About this trial
The overall objective for this clinical trial is to provide evidence for internal and external cueing for physical therapists and other rehabilitation clinicians to optimize resistance training within rehabilitation for older adults. The main questions it aims to answer are:
* What is the impact of external focus (providing velocity of movement for each repetition) compared to internal focus (i.e., no cues, control group) on physical percent velocity loss and neuromuscular activation in older adults with sarcopenia? * Does internal and external focus influence motivation and perceptual workload following resistance training in older adults with sarcopenia?
Researchers will compare external focus to internal focus to see if external focus impacts percent velocity loss, motivation, and perceived workload.
Participants will:
* Visit the lab once per week for 3 weeks * Perform exercise testing using a leg press * Answer questionnaires regarding perceived workload and motivation before and after exercise
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Community-dwelling older adults 60-95 years of age
Physically independent
Free of severe mental impairment
Score 4 or greater on the SARC-F sarcopenia questionnaire
Disqualifiers
Participated in a structured resistance training program in the last 12 months
Had a lower extremity injury or surgical intervention within the past 6 months
Have neuromuscular (i.e., Parkinson's Disease, Multiple Sclerosis), circulatory, or edema pathology
Trial design
Crossover
Treatments tested in this trial
Experimental: External Focus
BehavioralParticipants will perform a short, standardized warm-up (1 set of 10 repetitions of 20% of the participant's estimated 1-repetition maximum). Following the warm-up, participants will perform 30 repetitions using 50% of their estimated 1-repetition maximum on a leg press machine. Participants will receive visual feedback from a linear position transducer for each repetition, indicating the speed of the last repetition/movement.
Other: Internal Focus
BehavioralArm Description: Participants will perform a short, standardized warm-up (1 set of 10 repetitions of 20% of the participant's estimated 1RM). Following the warm-up, participants will perform 30 repetitions using 50% of their estimated 1-repetition maximum on a leg press machine. Participants will NOT receive visual feedback for each repetition. This is the control condition.
Treatment groups
Trial outcomes
Primary outcomes
Percent Velocity Loss
The linear position transducer is a spring-powered retractable apparatus that attaches to the leg press on one end and to the machine near the participant's hip joint. Velocity data from a linear position transducer will be collected following each repetition. Percent velocity loss (%VL) measures the reduction in the movement speed from the initial repetition to the final repetition. The %VL will quantify the level of fatigue and performance decline that occurs throughout the repetitions of leg press. This would suggest that a higher %VL would indicate a greater degree of fatigue, while a lower %VL loss would indicate a better ability to maintain movement velocity across the repetitions.
Muscle Activation
To examine muscle activation, surface electromyographic (sEMG) signals will be collected in millivolts (mV) during each repetition using wireless sEMG sensors from the right vastus lateralis. A higher number of millivolts is associated with greater muscular activation. All sEMG signals will use a commercially available signal acquisition system. To optimize signal quality, the skin will be prepared, and the surface electrodes will be secured to the skin with skin-sensor adhesive in a standardized position directly above the muscle in line with the muscle fiber pennation in a bipolar fashion. An electrogoniometer will be placed across the right knee's joint space. The electrogoniometer will be calibrated to 90° flexion and 180° full extension of the knee joint.
Motivation
The Dundee Stress State Questionnaire (DDSQ) has been used to determine task stress and performance impact of stress on task completion. Our proposal focuses on the motivation construct (15 item questionnaire, \~5 minutes to complete) of the DDSQ which has been shown to be reliable and scored on a 4-point Likert scale (Extremely = 4 Very much = 3 Somewhat = 2 A little bit = 1 Not at all = 0). The maximum score possible is 60 points and minimum score possible is 0 points. Higher scores indicate higher motivation. Note that certain items are reverse coded when scoring. Motivation will be assessed before sessions to determine baseline motivation to complete the resistance training protocol and 10 minutes after the resistance training protocol to determine if the visual movement velocity biofeedback improves motivation throughout the resistance training protocol.
Perceived Workload
Perceived workload will be assessed using the NASA task index (NASA-TLX). This questionnaire assesses six separate indices that examine the mental demand, physical demand, temporal demand, performance, effort, and frustration level following the completion of the resistance training protocol. Adjusted scores range from 0-500 with higher scores indicate greater demand, failure, higher effort, or higher frustration. The NASA-TLX will provide valuable information about how visual movement velocity biofeedback may change the perceived workload compared to the non-biofeedback condition.
Sponsors and contacts
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Creighton University
Lead sponsor
Foundation for Physical Therapy Research
Collaborator