Low Intensity Training Combined With KAATSU on Muscle Vasodilatation and Arterial Stiffness in the Elderly Population

Frail Elderly Syndrome Clinical Trial

Official title:

Effect of Low Intensity Strength Training Combined With Moderate Blood Flow Restriction on Muscle Vasodilatation and Arterial Stiffness in Elders With Low Gait Velocity.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03272737
• Other study ID #: 2016/07993-3
• Status: Completed
• Phase: N/A
• Start date: February 4, 2018
• Est. completion date: January 4, 2022

Study information

• Verified date: March 2020
• Source: Hospital Israelita Albert Einstein
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the present study is to evaluate the acute and chronic effect of low intensity strength training with or without moderate blood flow restriction on muscle vasodilation and arterial stiffness in elders with low gait speed. In addition, the responses of prothrombotic factors in blood coagulation, the impact on heart rate and arterial pressure will be assessed.

Description:

The investigators propose a study of 26 sedentary elders with low speed gait, supervised by the Hospital Israelita Albert Einstein - Vila Mariana ambulatory. This will be an open clinical trial, prospective, single center, randomized and controlled study. It will be divided into two parts: acute and chronic phases. After signing an informed consent, the participants will be separated in two groups:

Group 1. Resistance exercise with low intensity combined with partial blood flow restriction Group 2. Conventional resistance exercise with low intensity

All of participants will be submitted to interventions tests before and after the period of training which are:

1. Laboratory Tests: Blood tests

2. Plethysmography

3. Handgrip

4. Quality of life questionaire

5. FMD tests

6. Vasodilation capacity

Recruitment information / eligibility

• Status: Completed
• Enrollment: 26
• Est. completion date: January 4, 2022
• Est. primary completion date: June 4, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 60 Years to 85 Years

Eligibility

Inclusion Criteria:

• Elderly people aged 60 to 85 years, with walking speed <0.8m / s (Guralnik, 1994).

Exclusion Criteria:

• Elderly patients with uncontrolled diabetes mellitus or peripheral neuropathy;

• Symptomatic peripheral obstructive arterial disease or brachial ankle index <0.9;

• Uncontrolled arterial hypertension (BP> 160 / 100mmHg);

• Uncontrolled dyslipidemia (total colostrum> 220mg / dL);

• Infectious with less than 1 month;

• Osteoarticular or neurological problems that prevent training;

• History of anemia, cerebrovascular disease, myocardial infarction in the last 6 months;

• Pior deep venous thrombosis;

• Use of oral anticoagulant;

• Smoking <6 months;

• Use of antiplatelet agents and anticoagulants;

• Cognitive dysfunctions: Mini-mental <24. (Brucki, 2003).

Related Conditions & MeSH terms

• Frail Elderly Syndrome

Intervention

Procedure:
• 1RM Test
The dynamic force of the lower limb muscles will be evaluated by the maximal repetition of knee extension and leg press exercise, according to the protocol presented in a previous study [37]. The elderly will perform a warm up consisting of 1 series with 10 unloaded repetitions. After the warm up, the mass to be lifted will be progressively increased until the maximum load that can be lifted is reached, with a maximum limit of 5 attempts and a 3 to 5 minutes interval between them. The test will be conducted by a physical education professional who will verbally encourage participants throughout these steps and perform the load adjustment at week 5 and 10 (Radaelli, 2014).
• Speed gait test
To measure the gait speed of participants they will walk 4.6 metres and the time needed to cover this distance is measured. The mean of three attempts is recorded and divided by the distance. The participants included must achieve in the walking test an average of < 0.,9 m/s (Guralnik, 1994).

Device:
• Venous occlusion plethysmography protocol
A mercury-filled silastic tube, connected to a low-pressure transducer and a plethysmograph (D.E. Hokanson), will be placed around the largest circumference of the calf region. One cuff will be placed around the ankle and another around the thigh. The ankle cuff will be inflated to a supra-systolic pressure 30 seconds before starting the measurements. At 15-second intervals, the cuff around the thigh will be inflated above the venous pressure for a period of seven to eight seconds. Increased tension in the silastic tube reflects an increase in leg volume and vasodilation. The signal of the muscle blood flow wave will be recorded on a polygraph and analysed every minute, averaging three records per minute. The protocol will be performed during 5 minutes of rest, 3 minutes isometric exercise and 2 minutes of recovery (Bahia, 2006).
• Measurement of Arterial Stiffness - Pulse Wave Analysis and Velocity
Arterial stiffness will be estimated from the carotid-femoral aortic pulse wave velocity [33]. Carotid-femoral aortic pulse waves will be recorded by tonometry (SphygmoCor, AtCor Medical, Australia). At the same time, an electrocardiogram will be obtained to calculate the wave transit time. Two distances will be measured: the recording point of the carotid artery and the sternal furcula (distance 1) and the sternal furcula and the recording point in the femoral artery (distance 2). The distance travelled by the pulse wave will be calculated as "distance 2" - "distance 1". The carotid-femoral aortic pulse wave velocity will be calculated as: carotid-femoral aortic pulse wave velocity = ¼ * distance travelled by the pulse wave (m) / transit time(s).
• Isometric handgrip exercise protocol
In a supine position, the maximal voluntary handgrip force will be determined as the highest force in 3 consecutive attempts using a Jamar hydraulic palmar dynamometer (Asimow Engineering, CAL, USA). For activation of the central command, mechanoreceptors and muscular metaboreceptors the individual will perform, after 5 minutes of rest (baseline records), 3 minutes of exercise at 30% MVC. This manoeuvre isolates the activation of muscle metaboreceptors, observing the selective activation of these. After the isometric handgrip exercise, 2 minutes of recovery will be performed. Throughout the protocol muscle blood flow, blood pressure and heart rate will be recorded.
• Vasodilatory capacity
The vasodilatory capacity will be calculated as the percentage of increase of the diameter of the brachial artery and femoral post occlusion in relation to its basal values.
• Basal blood flow and vasodilatory capacity - Flow mediated dilation (FMD)
Images of the brachial artery will be recorded by a two-dimensional ultrasonography device with a spectral Doppler and linear transducer (Ultra-0122, Philips, The Netherlands).

Diagnostic Test:
• Quality of Life EuroQol-5 Domain
This questionnaire is used to estimate the quality of life in participants before and after the study.

Other:
• Anthropometric Assessment
Anthropometric measurements will be made before and after the training program following the standardization of the International Society for Anthropometric Assessments. The body mass will be measured with an accuracy of 0.1 kg (Filizola). The stature will be obtained by means of the stadiometer with an accuracy of 0.5 cm. The BMI will be calculated as body mass divided by height squared. The circumference of the quadriceps will be measured with a tape measure (Seca) with a precision of 0.1 cm.

Locations

Country	Name	City	State
Brazil	Instituto Israelita de Ensino e Pesquisa Albert Einstein 's (IIEP)	São Paulo	SP

Sponsors (2)

Lead Sponsor	Collaborator
Hospital Israelita Albert Einstein	Fundação de Amparo à Pesquisa do Estado de São Paulo

Country where clinical trial is conducted

Brazil, 

References & Publications (65)

Amano S, Ludin AF, Clift R, Nakazawa M, Law TD, Rush LJ, Manini TM, Thomas JS, Russ DW, Clark BC. Effectiveness of blood flow restricted exercise compared with standard exercise in patients with recurrent low back pain: study protocol for a randomized con — View Citation

Bahia L, de Aguiar LG, Villela NR, Bottino D, Bouskela E. [The endothelium in the metabolic syndrome]. Arq Bras Endocrinol Metabol. 2006 Apr;50(2):291-303. Epub 2006 May 23. Review. Portuguese. Erratum in: Arq Bras Endocrinol Metabol. 2006 Jun;50(3):574. — View Citation

Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr. 2003 Sep;61(3B):777-81. Epub 2003 Oct 28. Portuguese. — View Citation

Cadore EL, Rodríguez-Mañas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013 Apr;16(2):105-14. doi: 10.1089/rej — View Citation

Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011 Apr 5;57(14):1511-22. doi: 10.1016/j.jacc.2010.12.017. Review. — View Citation

Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014 Mar 19;9:433-41. doi: 10.2147/CIA.S45300. eCollection 2014. Review. — View Citation

Crenshaw AG, Hargens AR, Gershuni DH, Rydevik B. Wide tourniquet cuffs more effective at lower inflation pressures. Acta Orthop Scand. 1988 Aug;59(4):447-51. — View Citation

D'Antona G, Pellegrino MA, Adami R, Rossi R, Carlizzi CN, Canepari M, Saltin B, Bottinelli R. The effect of ageing and immobilization on structure and function of human skeletal muscle fibres. J Physiol. 2003 Oct 15;552(Pt 2):499-511. — View Citation

de Souza ER, Correia BS. [Construction of indicators for assessing the policy of reducing accidents and violence for the elderly care]. Cien Saude Colet. 2010 Sep;15(6):2753-62. Portuguese. — View Citation

Dobrosielski DA, Greenway FL, Welsh DA, Jazwinski SM, Welsch MA; Louisiana Healthy Aging Study. Modification of vascular function after handgrip exercise training in 73- to 90-yr-old men. Med Sci Sports Exerc. 2009 Jul;41(7):1429-35. doi: 10.1249/MSS.0b01 — View Citation

Esmon CT. Basic mechanisms and pathogenesis of venous thrombosis. Blood Rev. 2009 Sep;23(5):225-9. doi: 10.1016/j.blre.2009.07.002. Review. — View Citation

Fahs CA, Rossow LM, Thiebaud RS, Loenneke JP, Kim D, Abe T, Beck TW, Feeback DL, Bemben DA, Bemben MG. Vascular adaptations to low-load resistance training with and without blood flow restriction. Eur J Appl Physiol. 2014 Apr;114(4):715-24. doi: 10.1007/s — View Citation

Fielding RA, Rejeski WJ, Blair S, Church T, Espeland MA, Gill TM, Guralnik JM, Hsu FC, Katula J, King AC, Kritchevsky SB, McDermott MM, Miller ME, Nayfield S, Newman AB, Williamson JD, Bonds D, Romashkan S, Hadley E, Pahor M; LIFE Research Group. The Life — View Citation

Fried LP, Carlson MC, Freedman M, Frick KD, Glass TA, Hill J, McGill S, Rebok GW, Seeman T, Tielsch J, Wasik BA, Zeger S. A social model for health promotion for an aging population: initial evidence on the Experience Corps model. J Urban Health. 2004 Mar — View Citation

Frontera WR, Suh D, Krivickas LS, Hughes VA, Goldstein R, Roubenoff R. Skeletal muscle fiber quality in older men and women. Am J Physiol Cell Physiol. 2000 Sep;279(3):C611-8. — View Citation

Fry CS, Glynn EL, Drummond MJ, Timmerman KL, Fujita S, Abe T, Dhanani S, Volpi E, Rasmussen BB. Blood flow restriction exercise stimulates mTORC1 signaling and muscle protein synthesis in older men. J Appl Physiol (1985). 2010 May;108(5):1199-209. doi: 10 — View Citation

Fujimoto N, Prasad A, Hastings JL, Arbab-Zadeh A, Bhella PS, Shibata S, Palmer D, Levine BD. Cardiovascular effects of 1 year of progressive and vigorous exercise training in previously sedentary individuals older than 65 years of age. Circulation. 2010 N — View Citation

Gates PE, Tanaka H, Graves J, Seals DR. Left ventricular structure and diastolic function with human ageing. Relation to habitual exercise and arterial stiffness. Eur Heart J. 2003 Dec;24(24):2213-20. — View Citation

Golbidi S, Laher I. Exercise and the aging endothelium. J Diabetes Res. 2013;2013:789607. doi: 10.1155/2013/789607. Epub 2013 Aug 1. Review. — View Citation

Graham B, Breault MJ, McEwen JA, McGraw RW. Occlusion of arterial flow in the extremities at subsystolic pressures through the use of wide tourniquet cuffs. Clin Orthop Relat Res. 1993 Jan;(286):257-61. — View Citation

Harris RA, Nishiyama SK, Wray DW, Richardson RS. Ultrasound assessment of flow-mediated dilation. Hypertension. 2010 May;55(5):1075-85. doi: 10.1161/HYPERTENSIONAHA.110.150821. Epub 2010 Mar 29. — View Citation

Horiuchi M, Okita K. Blood flow restricted exercise and vascular function. Int J Vasc Med. 2012;2012:543218. doi: 10.1155/2012/543218. Epub 2012 Oct 22. — View Citation

Karabulut M, Sherk VD, Bemben DA, Bemben MG. Inflammation marker, damage marker and anabolic hormone responses to resistance training with vascular restriction in older males. Clin Physiol Funct Imaging. 2013 Sep;33(5):393-9. doi: 10.1111/cpf.12044. Epub — View Citation

Kovacic JC, Moreno P, Nabel EG, Hachinski V, Fuster V. Cellular senescence, vascular disease, and aging: part 2 of a 2-part review: clinical vascular disease in the elderly. Circulation. 2011 May 3;123(17):1900-10. doi: 10.1161/CIRCULATIONAHA.110.009118. — View Citation

Lexell J. Human aging, muscle mass, and fiber type composition. J Gerontol A Biol Sci Med Sci. 1995 Nov;50 Spec No:11-6. Review. — View Citation

Libardi CA, Chacon-Mikahil MP, Cavaglieri CR, Tricoli V, Roschel H, Vechin FC, Conceição MS, Ugrinowitsch C. Effect of concurrent training with blood flow restriction in the elderly. Int J Sports Med. 2015 May;36(5):395-9. doi: 10.1055/s-0034-1390496. Epu — View Citation

Loenneke JP, Fahs CA, Rossow LM, Thiebaud RS, Mattocks KT, Abe T, Bemben MG. Blood flow restriction pressure recommendations: a tale of two cuffs. Front Physiol. 2013 Sep 10;4:249. doi: 10.3389/fphys.2013.00249. eCollection 2013. — View Citation

Manini TM, Visser M, Won-Park S, Patel KV, Strotmeyer ES, Chen H, Goodpaster B, De Rekeneire N, Newman AB, Simonsick EM, Kritchevsky SB, Ryder K, Schwartz AV, Harris TB. Knee extension strength cutpoints for maintaining mobility. J Am Geriatr Soc. 2007 Ma — View Citation

Manini TM, Yarrow JF, Buford TW, Clark BC, Conover CF, Borst SE. Growth hormone responses to acute resistance exercise with vascular restriction in young and old men. Growth Horm IGF Res. 2012 Oct;22(5):167-72. doi: 10.1016/j.ghir.2012.05.002. Epub 2012 J — View Citation

Martínez-Ramírez A, Martinikorena I, Gómez M, Lecumberri P, Millor N, Rodríguez-Mañas L, García García FJ, Izquierdo M. Frailty assessment based on trunk kinematic parameters during walking. J Neuroeng Rehabil. 2015 May 24;12:48. doi: 10.1186/s12984-015-0 — View Citation

Mattar MA, Gualano B, Perandini LA, Shinjo SK, Lima FR, Sá-Pinto AL, Roschel H. Safety and possible effects of low-intensity resistance training associated with partial blood flow restriction in polymyositis and dermatomyositis. Arthritis Res Ther. 2014 O — View Citation

Miljkovic N, Lim JY, Miljkovic I, Frontera WR. Aging of skeletal muscle fibers. Ann Rehabil Med. 2015 Apr;39(2):155-62. doi: 10.5535/arm.2015.39.2.155. Epub 2015 Apr 24. Review. — View Citation

Moore A, Mangoni AA, Lyons D, Jackson SH. The cardiovascular system. Br J Clin Pharmacol. 2003 Sep;56(3):254-60. Review. — View Citation

Nakajima, T. et al. Effects of Exercise and Anti-Aging. Anti-Aging Medicine. 2011. v. 7 n. 8. p. 92-102.

Nakajima, T. et al. Effects of low intensity Kaatsu resistance training on skeletal muscle size/strength and endurance capacity in patients with ischemic heart diseases. International Journal of Kaatsu Training Research. 2010. v. 6. p. 1-7.

Nakajima, T. et al. Use and safety of KAATSU training; Results of a national survey. International Journal of Kaatsu Training Research. 2006. v. 2. p. 5-13

Nakajima, T.; Morita, T.; Sato, Y. Key considerations when conducting KAATSU training. International Journal of Kaatsu Training Research. 2011. v. 7. p. 1-6.

Nazari-Shafti TZ, Cooke JP. Telomerase Therapy to Reverse Cardiovascular Senescence. Methodist Debakey Cardiovasc J. 2015 Jul-Sep;11(3):172-5. doi: 10.14797/mdcj-11-3-172. Review. — View Citation

Norton K.; Olds T. International Standards for Anthropometric Assessment. 1a ed. Austrália: The International Society for the Advancement of Kinanthropometry; 1996.

Odden MC, Peralta CA, Haan MN, Covinsky KE. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med. 2012 Aug 13;172(15):1162-8. doi: 10.1001/archinternmed.2012.2555. — View Citation

Ozaki H, Loenneke JP, Thiebaud RS, Stager JM, Abe T. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review. Clin Interv Aging. 2013;8:369-75. doi: 10.2147/CIA.S43837. Epub 2013 Mar 31. Review. — View Citation

Park DC, Yeo SG. Aging. Korean J Audiol. 2013 Sep;17(2):39-44. doi: 10.7874/kja.2013.17.2.39. Epub 2013 Sep 24. Review. — View Citation

Park SY, Kwak YS, Harveson A, Weavil JC, Seo KE. Low intensity resistance exercise training with blood flow restriction: insight into cardiovascular function, and skeletal muscle hypertrophy in humans. Korean J Physiol Pharmacol. 2015 May;19(3):191-6. doi — View Citation

Radaelli R, Botton CE, Wilhelm EN, Bottaro M, Brown LE, Lacerda F, Gaya A, Moraes K, Peruzzolo A, Pinto RS. Time course of low- and high-volume strength training on neuromuscular adaptations and muscle quality in older women. Age (Dordr). 2014 Apr;36(2):8 — View Citation

Raskob GE, Angchaisuksiri P, Blanco AN, Buller H, Gallus A, Hunt BJ, Hylek EM, Kakkar A, Konstantinides SV, McCumber M, Ozaki Y, Wendelboe A, Weitz JI; ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease bur — View Citation

Ray CA, Rea RF, Clary MP, Mark AL. Muscle sympathetic nerve responses to dynamic one-legged exercise: effect of body posture. Am J Physiol. 1993 Jan;264(1 Pt 2):H1-7. — View Citation

Ribeiro, F.A et al. Síndrome metabólica: complacência arterial e a velocidade de onda de pulso. Revista da AMRIGS. 2012. v. 56. n. 1. p. 75-80.

Ricci NA, Pessoa GS, Ferriolli E, Dias RC, Perracini MR. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study. Clin Interv Aging. 2014 Oct 6;9:1677-85. doi: 10.2147/CIA.S68642. eCollection 2014. — View Citation

Russ DW, Grandy JS, Toma K, Ward CW. Ageing, but not yet senescent, rats exhibit reduced muscle quality and sarcoplasmic reticulum function. Acta Physiol (Oxf). 2011 Mar;201(3):391-403. doi: 10.1111/j.1748-1716.2010.02191.x. Epub 2010 Nov 9. — View Citation

Satoh, I. Kaatsu Training: Application to Metabolic Syndrome. 2011. International Journal of Kaatsu Training Research. 2011. v. 7. p. 7-12.

Scott BR, Loenneke JP, Slattery KM, Dascombe BJ. Blood flow restricted exercise for athletes: A review of available evidence. J Sci Med Sport. 2016 May;19(5):360-7. doi: 10.1016/j.jsams.2015.04.014. Epub 2015 May 9. Review. — View Citation

Singh M, Stewart R, White H. Importance of frailty in patients with cardiovascular disease. Eur Heart J. 2014 Jul;35(26):1726-31. doi: 10.1093/eurheartj/ehu197. Epub 2014 May 26. Review. — View Citation

Takarada Y, Takazawa H, Sato Y, Takebayashi S, Tanaka Y, Ishii N. Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol (1985). 2000 Jun;88(6):2097-106. — View Citation

Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, Parker B, Widlansky ME, Tschakovsky ME, Green DJ. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2011 Jan;300 — View Citation

Verdijk LB, Koopman R, Schaart G, Meijer K, Savelberg HH, van Loon LJ. Satellite cell content is specifically reduced in type II skeletal muscle fibers in the elderly. Am J Physiol Endocrinol Metab. 2007 Jan;292(1):E151-7. Epub 2006 Aug 22. — View Citation

Villacorta H, Bortolotto LA, Arteaga E, Mady C. Aortic distensibility measured by pulse-wave velocity is not modified in patients with Chagas' disease. J Negat Results Biomed. 2006 Jun 12;5:9. — View Citation

Wernbom, M. Effects of an acute bout of low-load resistance training with blood flow restriction. 2011. 206 f. Dissertation. The Norwegian School of Sports Sciences. Noruega. 2011.

Willoughby, D.S. American College of Sports Medicine. ACSM current comment: Resistance Training and the Older Adult. 2012.

World Health Organization. Global brief for World Health Day. 2012. http://www.who.int/world_health_day/2012.

Wu IC, Lin CC, Hsiung CA. Emerging roles of frailty and inflammaging in risk assessment of age-related chronic diseases in older adults: the intersection between aging biology and personalized medicine. Biomedicine (Taipei). 2015;5(1):1. doi: 10.7603/s406 — View Citation

Yasuda T, Fukumura K, Iida H, Nakajima T. Effects of detraining after blood flow-restricted low-load elastic band training on muscle size and arterial stiffness in older women. Springerplus. 2015 Jul 15;4:348. doi: 10.1186/s40064-015-1132-2. eCollection 2 — View Citation

Yasuda T, Fukumura K, Uchida Y, Koshi H, Iida H, Masamune K, Yamasoba T, Sato Y, Nakajima T. Effects of Low-Load, Elastic Band Resistance Training Combined With Blood Flow Restriction on Muscle Size and Arterial Stiffness in Older Adults. J Gerontol A Bio — View Citation

Yasuda T, Loenneke JP, Thiebaud RS, Abe T. Effects of blood flow restricted low-intensity concentric or eccentric training on muscle size and strength. PLoS One. 2012;7(12):e52843. doi: 10.1371/journal.pone.0052843. Epub 2012 Dec 31. — View Citation

Yokokawa Y, Hongo M, Urayama H, Nishimura T, Kai I. Effects of low-intensity resistance exercise with vascular occlusion on physical function in healthy elderly people. Biosci Trends. 2008 Jun;2(3):117-23. — View Citation

Zembron-Lacny A, Dziubek W, Rogowski L, Skorupka E, Dabrowska G. Sarcopenia: monitoring, molecular mechanisms, and physical intervention. Physiol Res. 2014;63(6):683-91. Epub 2014 Aug 26. Review. — View Citation

* Note: There are 65 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Plesthysmography	Evaluation of muscle blood flow by plethysmography of venous occlusion	Before and after 12 weeks of training
Other	Pulse wave velocity	The estimation of the arterial stiffness will be made from the evaluation of the carotid-femoral aortic pulse wave velocity.	Before and after 12 weeks of training
Primary	Anthropometric Assessment	The body weight will be evaluated using the Filizola brand scale, with an accuracy of 0.1 kg. The stature will be obtained by means of the stadiometer coupled to the Filizola scale, with an accuracy of 0.5 cm. The BMI will be calculated from the weight ratio by height squared. For measures of circumference of the quadriceps, a tape measure of the brand Seca, with precision of 0.1 cm will be used. Anthropometric measurements will be made following the standardization of the International Society for Anthropometric Assessments (ISAK, 2001).	Before and after 12 weeksof training
Secondary	Coagulation factors	Blood tests (fibrinogen, Factor VIII, von Willebrand Factor, D-dimer, t-PA and PAI 1)	Before and after 12 weeksof training
Secondary	Tolerability, adherence and adverse effects	Evaluate the tolerability, adherence and adverse effects of both groups - Questionnaire	Before and after 12 weeks of training
Secondary	Arterial pressure and heart rate	Blood pressure and heart rate measurements	Before and after 12 weeks of training
Secondary	Speed Gait	The gait velocity analysis will be performed with time marking, in thousandths of a second, from the displacement of the elderly in a 4.6-meter straight course, based on the measurement (speed / distance traveled).	Before and after 12 weeks of training