ARMS-II: Detection and Treatment of Sarcopenia and Myosteatosis in Older African Americans
Study Details
Study Description
Brief Summary
The objectives of this study are to: 1) validate a rapid, portable, cost-effective method for screening myosteatosis and sarcopenia using diagnostic ultrasound, and 2) investigate a novel approach to progressive resistance exercise involving eccentric muscle actions that will counter the local effects of myosteatosis and sarcopenia in African Americans.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
The rationale for this study is the need to proactively address health disparities associated with age-related skeletal muscle dysfunction. Age-related changes in muscle may be characterized by sarcopenia (i.e., loss of muscle mass) and/or myosteatosis (i.e., excessive intramuscular adipose tissue). These changes may result in physical impairments that may be exacerbated by the lack of a formal screening and diagnosis process for older adults in standard healthcare settings. Myosteatosis may compound the effects of sarcopenia and play a significant role the age-related functional decline and higher incidence of type 2 diabetes observed in African Americans in comparison to other ethnic/racial groups. The initial phase of the study will involve the assessment of older African Americans (n = 70) to characterize muscle size and quality in comparison to a younger reference group (n = 70). Participants randomly selected from the older subject pool will be assigned to either the Eccentric Exercise Group or the Concentric Exercise Group for 12 weeks of a supervised strengthening exercise regimen.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Eccentric Exercise Supervised strengthening exercise using eccentric muscle actions. |
Behavioral: Eccentric Exercise
Submaximal progressive resistance exercise (PRE) using eccentric muscle actions for the knee extensors/flexors will be performed for 10 repetitions, 3 to 4 sets, twice per week for 12 weeks.
Other Names:
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Active Comparator: Concentric Exercise Supervised strengthening exercise using concentric muscle actions. |
Behavioral: Concentric Exercise
Submaximal progressive resistance exercise (PRE) using concentric muscle actions for the knee extensors/flexors will be performed for 10 repetitions, 3 to 4 sets, twice per week for 12 weeks.
Other Names:
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Outcome Measures
Primary Outcome Measures
- Change from Baseline in Sonographic Lean Body Mass at 3 months [At study baseline for all subjects, and at Week 6 and 12 of the intervention period for subjects randomly assigned to an exercise group]
US estimates of aggregate regional LBM (muscle thickness, cm), will be assessed using B-mode diagnostic US with a 13-6 megahertz (MHz) linear array transducer for morphology measures at 6 axial and appendicular sites.
Secondary Outcome Measures
- Change from Baseline in dual-energy X-ray absorptiometry (DXA) scanning at 3 months [At study baseline for all subjects, and at Week 12 of the intervention period for subjects randomly assigned to an exercise group]
Participants will undergo DXA scanning in the supine position per manufacturer guidelines to estimate absolute and percentage of total lean body mass (LBM) and body fat (BF).
- Change from Baseline in metabolic status at 3 months [At study baseline for all subjects]
A blood sample (60 cc) will be obtained after an 8-hour overnight fast: glucose and insulin levels will be assessed. Other laboratory values will be obtained such as a standard lipid profile and glycated hemoglobin (HbA1C).
- Change from Baseline in intramuscular adipose tissue assessment at 3 months [At study baseline for all subjects]
Estimates of intramuscular adipose tissue (IMAT) will be obtained with magnetic resonance imaging using a whole body transmit/receive coil for T2 fat image acquisition of the thigh (dominant side) will be obtained at the mid-femur region.
- Change from Baseline in strength assessment at 3 months [At study baseline for all subjects, and at Week 6 and 12 of the intervention period for subjects randomly assigned to an exercise group]
Grip strength will be assessed bilaterally; isometric and isokinetic knee extension/flexion torques will be obtained bilaterally using a dynamometer. Peak concentric torque (at 60 /s and 180 /s) will be obtained in a randomized fashion with subject positioning and stabilization per the manufacturer operations manual.
Eligibility Criteria
Criteria
Inclusion Criteria:
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An African American adult.
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Between 18 and 30 years of age, or between 65 and 85 years of age.
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Able to independently walk at home and in your community (use of an assistive device like a cane or a walker is acceptable).
Exclusion Criteria:
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Uncontrolled hypertension or other cardiovascular disease.
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A Body Mass Index of 32.5 or above may be an exclusion criterion if the X-ray technician determines that dimensions of the scanning bed are not adequate for a reliable examination.
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A musculoskeletal condition that would stop you from performing the physical assessment tests.
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Muscle weakness due to neurological disease or injury (such as stroke or spinal cord injury).
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Moderate to severe sepsis (blood infection) or edema (such as swelling of a limb).
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Been hospitalized over the last three months.
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History of a broken arm or leg bone because of osteoporosis.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Rocky Mountain Regional VA Medical Center, Aurora, CO | Aurora | Colorado | United States | 80045 |
2 | University of Colorado Anschutz Medical Campus | Aurora | Colorado | United States | 80045 |
3 | Howard University | Washington | District of Columbia | United States | 20060 |
Sponsors and Collaborators
- VA Office of Research and Development
Investigators
- Principal Investigator: Michael Harris-Love, DSc MPT BS, Rocky Mountain Regional VA Medical Center, Aurora, CO
Study Documents (Full-Text)
None provided.More Information
Publications
- Harris-Love MO, Adams B, Hernandez HJ, DiPietro L, Blackman MR. Disparities in the consequences of sarcopenia: implications for African American Veterans. Front Physiol. 2014 Jul 7;5:250. doi: 10.3389/fphys.2014.00250. eCollection 2014.
- Harris-Love MO, Monfaredi R, Ismail C, Blackman MR, Cleary K. Quantitative ultrasound: measurement considerations for the assessment of muscular dystrophy and sarcopenia. Front Aging Neurosci. 2014 Jul 14;6:172. doi: 10.3389/fnagi.2014.00172. eCollection 2014. Review.
- Harris-Love MO, Seamon BA, Teixeira C, Ismail C. Ultrasound estimates of muscle quality in older adults: reliability and comparison of Photoshop and ImageJ for the grayscale analysis of muscle echogenicity. PeerJ. 2016 Feb 22;4:e1721. doi: 10.7717/peerj.1721. eCollection 2016.
- E1854-W
- MIRB01714