Toyota, Aichi 470-0393, Japan, Tel: +81 (565) 46-6952, E-mail:



To assess the effects of 24 months training on muscle quality, size, strength, and gait abilities in older adults who need long-term care.


Non-randomized controlled trial Setting: Kawai Rehabilitation Center and Kajinoki Medical Clinic.


Ten older participants who needed long-term care (age, 76.7 ± 5.6 years) were participated as training group (Tr-group) and 10 older men and women who did not require long-term care (age, 72.9 ± 6.6 years) comprised the control group (Cont-group).


Tr-group performed resistive and endurance exercises once or twice a week for 24 months.


Using ultrasound images, echo intensity (EI) and muscle thickness were measured in the rectus femoris and biceps femoris as an index of muscle quality and size. Physical performance was measured before and after the training; performance parameters included knee extension peak torque, 5-m normal and maximal walk test, sit-to-stand and timed up and go test.


After the training, there was no change in EI, while BF thickness was increased (pre; 1.82 ± 0.29 cm, 24 months; 2.14 ± 0.23 cm, p < 0.05) in Tr-group. Walk-related performances were improved after the training in Tr-group (i.e. 5-m walk test and timed up and go test). The percent change of knee extension peak torque explained the percent change of EI in the rectus femoris (regression coefficient = 1.24, R = 0.91, adjusted R2 = 0.82, p < 0.001).


Twenty-four months' training induced muscle hypertrophy and improved physical functions. Increased muscle quality in the rectus femoris could be a key to improved knee extension peak torque, with the potential to eventually reduce the need for long-term care in older individuals.


Echo intensity; endurance training; long-term care; older individuals; resistance training; twenty-four months; ultrasonography


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