Balance, Resistance and Interval Training Trial

Summary

BRAIN, or The BRaIN Training Trial (Balance, Resistance and Interval Training Trial) is a large, multi-national randomised controlled trial (RCT). The purpose of the trial the efficacy of progressive resistance training and high intensity interval training compared to a balance/coordination control group in 530 community-dwelling older adults with Mild Cognitive Impairment (MCI) over 12 months.  The primary outcome is cognitive function, with particular emphasis on executive function.  Secondary outcomes include potential mediators and covariates, changes in brain structure and function, genetic and molecular biomarkers related to cognition, physical and psychological health status, body composition, nutritional status and functional independence, among others.

PhD and Master's Degree candidates are sought to participate in the conduct of this trial, including USYD clinical trial site administrative tasks, participant recruitment, health screening, psychological and physiological assessments, supervised aerobic, resistance and balance exercise training, data management and analysis.  The candidates will gain hands-on experience in the conduct of a robust clinical trial, as well as testing older adults with chronic diseases and memory difficulties, as well as applying structured exercise paradigms in this cohort over a long-term intervention.

Supervisor(s)

Professor Maria Fiatarone Singh, Dr Yorgi Mavros

Research Location

Exercise, Health and Performance Research Group

Program Type

Masters/PHD

Synopsis

Mild cognitive impairment (MCI) affects at least 10% of older adults globally, and in this cohort the risk of incident dementia is greatly increased from1-2% per annum to 10-15%.  Exercise has been shown to be beneficial for some cognitive outcomes in MCI, although results are heterogeneous, and the optimum exercise dose and modality for preservation or improvement of cognition is not fully defined.  Progressive resistance training (PRT) has been shown to have larger effects on cognition than aerobic training in meta-analyses, and benefits are mediated in large part by the magnitude of muscle strength adaptations. On the other hand, the limited benefit of some aerobic training studies may be due to insufficient intensities of the intervention, which have produced suboptimal changes in aerobic capacity or other physiological adaptations potentially mechanistic for improved brain function.  A novel exercise modality- high intensity interval training (HIIT)- results in more beneficial cardiovascular adaptations compared to standard moderate intensity aerobic training in other cohorts, including older adults with chronic disease. The wealth of data linking aerobic fitness to cognition suggest that HIIT, which approximately doubles the average improvement in aerobic fitness compared to standard training, is of potentially great interest in MCI therefore.  However, HIIT has never been tested alone or directly compared to PRT for cognitive benefits in any cohort.

Therefore, we hypothesize that PRT and HIIT will be robust, alternative exercise interventions to improve cognition in MCI. We will conduct a multi-national, randomised controlled trial in which we randomise 530 older adults with MCI in Queensland, Sydney and Canada to PRT, HIIT or a sham exercise control group for 12 months.  Executive function is the primary cognitive outcome.  Secondary outcomes include other cognitive domains, biomarkers for cognitive decline and distinct mediators of benefit for PRT (e.g. anabolic hormones, lean mass) vs. HIIT (e.g. arterial stiffness, aerobic fitness), functional status, brain structure and connectivity, and psychological wellbeing.

Additional Information

Use of research technique / methodology / technology

  • Progressive resistance training, High intensity interval training, balance training in older adults with multiple co-morbidities, cognitive impairment and frailty
  • Maximal strength testing
  • Maximal aerobic capacity testing
  • Accelerometry for physical activity, sedentary behaviour, gait instability, sleep quantity/quality, and position
  • Arterial stiffness and central pressures
  • Body composition with DXA scan and anthropometrics
  • Neuro-psychological assessment
  • Nutritional assessment
  • Assessment of performance-based and self reported function
  • Phlebotomy and blood processing
  • Preparation of Manual of Procedures and study protocols
  • Data management via REDCAP
  • Statistical analysis of longitudinal data sets using mixed models and other techniques
  • Conduct of systematic reviews of the literature and meta-analysis
  • Manuscript preparation and ethics reports, applications, modifications
  • Recruitment and retention strategies in RCTs, monitoring and reporting of adverse events

Potential topics of interest for the research opportunity (among many others)
  • Cognitive function
  • Sleep
  • Fall risk
  • Affect and Self-Efficacy
  • Cardiovascular function and adaptation
  • Body composition
  • Anabolic adaptation to PRT
  • Biomarkers mediating cognitive adaptations to exercise
  • Nutritional intake and cognition
  • MRI structure and functional networks
  • Genetic profile and epigenetic modification after exercise in MCI

Eligibility criteria / candidate profile
  • Primary interest in exercise as medicine for the prevention and treatment of chronic disease in older adults
  • Undergraduate degree in related field of health or science

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Keywords

Progressive resistance training, High intensity interval training, geriatric medicine, brain, mild cognitive impairment, dementia

Opportunity ID

The opportunity ID for this research opportunity is: 2180