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Strength training and protein supplementation improve muscle mass, strength, and function in mobility-limited older adults: a randomized controlled trial



Adaptation to strength training in very old mobility-limited individuals is not fully characterized. Therefore, the aim of this study was to perform a thorough investigation of the adaptation to a lower body strength training regime in this population, with particular emphasis on the relationship between changes in selected variables.


Twenty-two mobility-limited older men and women (85 ± 6 years) were randomized to either a group performing 30 min of heavy-load strength training three times a week, with daily protein supplementation, for 10 weeks (ST), or a control group. End points were leg lean mass assessed by DXA, muscle thickness assessed by ultrasound, isometric and dynamic strength, rate of torque development, and functional capacity.


Leg lean mass increased from baseline in ST (0.7 ± 0.3 kg), along with increased thickness of vastus lateralis (4.4 ± 3.2%), rectus femoris (6.7 ± 5.1%), and vastus intermedius (5.8 ± 5.9%). The hypertrophy was accompanied by improved knee extensor strength (20–23%) and functional performance (7–11%). In ST, neither the change in leg lean mass nor muscle thickness correlated with changes in muscle strength. However, a strong correlation was observed between the change in isometric strength and gait velocity (r = 0.70).


The mismatch between gains in muscle size and strength suggests that muscle quality-related adaptations contributed to the increases in strength. The correlations observed between improvements in strength and function suggests that interventions eliciting large improvements in strength may also be superior in terms of functional gains in this population.

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The authors would like to thank Kristin Holte for analysis of the dietary registrations, Mauritz Kaashagen for performing the ultrasound measurements, and Anne Lene Nordengen for assistance during the supervision of training. We thank TINE SA for providing the nutritional supplements. We also thank our participants for their great contributions.


The study was funded by the Norwegian School of Sport Sciences.

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Authors and Affiliations



SA and TR contributed to the conception and design of the research; SA performed the experiments; SA analyzed the data; SA, OS, HB, and TR interpreted the results of the experiments; SA prepared the figures; SA drafted the manuscript; SA, OS, HB, and TR edited and revised the manuscript; SA, OS, HB, and TR approved the final version of the manuscript.

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Correspondence to Sigve Nyvik Aas.

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All procedures were in accordance with the ethical standards of the national research committee (Regional Committee for Medical and Health Research Ethics, Section C, South East Norway) and the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Aas, S.N., Seynnes, O., Benestad, H.B. et al. Strength training and protein supplementation improve muscle mass, strength, and function in mobility-limited older adults: a randomized controlled trial. Aging Clin Exp Res 32, 605–616 (2020).

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  • Resistance exercise
  • Frailty
  • Sarcopenia
  • Hypertrophy
  • Mobility limited
  • Skeletal muscle