Randomized controlled trials (RCTs) indicate that power training has the ability to improve muscle power and physical performance in older adults. However, power training definitions are broad and previously-established criteria are vague, making the validity and replicability of power training interventions used in RCTs uncertain. The aim of this review was to assess whether the power training interventions identified in a previous systematic review (el Hadouchi 2022) are fully described, therapeutically valid, and meet our proposed criteria for power training.
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Previous research shows that power training can increase power output in older adults and may also improve physical performance, physical functioning, and independence. However, power training interventions have not been optimized for older adults. The aim of this study was to assess the feasibility and preliminary effectiveness of a power training program called Powerful Ageing in older adults. A total of 28 older adults participated in a 12-week power training intervention at an intensity of 20-30% 1RM. The primary outcome, feasibility, was assessed through intervention retention, adherence (attendance and compliance), and safety. Secondary outcomes were measured in health domains of the ICF. In the function domain, muscle power and anaerobic power were assessed using a weighted squat and Wingate test, respectively. In the activities domain, physical performance was measured using the 6-minute walk test, and in the participation domain, physical activity in daily life and health status were evaluated using an accelerometer and the SF-36 questionnaire, respectively.
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Powerful Ageing is a power training intervention offered by Dutch municipalities to improve the physical functioning of its older residents, thereby reducing their reliance on assistive living devices and social support services. This study aimed to investigate the effects of Powerful Ageing on muscle power, physical performance, and physical functioning in older adults immediately following the intervention and at 1-year follow-up. The study design was a prospective longitudinal case series. Eligible older adults requesting social support services from their municipality participated in a 14-week power training intervention. Primary outcomes were categorized according to ICF health domains: within the function domain, muscle power was measured with a Power Squat Test and a Lifting Test; within the activities domain, physical performance was assessed using the Star Agility Run and Timed Up-and-Go Test; and within the participation domain, physical functioning was assessed using a patient-specific complaints questionnaire. Participant motivation, a secondary outcome, was assessed using a short questionnaire.
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Research suggests that muscle power is a more critical determinant of physical functioning in older adults than muscle strength. The objective of this study was to systematically review the literature on the effect of power training compared to strength training in older adults on tests for muscle power, two groups of activity-based tests under controlled conditions: generic tests and tests with an emphasis on movement speed, and finally, physical activity level in daily life. A systematic search for randomized controlled trials comparing effects of power training to strength training in older adults was performed in PubMed, Embase, Ebsco/CINAHL, Ebsco/SPORTDiscus, Wiley/Cochrane Library and Scopus. Risk of bias was assessed using the Cochrane Collaboration Tool, and quality of evidence was evaluated using GRADEpro Guideline Development Tool. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes separately using a random effects model.
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Studies evaluating the effects of power training in older adults use a variety of measurement tools and outcome parameters, limiting comparability of results and calling the validity of conclusions into question. This study aimed to identify a core outcome set (COS) to measure the effects of power training in older adults, encompassing the function, activities, and participation domain of the International Classification of Functioning, Disease, and Health (ICF). Twenty-one tests were evaluated based on their ability to measure muscle power and the effects of power training. Our methodology consisted of two Delphi survey rounds and an expert panel meeting using modified Nominal Group Technique. The COS consisted of tests considered most feasible for clinical practice and least burdensome for older adults. The COS included the Squat Jump Test (paired with accelerometery-based instrumentation) and the Timed Up-and-Go Test for the function and function and activities domain, respectively. No test was identified for the participation domain, however, experts proposed using daily-life accelerometery until more suitable outcome measures are defined and validated. This study addresses a critical research gap in standardised assessment protocols, and contributes to a multifaceted approach to measuring the impact of power training in older adults.
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Research shows that power training offers more potential for improving muscle power and physical performance in older adults than strength training. However, the measurement properties of the tests used to assess the effects of power training are unclear. Objective: to review the reliability, validity, and responsiveness of tests used to measure the effects of power training in older adults.
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PURPOSE: Athletes require feedback in order to comply with prescribed training programs designed to optimize their performance. In rowing, current feedback parameters on intensity are inaccurate. Mechanical power output is a suitable objective measure for training intensity, but due to movement restrictions related to crew rowing, it is uncertain whether crew rowers are able to adjust their intensity based on power-output feedback. The authors examined whether rowers improve compliance with prescribed power-output targets when visual real-time feedback on power output is provided in addition to commonly used feedback.METHODS: A total of 16 crew rowers rowed in 3 training sessions. During the first 2 sessions, they received commonly used feedback, followed by a session with additional power-output feedback. Targets were set by their coaches before the experiment. Compliance was operationalized as accuracy (absolute difference between target and delivered power output) and consistency (high- and low-frequency variations in delivered power output).RESULTS: Multilevel analyses indicated that accuracy and low-frequency variations improved by, respectively, 65% (P > .001) and 32% (P = .024) when additional feedback was provided.CONCLUSION: Compliance with power-output targets improved when crew rowers received additional feedback on power output. Two additional observations were made during the study that highlighted the relevance of power-output feedback for practice: There was a marked discrepancy between the prescribed targets and the actually delivered power output by the rowers, and coaches had difficulties perceiving improvements in rowers' compliance with power-output targets.
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In wheelchair sports, there is an increasing need to monitor mechanical power in the field. When rolling resistance is known, inertial measurement units (IMUs) can be used to determine mechanical power. However, upper body (i.e., trunk) motion affects the mass distribution between the small front and large rear wheels, thus affecting rolling resistance. Therefore, drag tests – which are commonly used to estimate rolling resistance – may not be valid. The aim of this study was to investigate the influence of trunk motion on mechanical power estimates in hand-rim wheelchair propulsion by comparing instantaneous resistance-based power loss with drag test-based power loss. Experiments were performed with no, moderate and full trunk motion during wheelchair propulsion. During these experiments, power loss was determined based on 1) the instantaneous rolling resistance and 2) based on the rolling resistance determined from drag tests (thus neglecting the effects of trunk motion). Results showed that power loss values of the two methods were similar when no trunk motion was present (mean difference [MD] of 0.6 1.6 %). However, drag test-based power loss was underestimated up to −3.3 2.3 % MD when the extent of trunk motion increased (r = 0.85). To conclude, during wheelchair propulsion with active trunk motion, neglecting the effects of trunk motion leads to an underestimated mechanical power of 1 to 6 % when it is estimated with drag test values. Depending on the required accuracy and the amount of trunk motion in the target group, the influence of trunk motion on power estimates should be corrected for.
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An important performance determinant in wheelchair sports is the power exchanged between the athletewheelchair combination and the environment, in short, mechanical power. Inertial measurement units (IMUs) might be used to estimate the exchanged mechanical power during wheelchair sports practice. However, to validly apply IMUs for mechanical power assessment in wheelchair sports, a well-founded and unambiguous theoretical framework is required that follows the dynamics of manual wheelchair propulsion. Therefore, this research has two goals. First, to present a theoretical framework that supports the use of IMUs to estimate power output via power balance equations. Second, to demonstrate the use of the IMU-based power estimates during wheelchair propulsion based on experimental data. Mechanical power during straight-line wheelchair propulsion on a treadmill was estimated using a wheel mounted IMU and was subsequently compared to optical motion capture data serving as a reference. IMU-based power was calculated from rolling resistance (estimated from drag tests) and change in kinetic energy (estimated using wheelchair velocity and wheelchair acceleration). The results reveal no significant difference between reference power values and the proposed IMU-based power (1.8% mean difference, N.S.). As the estimated rolling resistance shows a 0.9–1.7% underestimation, over time, IMU-based power will be slightly underestimated as well. To conclude, the theoretical framework and the resulting IMU model seems to provide acceptable estimates of mechanical power during straight-line wheelchair propulsion in wheelchair (sports) practice, and it is an important first step towards feasible power estimations in all wheelchair sports situations.
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OBJECTIVE: To examine the use of a submaximal exercise test in detecting change in fitness level after a physical training program, and to investigate the correlation of outcomes as measured submaximally or maximally.DESIGN: A prospective study in which exercise testing was performed before and after training intervention.SETTING: Academic and general hospital and rehabilitation center.PARTICIPANTS: Cancer survivors (N=147) (all cancer types, medical treatment completed > or =3 mo ago) attended a 12-week supervised exercise program.INTERVENTIONS: A 12-week training program including aerobic training, strength training, and group sport.MAIN OUTCOME MEASURES: Outcome measures were changes in peak oxygen uptake (Vo(2)peak) and peak power output (both determined during exhaustive exercise testing) and submaximal heart rate (determined during submaximal testing at a fixed workload).RESULTS: The Vo(2)peak and peak power output increased and the submaximal heart rate decreased significantly from baseline to postintervention (P<.001). Changes in submaximal heart rate were only weakly correlated with changes in Vo(2)peak and peak power output. Comparing the participants performing submaximal testing with a heart rate less than 140 beats per minute (bpm) versus the participants achieving a heart rate of 140 bpm or higher showed that changes in submaximal heart rate in the group cycling with moderate to high intensity (ie, heart rate > or =140 bpm) were clearly related to changes in VO(2)peak and peak power output.CONCLUSIONS: For the monitoring of training progress in daily clinical practice, changes in heart rate at a fixed submaximal workload that requires a heart rate greater than 140 bpm may serve as an alternative to an exhaustive exercise test.
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