kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2014.14.1.26 kjhp-14-26 Original Article Effects of 12 Weeks High-Speed Elastic Band Training on Cognitive Function, Physical Performance and Muscle Strength in Older Women with Mild Cognitive Impairment: A Randomized Controlled Trial KangDongheon KimHeejae YoonDonghyun KimJinsoo SongWook Health and Exercise Science Laboratory, Institute of Sports Science, Institute on Aging, Seoul National University, Seoul, Korea ￭ Corresponding author：Wook Song, PhD Health and Exercise Science Laboratory, Institute of Sports Science, Institute on Aging, Seoul National University, 599 Gwanak-ro, Seoul 151-742, Korea Tel: +82-2-880-7804, Fax: +82-2-886-7804 E-mail: songw3@snu.ac.kr 01 2014 20 01 2014 14 1 26 32 06022014 14032014 Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

Exercise has shown to slow down the progression from mild cognitive impairment (MCI) to dementia. In particular, not only resistance exercise has been verified to improve physical performance and muscle strength, leading to the prevention of fall-related injuries in the frail elderly, but also cognitive function. In this study, we investigated how high-speed elastic band training, applied using a high-speed power training protocol, affects cognition, physical performance and muscle strength of female elderly individuals with MCI.

 Methods

Thirty-nine subjects diagnosed with MCI from one senior college using a Korean version of mini-mental state examination (MMSE-K) and a Korean version of the Montreal Cognitive Assessment (MoCA-K) were randomly divided into exercise group (n=20) and control group (n=19). The exercise group completed a 12-week high-speed resistance elastic band exercise program and was encouraged to exercise at home as well during the intervention period.

 Results

The results showed significant increases in cognitive function, physical performance and muscle strength assessed by digit span forward test (P<0.001), digit span backward test (P=0.003), the Stroop test B (P=0.031), SPPB scores (P=0.010), right knee 60° extensor peak torque (P=0.004), 60° flexor peak torque (P=0.001), 180° extensor peak torque (P=0.020) and grip strength (P=0.025)

 Conclusions

Our study showed that participants with MCI who continued the high-speed elastic band training program for 12 weeks showed improvements in cognitive function, physical performance and muscle strength.

 Mild cognitive impairment Resistance training Cognition Muscle strength Aged References Statistics Korea Statistics of elderly people Daejeon Korea Statistical information Service 2013 [Accessed Sep 30, 2013]. http://kostat.go.kr/portal/korea/kor_nw/3/index.board? bmode=read&aSeq=308689&ord=3.pdf. National Health Insurance Service Korea insurance Health insurance statistics analysis source book 2010. [Accessed Feb 8, 2011]. http://www.nhis.or.kr/cms/board/board/Board.jsp?act=VIEW&communityKey=B0070&boardId=20120 Ministry of Health and Welfare Nationwide Study on the prevalence of Dementia in Korean Elders 2008. [Accessed Apr 16, 2009]. http://www.mw.go.kr/front_new/jb/sjb030301vw.jsp? PAR_MENU_ID=03&MENU_ID=030502&CONT_SEQ=2 11706&FILE_SEQ=101156.pdf. Cho MJ The prevalence and risk factors of dementia in the Korean elderly Health-welfare Policy Forum. 2009156 156 438 Petersen RC Smith GE Waring SC Ivnik RJ Tangalos EG Kokmen E Mild cognitive impairment: clinical characterization and outcome Arch Neurol 199956 3 3038 Petersen RC Doody R Kurz A Mohs RC Morris JC Rabins PV Current concepts in mild cognitive impairment Arch Neurol 200158 12 198592 Bae HJ Treatment of mild cognitive impairment Dement Neurocognitive Disord 20032 2 10814 Gates N Fiatarone Singh MA Sachdev PS Valenzuela M The effect of exercise training on cognitive function in older adults with mild cognitive impairment: a metaanalysis of randomized controlled trials Am J Geriatr Psychiatry 201321 11 108697 Kovacs E Sztruhar Jonasne I Karoczi CK Korpos A Gondos T Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study European Journal of Physical and Rehabilitation Medicine 201349 5 63948 Nagamatsu LS Handy TC Hsu CL Voss M Liu-Ambrose T Resistance training promotes cognitive and functional brain plasticity in seniors with probable mild cognitive impairment Arch Intern Med 2012172 8 6668 Porter MM Power training for older adults Applied Physiology, Nutrition, and Metabolism 200631 2 8794 Sayers SP Gibson K A comparison of high-speed power training and traditional slow-speed resistance training in older men and women Journal of Strength and Conditioning Research 201024 12 336980 Steib S Schoene D Pfeifer K Dose-response relationship of resistance training in older adults: a metaanalysis Med Sci Sports Exerc 201042 5 90214 Caserotti P Aagaard P Larsen JB Puggaard L Explosive heavy-resistance training in old and very old adults: changes in rapid muscle force, strength and power Scand J Med Sci Sports 200818 6 77382 Pereira A Izquierdo M Silva AJ Costa AM González-Badillo JJ Marques MC Muscle performance and functional capacity retention in older women after high-speed power training cessation Exp Gerontol 201247 8 6204 So WY Song MS Cho BL Park YH Kim YS Song W The effect of elastic band exercise training and detraining on body composition and fitness in the elderly The Korean Gerontological Society 200929 4 124759 Page PA Labbe A Topp RV Clinical force production of thera-band elastic bands J Orthop Sports Phys Ther 200030 1 478 Folstein MF Folstein SE McHugh PR Mini-mental state. A practical method for grading the cognitive state of patients for the clinician J Psychiatr Res 197512 3 18998 Nasreddine ZS Phillips NA Bedirian V Charbonneau S Whitehead V Collin I The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment J Am Geriatr Soc 200553 4 6959 Lee JY Lee DW Cho SJ Na DL Jeon HJ Cho MJ Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal Cognitive Assessment J Geriatr Psychiatry Neurol 200821 2 10410 American College of Sports Medicine ACSM's guidelines for exercise testing and prescription 9th ed. Mc Baltimore Lippincott Williams & Wilkins 2013 209 Kang Y Na DL Seoul Neuropsychological Screening Battery (SNSB) 1st ed. Incheon Human Brain Research & Consulting Co. 2003 Kim AK Characteristics of frontal executive functions and attention in patients with Parkinson's disease and Parkinson's disease dementia [dissertation] Daegu Kyungpook National University 2012 Korean. Guralnik JM Seeman TE Tinetti ME Nevitt MC Berkman LF Validation and use of performance measures of functioning in a non-disabled older population: MacArthur studies of successful aging Aging (Milano) 19946 6 4109 Podsiadlo D Richardson S The timed "Up & Go": a test of basic functional mobility for frail elderly persons J Am Geriatr Soc 199139 2 1428 Stevens PJ Syddall HE Patel HP Martin HJ Cooper C Aihie Sayer A Is grip strength a good marker of physical performance among community-dwelling older people? Journal of Nutrition, Health and Aging 201216 9 76974 Chodzko-Zajko WJ Moore KA Physical fitness and cognitive functioning in aging Exerc Sport Sci Rev 199422 1 195220 Tables

General characteristics of subjectsa

Variables Control group (n=7) Exercise group (n=14) Pb
Age, y 78.0±2.8 75.0±3.5 0.079
Height, cm 149.5±4.1 151.4±6.1 0.488
Weight, kg 51.2±4.1 58.4±6.8 0.016
Skeletal muscle mass, kg 17.1±1.5 18.8±2.8 0.255
Body fat, % 33.4±8.3 38.8±5.4 0.244
BMI, kg/m2 22.9±1.8 25.5±2.5 0.006
Waist hip ratio, % 0.9±0.1 0.9±0.1 0.400
MMSE-K, score 22.3±1.1 21.0±1.0 0.025
MoCA-K, score 18.7±2.6 18.3±2.8 0.636

Abbreviations: BMI, body mass index; MMSE-K, Korean version of mini mental state examination.; MoCA-K, Korean version of Montrea Cognitive Assessment.

Values are presented as mean±SD.

Calculated by Mann-Whitney U test.

Effects of high-speed elastic band training on cognitive functiona

Variables Control group (n=7) Exercise group (n=14) Pb
Before After Before After
DST-F 4.71±0.49 3.00±0.58c 4.86±0.95 7.00±0.88d <0.001
DST-B 2.00±1.00 1.43±0.54 2.43±0.85 3.79±0.43d 0.003
ST A 11.43±4.72 10.14±3.76 12.21±6.99 13.57±6.17 NS
ST B 6.43±2.82 6.86±2.19 7.21±3.07 10.71±3.22e 0.031

Abbreviations: DST-F, digit span forward test; DST-B, digit span backward test; ST A, stroop test A; ST B, stroop test B; NS, not significant.

Values are presented as mean±SD.

Main effect calculated by Mann-Whitney U test.

Significantly different compared with Before Control group assessed by Wilcoxon signed rank test, P=0.014.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.001.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.007.

Effects of high-speed elastic band training on physical performance testa

Variables Control group (n=7) Exercise group (n=14) Pb
Before After Before After
SPPB (score) 7.14±1.77 7.57±0.98 8.14±2.48 10.79±1.59c 0.010
TUG (sec) 11.48±1.02 10.59±1.03 10.51±1.86 9.14±1.42d NS

Abbreviations: SPPB, short physical performance battery; TUG, timed up and go test; NS, not significant.

Values are presented as mean±SD.

Main effect calculated by Mann-Whitney U test.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.002.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.004.

Effects of high-speed elastic band training on muscle strengtha

Variables     Control group (n=7) Exercise group (n=14) Pb
Before After Before After
60°/sec (Nm) Knee extensor Peak TQ (R)/BW 105.71±20.92 116.86±31.74 77.57±29.03 115.43±31.92c 0.004
  Knee flexor Peak TQ (R)/BW 74.86±17.44 58.14±18.00d 66.21±20.77 67.43±17.82 0.001
180°/sec (Nm) Knee extensor Peak TQ (R)/BW 29.43±7.98 33.29±9.80d 28.71±12.63 39.29±11.45c 0.020
  Knee flexor Peak TQ (R)/BW 54.43±9.26 37.71±9.93d 44.14±14.49 36.00±15.11e NS
Grip strength     17.69±1.91 18.99±1.81 19.26±3.57 24.01±4.14c 0.025

Abbreviations: Nm, newton meter; TQ, torque; R, right; BW, body weight; NS, not significant.

Values are presented as mean±SD.

Main effect calculated by Mann-Whitney U test.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.001.

Significantly different compared with Before Control group assessed by Wilcoxon signed rank test, P=0.018.

Significantly different compared with Before Exercise group assessed by Wilcoxon signed rank test, P=0.041.