Muscle Weakness Clinical Trial
Official title:
Effects of Creatine Supplementation on Muscle Mass and Function Among Older Women Subjected to Resistance Training
To determine, in a double blind trial, the effects of creatine supplementation during 12 weeks on muscle mass and function of community living older women subjected to resistance training. Material and methods: Fifty healthy older women will be selected for the study. All participants will be subjected to a progressive resistance training program using elastic bands and weights, consisting in three sessions per week lasting 1 hour. Participant will be randomly allocated in a double blind fashion, to receive creatine 5 g per day or an identical placebo. The training and supplementation period will last 12 weeks. At baseline and at the end of the study, body composition will be measured by dual energy x-ray absorptiometry, rectus femoris cross sectional height and surface will be measured by ultrasound, quadriceps strength will be measured in a quadriceps table and 12 minutes' walk will be assessed. The main outcome measure will be quadriceps cross sectional height. Expected results: We expect that creatine supplementation will increase rectus femoris height over and above the effect of resistance training.
Healthy women of middle and low socioeconomic level, living in the community and aged
between 60 and 75 years, will be invited to participate in this study.
At baseline and after signing an informed consent form, the following assessments will be
carried out:
1. A complete medical history including medications, previous diseases and surgical
procedures.
2. Evaluation of usual physical activity using the International Physical Activity
Questionnaire (IPAQ) .
3. Minimental state examination .
4. Mininutritional assessment .
5. Measurement of weight, height, waist and hip circumference.
6. Measurement of body composition by double energy X ray absorptiometry in a General
Electric iDEXA equipment.
7. Measurement of rectus femoris cross sectional height using a General Electric LogiQ
ultrasonographer. Measurements will be made with the participant in supine position and
the tight relaxed. The mid-point between the superior anterior iliac spine and the
superior border to the patella will be the measurement point.
8. Measurement of quadriceps isometric force using a quadriceps table as previously
described .
9. Measurement of hand grip strength using a hand grip dynamometer.
10. Measurement of 12 minutes walking capacity .
After performing the baseline assessment, participants will be randomized in one of two
groups, balancing by age and nutritional status, using a double blind design:
1. The active group will receive creatine 5 g/day in one dose as a powder to be dissolved
in water
2. The control group will receive a placebo of similar aspect and taste as creatine.
The active prescription and the placebo will be identified by a unique numeric code. The
codes will be known by an external professional, not involved in the research. In case of
adverse events, the opening of a specific patient code of a will be requested to this
professional, who will decide the pertinence of the request. Thus, even breaking one code,
the double blind will be maintained for the rest of participants
All participants will be incorporated to an exercise training program, that will last 12
weeks, with three sessions per week. Each exercise session will consist of:
1. A warm-up period of 15 minutes, consisting in walking and cycling in braked bicycle
ergometers.
2. Resistance training of upper and lower limbs, using elastic bands and tubing and free
weights. Training will be calibrated at 60% of one repetition maximum for each muscle
group with three sets of 15 repetitions with one minute rest between each set. All
exercises will be additionally calibrated to be of moderate intensity according to the
Borg scale. The exercise load will be adapted according to the progression of each
participant.
3. An elongation period lasting 10 minutes that will include elongation in mats and
exercise balls.
The attendance of participants to each session, their level of engagement with the exercise
protocol and the overall Borg score will be recorded. All adverse events will be also
recorded following good clinical practice guidelines Every two weeks, a new supply of the
research prescription will be delivered. Participants will be requested to return the unused
sachets to have an approximate assessment of compliance.
At the end of 12 weeks of intervention, all the assessments done at baseline will be
repeated.
All the information of participants will be recorded in encrypted INTERNET databases. Only
researchers will have access to the information, but participants will be informed about the
results of all assessments.
Main outcome measure and calculation of sample size:
The main outcome will be rectus femoris cross sectional height. According to previously
published results, this parameter increases from 20 ± 3.2 to 24.3 ± 3.8 mm after a training
period of 12 weeks . If we expect a 15% difference in rectus femoris cross sectional height
at the end of the intervention period, we would require 19 participants per group to obtain
differences with an α of 0.05 and a power of 0.8- Considering an attrition rate of 30%
during training, we would require 25 participants per group.
Analysis of results:
An intention to treat analysis will be performed. Also a safety analysis will also be
carried out, considering all participants that took at least one dose of creatine or
placebo. According to the normality of variable distribution, parametric or non-parametric
tests will be used to analyze differences.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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