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Muscle Quality Improves with Extended High-Intensity Resistance Training After Hip Fracture

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Abstract

Background

Muscle mass deficits endure after hip fracture. Strategies to improve muscle quality may improve mobility and physical function. It is unknown whether training after usual care yields muscle quality gains after hip fracture.

Objectives

To determine whether muscle quality improves after hip fracture with high-intensity resistance training and protein supplementation. Design: Case series. Setting: University of Utah Skeletal Muscle Exercise Research Facility.

Participants

17 community-dwelling older adults, 3.6+/-1.1 months post-hip fracture, recently discharged from usual-care physical therapy (mean age 77.0+/-12.0 years, 12 female), enrolled.

Intervention

Participants underwent 12 weeks (3x/week) of unilaterally-biased resistance training.

Methods/Materials

Participants were measured via a 3.0 Tesla whole-body MR imager for muscle lean and intramuscular adipose tissue (IMAT) of the quadriceps before and after resistance training. Peak isometric knee extension force output was measured with an isokinetic dynamometer. Muscle quality was calculated by dividing peak isometric knee extension force (N) by quadriceps lean muscle mass (cm2). In addition, common physical function variables were measured before and after training.

Results

Surgical and nonsurgical lean quadriceps muscle mass improved among participants (mean change: 2.9 cm2+/-1.4 cm2, and 2.7 cm2+/-1.3 cm2, respectively), while IMAT remained unchanged. Peak force improved in the surgical limb by 43.1+/-23N, with no significant change in the nonsurgical limb. Significant gains in physical function were evident after training.

Conclusion

Participants recovering from hip fracture demonstrated improvements in muscle mass, muscle strength, and muscle quality in the surgical limb after hip fracture. These were in addition to gains made in the first months after fracture with traditional care. Future studies should determine the impact that muscle quality has on long-term functional recovery in this population.

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Authors and Affiliations

  1. University of Utah, College of Health, Dept of Physical Therapy and Athletic Training, Salt Lake City, UT, USA

    Robert A. Briggs, M. J. Drummond, J. M. Fritz, P. C. Lastayo & R. L. Marcus

  2. George Fox University, Dept of Physical Therapy, Newberg, OR, USA

    J. R. Houck

Authors
  1. Robert A. Briggs
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  2. J. R. Houck
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  3. M. J. Drummond
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  4. J. M. Fritz
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  5. P. C. Lastayo
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  6. R. L. Marcus
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Correspondence to Robert A. Briggs.

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Briggs, R.A., Houck, J.R., Drummond, M.J. et al. Muscle Quality Improves with Extended High-Intensity Resistance Training After Hip Fracture. J Frailty Aging 7, 51–56 (2018). https://doi.org/10.14283/jfa.2017.31

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  • DOI: https://doi.org/10.14283/jfa.2017.31

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