MIXED SESSION PERIODIZATION AS A NEW APPROACH
FOR STRENGTH, POWER, FUNCTIONAL PERFORMANCE,
AND BODY COMPOSITION ENHANCEMENT IN AGING
ADULTS
Downloaded from http://journals.lww.com/nsca-jscr by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 03/22/2022
EWERTTON DE SOUZA BEZERRA,1,2 LUCAS BET DA ROSA ORSSATTO,1 BRUNO MONTEIRO
JEFFREY M. WILLARDSON,3 ROBERTO SIMÃO,4 AND ANTÔNIO RENATO PEREIRA MORO1
DE
MOURA,1
1
Biomechanics Laboratory, Sports Center, Federal University of Santa Catarina, Floriano´polis, Brazil; 2Human Performance
Laboratory, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, Brazil; 3Health and
Human Performance Department, Montana State University Billings, Billings, Montana; and 4Physical Education and Sports
School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
ABSTRACT
Berzerra, ES, Orssatto, LBR, Moura, BM, Willardson, JM,
Simão, R, and Moro, ARP. Mixed session periodization as
a new approach for strength, power, functional performance,
and body composition enhancement in aging adults. J Strength
Cond Res 32(10): 2795–2806, 2018—The purpose of this
study was to compare the effects of mixed session periodization (MSP) vs. traditional periodization (TP) on strength, power,
functional performance, and body composition in aging adults.
Forty-five healthy aging adults were randomly divided into 3
groups: MSP, TP, and Control. Subjects were tested before
the intervention for baseline values (week 4) and then repeated
testing during (week 7 and week 11), as well as after the
intervention (week 15). Subjects were tested on the following
performance measures: 5 repetition maximum (5RM) leg press
and seated leg curl; 12RM cable chest press; countermovement jump (CMJ) and squat jump; up-and-down stairs; timed
up and go (TUG); and body composition. All comparisons were
analyzed through a mixed-model analysis with repeated measures (group 3 time) and with Bonferroni post hoc tests (p #
0.05). After the intervention, no significant differences were
observed between experimental groups; however, the MSP
and TP groups demonstrated significantly greater values vs.
the Control group in the 5RM leg press (p , 0.01), seated
leg curl (p , 0.01), and 12RM cable chest press (p , 0.001).
For CMJ performance, the MSP and TP groups significantly
increased at week 7 (p , 0.001). The MSP and TP groups
significantly improved functional task performance, including
Address correspondence to Ewertton de Souza Bezerra, esbezerra@
gmail.com.
32(10)/2795–2806
Journal of Strength and Conditioning Research
Ó 2018 National Strength and Conditioning Association
TUG (p , 0.001), upstairs (p , 0.01), and downstairs (p ,
0.01) after training. Furthermore, body composition for the
lower limbs significantly changed for the MSP and TP groups,
with increased fat-free mass (p , 0.001) and decreased fat
mass (p , 0.01) after training. In conclusion, the MSP and TP
models used in this study were equally effective in developing
strength, power, and functional performance while increasing
fat-free mass and improving body fat percentage in aging
adults. However, it should be considered that the MSP protocol did result in greater effect sizes in lower-limb strength,
lower-limb fat-free mass, up-and-down stair, and TUG performance.
KEY WORDS training model, resistance training, muscle
strength, muscle hypertrophy
INTRODUCTION
P
eriodization in the context of resistance training
(RT) was introduced to reduce the risk of overtraining and to achieve peak neuromuscular performance by targeting a specific competition or
match (19). The most popular periodization models applied
in RT are defined as linear and nonlinear. In the linear
model, the beginning of the program is characterized by
higher training volume and lower intensity, with an overall
pattern of decreasing volume and increasing intensity over
time. Conversely, in the nonlinear model, volume and intensity fluctuate daily or weekly, without a distinguishable pattern (17).
In young subjects (18–30 years), studies have assessed
changes in strength parameters between these periodization
models, with some studies favoring the nonlinear model in
trained subjects (28,29), trained male judo athletes (15), and
untrained women (25). However, other studies reported no
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Mixed Session Periodization for Aging Adults
differences between models in trained men (6,18). A recent
systematic review and meta-analysis that included 510 subjects, revealed no differences between linear and nonlinear
models for upper-body strength (bench press overall effect
size [ES], 0.89) and lower-body strength (squat overall ES,
0.36) (17).
In older adults, few studies have compared the effects of
progressive RT vs. different periodization models (9,10,22,35).
However, in these studies, the periodization program was
based on variations training intensity and volume, without
manipulations in training velocity (9,10,22,35). Strohacker
et al. (40) suggested that further research is necessary to
understand the effectiveness of different (e.g., flexible nonlinear) periodization models in the older adult population. Possibly, a periodization model that mixes hypertrophic, strength,
and power methods within the same training session would
elicit superior stress and consequently greater adaptations in
neuromuscular characteristics in older adults. A flexible nonlinear periodized model is characterized by within-session
variations in load intensity and movement velocity. Different
load intensities and movement velocities are characterized by
distinct motor unit recruitment patterns (12,13), with fast contractions resulting in greater motor unit recruitment and distinct fiber recruitment patterns vs. slow contractions
(12,13,16). Within-session manipulation of such training variables has been discussed in the context of allostasis, a concept
which suggests that organisms maintain physiological stability
by anticipating “needs” before they arise, and by mobilizing
a diverse breadth of neurological, biological, and immunological accommodations to counter emerging challenges (23).
There is a strong growing body of evidence supporting RT
is a very effective method to counteract aging-associated
decreases in strength (33), power, functional performance (7),
and lean mass (34) in untrained subjects. The use of slow-tomoderate velocities and moderate load intensities (60–80% of
one repetition maximum [1RM]) are recommended for improvements in strength and hypertrophy in older untrained
adults (37). However, this type of training is not recommended as efficient for power and functional task improvements
(42,43). Thus, it might also be beneficial to include exercises
during which the concentric phase is performed as fast as
possible, in conjunction with low-to-moderate load intensities (20–80% of 1RM) (7,37).
In older adults, an optimal periodization model has not
been determined to facilitate concomitant gains in muscle
mass and strength, body composition enhancement, and
functional task performance. These are important priorities
for older adults to preserve independence in performing daily
living activities (7) and reduce the risk of falls (20). To
the author’s knowledge, there is no information about the
effects of targeting different neuromuscular characteristics
(i.e., power, strength, hypertrophy, and localized muscular
endurance) within the same session (i.e., mixed session periodization [MSP]) for older adults. Therefore, the purpose of
this study was to compare the effects of MSP vs. traditional
2796
the
periodization (TP) on strength, power, functional performance, and body composition in aging adults. Our hypothesis was that the MSP would promote superior improvements
in outcome measures, when compared with a TP model.
METHODS
Experimental Approach to the Problem
This study was a randomized controlled trial. Healthy
untrained aging adults were randomly divided into 3 groups:
MSP, TP, and Control. The study included 4 phases: phase 1,
subjects completed 3 familiarization sessions to ensure that the
training exercises could be performed with proper technique.
Phase 2, baseline test and retest assessments were performed to
ensure data reproducibility. Tests were performed on 2 nonconsecutive days with at least 48 hours of rest (i.e., days 1 and 3,
power and functional tests; days 2 and 4, strength tests). The
tests were performed in random order (i.e., countermovement
jump [CMJ] and squat jump; up-and-down stairs and timed up
and go [TUG]; and 5RM leg press, seated leg curl, and 12RM
cable chest press). Body composition was measured using dualenergy x-ray absorptiometry (DXA) at baseline and at posttraining (week 15). Phase 3, the experimental groups performed
9 weeks (3 sessions per week) of either TP or MSP training.
Phase 4, post-testing was conducted using the same order as
baseline and 48 hours after the last training session. All subjects
were evaluated at the same time of day on assessment days.
The experimental design is displayed in Figure 1.
Subjects
Subjects completed specific health history and physical activity
questionnaires and met the following inclusion criteria: aged 55
years and older, physically independent, free of cardiac disease,
free from orthopedic dysfunction, and not performing regular
RT during the 6 months preceding the beginning of the study.
Forty-five men and women were randomly divided (simple
randomization, stratified by sex) into 3 groups: MSP, TP, and
Control (CG). A total of 30 older adults (men = 17 and women
= 13, aged 56–76 years 6 SD) completed the experimental
protocol (Table 1). Eight were aged older than 65 years (2 in
the CG; 3 in the TP group, and 3 in the MSP group). The
dropout rate was 33%; 4 subjects withdrew claiming muscular
discomfort during the RT regime; 4 did not meet the
established minimum session attendance (required frequency
.85%); 2 subjects in the Control group withdrew claiming
muscular discomfort during baseline tests; and 5 subjects did
not answer our call to return for post-testing. Written informed
consent was obtained from all subjects after a detailed description of study procedures. All procedures performed in this
study were approved by the Federal University of Santa Catarina Ethics Committee and followed the ethical guidelines of
the Declaration of Helsinki.
Procedures
Five repetition maximum (5RM) testing was performed for
the leg press and seated leg curl, and 12RM testing for the
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Figure 1. Study design. RT = resistance training.
cable chest press in random order, and using the same
equipment as during training (Righetto, São Paulo, Brazil).
These specific RM protocols were selected to maximize the
transfer of training, based on the loading prescribed across
the intervention.
To minimize error during RM testing, the following
strategies were adopted: (a) standardized instructions concerning the testing procedures and exercise technique were
given to subjects; and (b) verbal encouragement was provided during the testing. The RM for each exercise was
determined in no more than 3 attempts, with a rest interval
of 5 minutes between attempts, and 15-minute rest between
exercises. For a repetition to be considered successful, full
range of motion had to be evident, defined as 90–08 knee and
elbow extension. The heaviest RM test load achieved at each
time point (i.e., baseline, week 7, week 11, and week 15) was
used in the statistical analysis.
Muscular Power. The vertical jump test was performed on
a piezoelectric force platform (Kistler Quattro Jump
9290AD, Winterthur, Switzerland), with a sampling frequency of 500 Hz. The jump execution was controlled by
Kistler software (Quattro Jump, type 2822a1-1). Each subject
performed 2 attempts of each jump (i.e., squat jump and
CMJ) in random order, with 30-second rest between jumps.
The peak power output (PPO) and jump height (JH) were
calculated from the vertical ground reaction force of the
highest jump, according to Ache-Dias et al. (1).
In the CMJ protocol, subjects started from a static
standing position and were instructed to perform a countermovement (descent phase until approximately 708 knee flexion), followed by a rapid and vigorous extension of the
lower-limb joints (ascent phase). During the jump flight, subjects were asked to sustain their trunk as vertically as possible, with hands on their hips. Subjects were instructed to
TABLE 1. Baseline anthropometric and body composition characteristics.*†
General
Body mass (kg)
Height (m)
Age (y)
Body composition
LLF (%)
LLF (kg)
LLFF (kg)
LL BMD (g$cm22)
Femur BMD (g$cm22)
Lumbar BMD (g$cm22)
Control (n = 8)
(M = 3, W = 5)
TP (n = 11)
(M = 7, W = 4)
MSP (n = 11)
(M = 7, W = 4)
64.51 6 5.38
1.63 6 0.70
63.00 6 6.96
74.62 6 15.95
1.66 6 0.09
65.00 6 4.21
80.98 6 15.72
1.70 6 0.08
64.27 6 5.33
36.3
7.21
12.44
1.20
0.91
1.08
6
6
6
6
6
6
8.15
2.40
1.82z
0.10
0.13
0.16
29.32
6.47
15.55
1.30
0.91
1.19
6
6
6
6
6
6
9.01
1.35
4.24
0.16
0.13
0.18
31.87
7.96
17.03
1.30
0.97
1.20
6
6
6
6
6
6
8.93
3.55
3.12
0.76
0.94
0.12
*TP = traditional periodization; MSP = mixed session periodization; LLF = lower-limb fat mass; LLFF = lower-limb fat-free mass;
LL = lower limb; BMD = bone mineral density.
†Mean 6 SD.
zStatistical difference from MSP group (p , 0.05).
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Mixed Session Periodization for Aging Adults
jump as high as possible. For the squat jump, subjects were
given the same instructions, with the exception that subjects
started each jump from an initial squat position (knees flexed
708), so that the stretch-shorten cycle did not contribute to
the JH.
Body Composition. Anthropometric assessments included
height and body mass; and body composition assessments
included fat mass, fat-free mass, and bone mineral density
(BMD) of the lower limbs. Height was measured using
a stadiometer (Alturexata, Minas Gerais, Brazil) and body
mass with a digital balance scale (Welmy W200, São Paulo,
Brazil) measured to the nearest 0.1 cm and 0.1 kg, respectively. The fat mass, fat-free mass, and BMD measurements
of the lower limbs were performed with DXA Lunar Prodigy
Advance (GE Medical Lunar System, Madison, WI, USA).
The procedures and positioning were standardized for all
subjects, and all measurements were performed by the same
experienced technician, according to the International Society for Clinical Densitometry official position (adult and
pediatric) recommendations.
Specifically, the seated position required subjects to have
their back straight and feet flat on the floor about shoulder
width apart, arms crossed at chest height, with hip and knee
flexion of approximately 908 (39).
Caloric Intake. Caloric intake was evaluated during the
intervention period through a 24-hour food recall, which
was collected through a personal interview. The evaluator
recorded the food descriptions, and the size and volume of
the portions consumed. Three assessments were made
throughout the intervention period, specifically at baseline,
mid-training (week 11), and post-training (week 16). The
caloric intake was assessed by the same researcher at each
time point (14). Macronutrients (i.e., carbohydrate, protein,
and fat) were analyzed as a percentage of total calories
consumed.
Training Procedures. At the commencement of each training
session, subjects performed a general warm-up routine
(Table 2). Following, the TP and MSP groups performed
the leg press and seated leg curl in all training sessions, with
the order of exercises alternated. The TP intervention was
completed in blocks of training (mesocycles), where muscular characteristics (hypertrophy, maximal strength, and
power) were developed separately. Conversely, the MSP targeted different neuromuscular characteristics within the
same session (Table 3). The load when targeting hypertrophy and maximum strength characteristics was increased by
2.5–5.0 kg for the next session when subjects were able to
perform more repetitions than prescribed (Table 3). Immediately after completion of all exercises, the Omni Scale was
used to assess rating of perceived exertion (26).
After the performance of leg press and seated leg curl,
a further complementary upper-body program was performed, consisting of 1 set of 12 repetitions (to repetition
Functional Tests. All the functional performance tests were
performed 15 minutes after the muscular power assessments.
The order of the TUG and up-and-down stair tests were
randomized. Subjects completed 3 trials with 30-second rest
between attempts and 2-minute rest between tests. All
functional tests were recorded using a digital camera at
a sampling frequency of 100 Hz (GoPro Hero 4 Silver;
GoPro Inc., San Mateo, CA, USA) and timed by an evaluator
who was blinded to the subject’s group assignment with
specialized software (Kinovea, France). The trial with the
lowest completion time was used for further analysis (39).
Up-and-down stair performance was tested according
to da Silva et al. (39). Subjects started up a flight of 8 steps
(15-cm high and 30-cm deep).
After a brief rest (30 seconds),
subjects were asked to perform
TABLE 2. Experimental groups’ resistance training warm-up routine.*†
the downstairs test by descending the same flight of 8 steps.
Training
Rest Cadence
Timing commenced for the
Phase duration
Repetitions
(min) (C-I-E)
up-and-down stair test when
1
4–6 wk
Body mobility: 3 3 10
1
1:0:1
the subject raised their heel
Prone plank: 3 3 1500
off the ground to climb or
Back extension: 3 3 1500
descend the first step and stop2
8–10 wk
Body mobility: 3 3 10
1
1:0:1
ped when both feet were
Abdominal lateral: 3 3 20
Four-point kneeling: 3 3 15 (by side)
placed on the eighth step.
3
12–14 wk
Body mobility: 3 3 10 (by side)
1
1:0:1
They were instructed to comAbdominal crunch on the Swiss ball: 3 3 20
plete the task as fast as possible
Back extension on the Swiss ball: 3 3 15
and to use the handrail.
*C = concentric; I = isometric; E = eccentric.
The TUG test measured the
†Body mobility—get up off the bench (height = 50 cm) with wooden stick (length: 150 cm
time taken to raise from
and body mass: 600 g) on the thigh while raising the stick above the head (extension of hip
a seated position, walk forward
and knee associated with shoulder flexion).
2.44 m, and return to a seated
position as quickly as possible.
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TABLE 3. Experimental groups lower-limb training program.*
Groups
TP
Training
phase
Training
duration
1
4–6 wk
2
8–10 wk
3
12–14 wk
All sessions
RT
methods
Repetitions
range
Rest
(min)
Cadence
(C:I:E)
Hypertrophy
Strength
Power
Hypertrophy
Strength
Power
3 3 10–12
3 3 3–5
3 3 4–6
1 3 10–12
1 3 3–5
1 3 4–6
2
2:0:2
1:0:2
AFAP:0:2
2:0:2
1:0:2
AFAP:0:2
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sets 3 repetitions. Relative
dynamic strength was calculated by dividing the absolute
dynamic strength (kg) by the
free fat mass of the lower limbs
(kg).
Statistical Analyses
All values were reported as
mean 6 SD. The normality of
the distribution and homoscedasticity for outcome measures
*RT = resistance training; TP = traditional periodization; AFAP = as fast as possible; MSP
were tested using the Shapiro–
= mixed session periodization.
Wilk, and Mauchly and Levene criterion, respectively.
To check the random stratification of subjects, a 1-way
failure) of the cable chest press, seated row, biceps curl, and
analysis of variance (ANOVA) was used to assess betweentriceps extension, with a 1-minute rest between sets. On
group differences in baseline measures. Main training effects
average, the workout duration was ;37 minutes for both
within and between groups were assessed by a repeatedgroups. During all sessions, subjects were directly supervised
measures ANOVA (time [baseline vs. week 15] 3 3 groups
(i.e., trainers with Bachelor Degree in Physical Education)
[Control vs. TP vs. MSP]). The time course of effects within
to help ensure consistent and safe performance. Volume
and between groups were assessed by a mixed-model ANOVA (time [baseline vs. week 7 vs. week 11 vs. week 15] 3 2
load was calculated using the equation: load lifted 3
MSP
2
Figure 2. Absolute dynamic strength (ADS) and relative dynamic strength (RDS) change for leg press (A and C) and seated leg curl (B and D) at post-training
(week 15) to Control, traditional periodization (TP), and mixed session periodization (MSP). Statistical difference for @MSP group and &TP group (p , 0.01).
LPress = leg press; SLC = seated leg curl.
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Mixed Session Periodization for Aging Adults
groups [TP vs. MSP]). When a significant F value was
achieved, Bonferroni’s post hoc tests were used to determine
the pair-wise differences between the different time points
and between groups.
Test–retest reliability was determined by calculating intraclass correlation, coefficients with a 2-tailed t-test used to
determine whether a significant difference existed between
the 2 tests for a variable at baseline. For rating of perceived
exertion, a Friedman test was applied to analyze the difference between experimental groups. Sample size was calculated using GPOWER software (version 3.0.1) with a target
ES = 0.8, alpha = 0.05, power = 0.8, resulting in an estimated sample of 12 subjects per group. An alpha level of p #
0.05 was used to determine statistical significance. All statistical procedures were completed using SPSS 21 for Windows (Statistical Package for the Social Science; IBM,
Chicago, IL, USA). Effect sizes were calculated and determined in accordance with Rhea (38), based on the Control
group and pre-training measures. The ES magnitude was
defined as trivial (,0.50), small (0.50–1.25), moderate
(21.26 to 1.9), and large (.2.0).
RESULTS
Muscular Strength
The leg press and seated leg curl (5RM) showed a group 3
time interaction for absolute dynamic strength (F = 25.08;
p , 0.0001; h2p = 0.65 and F = 29.81; p , 0.0001; h2p = 0.70),
respectively. The TP and MSP groups demonstrated significantly greater leg press (TP: p , 0.003, ES = 2.56, large and
MSP, p , 0.0001, ES = 3.38, large) and seated leg curl
strength (TP: p , 0.028, ES = 1.53, moderate and MSP,
p , 0.001, ES = 2.27, large) vs. the Control group at posttraining (week 15), although there were no significant differences between experimental groups for both exercises (p =
1.00 and 0.76; Figure 2A, C), respectively.
Furthermore, there were group 3 time interactions for
relative dynamic strength on the leg press and seated leg
curl (F = 5.21; p , 0.012; h2p = 0.28 and F = 6.41; p ,
0.005; h2p = 0.32), respectively. Both experimental groups
showed significantly greater leg press performance vs. the
Control group (TP, p = 0.017 and MSP, p = 0.019). However,
only the MSP group demonstrated significantly greater performance in the seated leg curl vs. the Control group (p =
0.0001), whereas the TP was not significantly different vs.
the Control group (p = 0.089). The ESs were moderate and
large for the TP (1.94) and MSP (2.11) for the leg press; and
small (TP = 1.01) to moderate (MSP = 1.34) for the seated
leg curl (Figure 2B, D), respectively.
There was a group 3 time interaction in the cable chest
press (F = 49.78; p = 0.0001; h2p = 0.787). Both experimental
groups showed a significant increase after training when
compared with baseline for cable chest press strength (p ,
0.001 for both), whereas the Control group significantly
decreased (p = 0.048) (Table 4).
TABLE 4. Changes in muscular strength across the experimental period.*†
RM test (Kg)
Leg press—5RM
Period
Baseline
Week 7
Week 11
Week 15
Seated leg curl—5RM
Baseline
Week 7
Week 11
Week 15
Cable chest press—12RM
Baseline
Week 15
Control (n = 8)
71.5 6 16.62z
5.27 6 0.93
—
—
—
—
71.5 6 19.71z¶
5.69 6 0.93z¶
61.25 6 13.20
4.54 6 0.54
—
—
—
—
61.87 6 16.69z¶
4.88 6 0.81z
35.00 6 4.75
30.37 6 3.70§z¶
A
R
A
R
A
R
A
R
A
R
A
R
A
R
A
R
A
A
TP (n = 11)
96.72
6.47
99.55
6.69
115.73
7.60
122.27
8.00
72.54
4.80
77.55
5.07
82.55
5.31
87.54
5.70
39.27
60.18
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
28.66
2.86
35.64
3.41
32.85§║
3.54§║
36.60§║#
3.75§║#
20.91
1.80
23.17§
1.82§
22.41§║
1.97§║
23.07§║#
2.26§║#
10.32
16.28§
MSP (n = 11)
108.81
6.74
114.82
7.11
126.82
7.49
138.54
8.21
75.63
4.76
83.91
5.25
91.18
5.47
99.81
5.97
37.90
52.10
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
25.11
2.05
26.96
2.17
25.07§║
1.99§║
28.41§║#
2.32§║#
17.98
1.66
18.41§
1.79§
19.40§║
1.92§║
18.06§║#
1.89§║#
10.68
18.08§
*RM = repetition maximum; TP = traditional periodization; MSP = mixed session periodization; A = absolute; R = relative.
†Mean 6 SD.
zStatistical difference for MSP group (p , 0.05).
§Statistical difference from baseline.
║Statistical difference from week 7.
¶Statistical difference from TP group.
#Statistical difference from week 11.
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Figure 3. Time course of changes in absolute dynamic leg press (A) and seated leg curl (B) to traditional periodization (dashed lines) and mixed session
periodization (continuous lines) groups. Statistical difference for (p , 0.01) *statistical difference from baseline; #statistical difference from week 7.
The time course for absolute dynamic strength presented
significant increases for the TP and MSP with no significant
differences between groups (F = 75.25; p = 0.0001; h2p =
0.791 and F = 38.49; p = 0.0001; h2p = 0.658), respectively.
Leg press dynamic strength increased from week 7 to week
11 (p , 0.0001) and through week 15 (p , 0.0001), although
no difference occurred over the initial phase (baseline vs. 7
weeks, p = 0.15), Figure 3A. Absolute dynamic strength for
the seated leg curl showed gradual increases with training
(baseline , week 7 , week 11 , week 15, p , 0.001),
Figure 3B.
Muscular Power
Jump height and PPO derived from the squat jump and
CMJ are presented in Table 5. No statistical differences
were observed between experimental groups in jump
measures (p . 0.05). Furthermore, the ES for JH in the
TP group was small for squat jump (0.99) and CMJ
(0.93); and small (0.77) and trivial (=0.41) in the MSP
group for the squat jump and CMJ, respectively. The
PPO ES was small for the TP (squat jump = 0.56 and
CMJ = 0.66) and trivial for the MSP (squat jump = 0.45
and CMJ = 0.42).
TABLE 5. Changes in muscular power across the experimental period.*†
Power test
Countermovement
jump
Period
Baseline
Week 7
Week 11
Week 15
Squat jump
Baseline
Week 7
Week 11
Week 15
Control (n = 8)
PPO
Height
PPO
Height
PPO
Height
PPO
Height
PPO
Height
PPO
Height
PPO
Height
PPO
Height
27.92 6 5.03
22.84 6 5.32
—
—
—
—
26.80 6 5.30
23.54 6 5.00
26.27 6 4.52
30.89 6 5.35
—
—
—
—
26.13 6 4.67
30.73 6 5.48
TP (n = 11)
30.77
25.78
30.10
32.62
30.97
27.42
31.26
27.83
28.31
35.23
27.39
34.06
28.38
36.48
28.77
36.20
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6.25
6.79
5.37
7.98z
6.91
8.56§
6.26
7.10§
6.20
6.51
6.16
7.50
6.43
7.21
6.16
7.37
MSP (n = 11)
29.52
25.14
30.74
34.61
31.54
26.08
30.07
25.04
27.76
33.52
28.73
36.81
29.14
36.55
27.27
34.99
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
7.40
6.50
7.97
9.06z
8.82
8.28§
8.38
8.02§
7.85
7.34
8.06
9.79
7.77
8.63
8.64
8.03
*TP = traditional periodization; MSP = mixed session periodization; PPO = peak power output.
†Mean 6 SD.
zStatistical difference from baseline.
§Statistical difference from week 7; (p , 0.05).
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Mixed Session Periodization for Aging Adults
TABLE 6. Changes in functional performance across the experimental period.*†
Group
Period
Upstairs
Downstairs
Timed up and go
Control
TP
MSP
Control
TP
MSP
Control
TP
MSP
Control
TP
MSP
Baseline
2.95 6 0.34
3.22 6 0.47
3.47 6 0.56
—
3.27 6 0.67
3.47 6 0.51
—
3.12 6 0.57
3.36 6 0.66
3.17 6 0.30
3.02 6 0.56z§
3.18 6 0.53z§
3.05 6 0.38
2.99 6 0.69
3.24 6 0.60
—
2.98 6 0.73
3.17 6 0.64
—
2.92 6 0.77
3.07 6 0.60
3.14 6 0.37
2.78 6 0.74z§
2.89 6 0.58z§
5.50 6 0.44
5.45 6 0.78
5.53 6 0.77
—
5.46 6 0.94
5.53 6 0.80
—
5.38 6 0.58
5.48 6 0.74
5.61 6 0.44
5.28 6 0.92§
5.15 6 0.84z§
Week 7
Week 11
Week 15
*TP = traditional periodization; MSP = mixed session periodization.
†Mean 6 SD.
zStatistical difference from baseline.
§Statistical difference from week 7.
The time course showed significant increases in CMJ
height (F = 17.38; p = 0.001; h2p = 0.46); week 7 was significantly greater than baseline (p = 0.001), week 11 (p = 0.001),
and week 15 (p = 0.004). Peak power output did not present
significant differences (p . 0.05).
Functional Performance
Group mean 6 SD for functional tasks are presented in
Table 6. A main effect for time (F = 4.51, p = 0.01; h2p =
0.172) was observed for the
TUG (week 15 , week 7, p =
0.002) for upstairs (F = 8.43, p =
0.0001; h2p = 0.30), in which
week 15 was significantly lower
than week 7 (p = 0.001) and
baseline (p = 0.001), as well as,
for downstairs (F = 8.43, p =
0.0001; h2p = 0.30), in which
week 15 was significantly lower
than week 11 (p = 0.013), week 7
(p = 0.01), and baseline (p =
0.01). However, no interactions
or between-group differences
were observed (p . 0.05). Baseline to week 15 ES for TP and
MSP were 0.21 (trivial) and 0.50
(small) for TUG, 0.43 (trivial)
and 0.53 (small) for upstair, and
0.30 (trivial) and 0.58 (small) for
downstair tests, respectively.
Body Composition
Lower-limb fat-free mass presented a group 3 time interaction (F = 5.76; p = 0.0001; h2p = 0.30). Both experimental
groups were significantly greater after the intervention vs.
baseline (TP, p = 0.007, ES = 0.096 and MSP, p = 0.0001,
ES = 0.26). The MSP group displayed significantly greater
lower-limb fat-free mass vs. the Control group (p = 0.009, ES
= 2.81, large), however, similar to the TP group (p = 0.139),
Figure 4. Body composition variables: lower-limb fat-free mass (A), lower-limb fat mass (B and C), lower-limb BMD (D), femur BMD (E), and column BMD (F)
for all groups (Control, traditional periodization [TP], and mixed session periodization [MSP]). Mean 6 SD. *Statistical difference from baseline. BMD =
bone mineral density.
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TABLE 7. Macronutrients of food ingesting across the experimental period.*†
Group
Control
TP
MSP
Control
TP
MSP
Control
TP
MSP
Time
Group
Time 3 group
Period
Carbohydrate
Protein
Fat
Baseline
51.90 6 6.49
47.91 6 11.23
55.25 6 8.21
52.68 6 8.73
55.46 6 8.73
57.34 6 7.51
50.55 6 9.55
53.19 6 9.52
50.51 6 9.87
p = 0.14; h2p = 0.080
p = 0.69; h2p = 0.031
p = 0.26; h2p = 0.106
21.88 6 5.90
20.61 6 3.74
17.08 6 4.20
21.35 6 5.46
18.43 6 6.23
18.45 6 3.31
23.68 6 6.70
18.74 6 7.94
19.44 6 1.49
p = 0.52; h2p = 0.028
p = 0.38; h2p = 0.084
p = 0.20; h2p = 0.131
26.73 6 6.09
32.43 6 9.82
28.22 6 7.42
26.45 6 6.42
26.46 6 6.84
24.78 6 6.21
26.28 6 4.74
28.47 6 8.88
30.37 6 10.11
p = 0.20; h2p = 0.067
p = 0.48; h2p = 0.071
p = 0.67; h2p = 0.034
Middle
Post
*TP = traditional periodization; MSP = mixed session periodization.
†Mean 6 SD (percentage of daily ingest).
with a moderate ES (1.80) (Figure 4C). Furthermore, the
body fat percentage of the lower limb significantly decreased
for all groups after the intervention (F = 11.05; p = 0.002; h2p
= 0.30) vs. baseline (p = 0.002) (Figure 4A). However, the ES
for the experimental groups was small for both groups (TP,
0.85 and MSP, 0.66), in comparison with the Control group.
Lower-limb fat mass did not present a group 3 time interaction (F = 0.76; p = 0.47; h2p = 0.053), time main effect (F =
1.04; p = 0.32; h2p = 0.37), or group main effect (F = 1.06; p =
0.40; h2p = 0.073), respectively (Figure 4B). Similarly, the ES
was trivial (0.38) for both experimental groups in comparison with the Control group.
Bone mineral density was not significantly different at any
time point between groups for the spine, femur, and lower
limb (p . 0.05) (Figure 4D–F), respectively. The ES for spine
was trivial for both groups (TP = 20.26 and MSP = 0.14);
equal ES was observed for the femur (TP = 20.55 and MSP
= 0.12) and the lower limb (TP = 0.04 and MSP = 0.025).
Training Volume Load
There were no differences between experimental groups in
the absolute volume load (F = 2.30, p = 0.14; h2p = 0.103), TP
(4,271 6 1,339 kg), and MSP (5,007 6 891 kg). Rating of
perceived exertion was significantly different between experimental groups (TP = 9 and MSP = 8, p , 0.001).
Caloric Intake
There were no significant differences between experimental
groups at any time point (baseline, mid-training, and posttraining) for all macronutrients (carbohydrate, protein, and
fat; Table 7), respectively.
Intraclass Correlation Coefficients
Intraclass correlation coefficients for Control, TP, and MSP
were 0.96, 0.97, and 0.98 for leg press 5RM; 0.96, 0.95, and
0.97 for seated leg curl 5RM; 0.89, 0.98, and 0.98 for squat
jump; 0.99, 0.98, and 0.98 for CMJ, 0.89, 0.85, and 0.90 for
upstairs; 0.90, 0.89, and 0.95 for downstairs; and 0.90, 0.95,
and 0.95 for TUG, respectively.
Baseline
The MSP group displayed significantly greater lower-limb
fat-free mass vs. the Control group (F = 4.90; p = 0.015; h2 =
0.30) (Table 1). Leg press absolute dynamic strength was
significantly greater between experimental groups (TP and
MSP) vs. the Control group (F = 4.41; p = 0.02; h2 = 0.25).
All other variables did not present statistically significant
differences between groups (p . 0.05).
DISCUSSION
To our knowledge, this was the first study to evaluate the
effect of MSP vs. TP on strength, power, body composition,
and functional performance in older adults. The key finding
was that both periodization models (TP and MSP) induced
similarly significant dynamic strength increases over the
training intervention (ES overall; TP = 2.0, MSP = 2.8),
along with similarly significant improvements in functional
task performance (TUG, upstairs, and downstairs), and
lower-limb fat-free mass. Therefore, our original hypothesis
was rejected because the MSP model did not elicit superior
adaptions vs. the TP model after 9 weeks of RT in older
adults.
The present increases in muscular strength were consistent with multiple studies that aimed to investigate the
efficacy of various training strategies in older adults (5,33).
Recent studies have investigated different types of periodization to find more efficient strategies to develop muscular
strength in aging subjects (9,10,35). In the current study,
both the MSP and TP models resulted in increased leg press
VOLUME 32 | NUMBER 10 | OCTOBER 2018 |
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Mixed Session Periodization for Aging Adults
and seated leg curl 5RM, with no differences between
groups. However, after week 15, the MSP group ES was
higher than the TP group for the 5RM leg press (3.38 and
2.27) and seated leg curl (2.56 and 1.53), although the difference was not statistically significant between groups. This
effect was consistent with the initial study hypothesis that
the variation of stimuli within a single session would elicit
superior adaptations.
Different training volumes, intensities, and contraction
velocities are characterized by distinct motor unit and
muscle fiber recruitment patterns (12,13,16). Previous studies
that compared different periodization models for older persons did not find differences (9,35). However, these studies
only varied training volume and intensity across the intervention period; conversely, this study also included variations in contraction velocity (i.e., power training set).
In one study conducted by Conlon et al. (9), block and
nonlinear periodization models were examined over a 22week training period in older adults (65–81 years). The authors reported similar increases in leg press dynamic strength
(i.e., 1RM) for both periodization models. Prestes et al. (35)
also reported similar increases in leg press strength for linear
and nonlinear periodization models (repetition range from
12–14 to 4–6 during the intervention). It is important to note
that higher ESs were achieved for both the MSP (2.11) and
TP (1.94) groups in this study (over 27 sessions) vs. the study
by Conlon et al. (9) for the leg press in nonperiodized (1.13),
block (1.46), and nonlinear (0.96) periodization models (over
60 sessions); and also higher ESs vs. the study by Prestes et al.
(35) for the leg press in linear (0.96) and nonlinear (1.17)
periodization models (32 sessions).
The strategy for the MSP group of this study of adding 1
set of high velocity concentric actions within session may
have been the reason for the between-group percentage
differences observed, specifically in the first phase of the
intervention (at week 7) in CMJ height (TP, 26.5%, ES =
1.00 vs. MSP, 37%, ES = 1.45). Concentric actions performed
with the intent to contract as fast as possible have been
demonstrated to be more effective for power improvements
in the elderly population compared with slow contraction
methods (7,42). These adaptations can be explained by increases in maximum force, rate of force development (24),
the contraction velocity (2), and rate of electromyography
rise (11).
Previous studies reported improvements in power (37 6
29%) in the elderly after the inclusion of high-velocity contractions (30–50% of 1RM) as part (20%) of a traditional
heavy RT program (21) or training only with fast concentric
contractions (7,32,36). Caserotti et al. (8), Ramı́rez-Campillo
et al. (36), and Pereira et al. (32) all reported CMJ height
increases of ;18% (ES = 1.1), 23% (ES = 0.63), and 40%
after 24, 36, and 36 sessions, respectively. With relevance to
older adults, the improvement in power performance might
be associated with maintenance of fast-twitch muscle fibers,
and an increase in maximal fiber contraction velocity, less-
2804
the
ening the risk of disability, rate of falls, and injuries in older
adults (8,20).
Regarding functional capacity, it was expected that the
MSP group would experience better improvements vs. the
TP group at week 7, due to the inclusion of power training
(i.e., 1 set per session). Power increases can result in greater
improvements of functional capacity (7) vs. traditional slow
contraction RT (42). However, both periodization models
produced similar improvements in functional task performance by week 15, with a slightly percentage advantage
for the MSP group (downstairs, TP = 7% and MSP =
10%; upstairs, TP = 6.5% and MSP = 8.5%; and TUG, TP
= 3% and MSP = 7%). It was hypothesized that functional
task performance needs a longer time to demonstrate a transfer of training effect in the present population, although
strength and power had increased by week 7 for both experimental groups.
Recently, Moura et al. (30) reported similar improvements
in muscular strength (normalized to body mass) and functional task performance after 12 weeks of nonlinear periodization. In the current data set, the improvements in strength
observed for TP and MSP at week 15 might be one of the
reasons for the concomitant improvements in functional task
performance. This study was in agreement with others that
reported increases in functional task performance after RT,
without differences between periodization models
(i.e., undulating vs. TP (35) or nonperiodized vs. block vs.
undulating (8)). It is important to highlight that all functional
tests were filmed and then later analyzed offline, which was
different from the data collection method of the aforementioned studies. This technique decreases measurement errors
and increases data accuracy (39).
Different from muscular strength, increases in lower-limb
fat-free mass after RT have not been consistent among studies
in the aging population (34,41). In this study, improvements
were observed for both the MSP and TP groups occurring
after week 15 only. These results were in agreement with the
results of the study by Lixandrão et al. (27) that examined the
time course of muscle hypertrophy after progressive linear
RT in older adults and found significant increases in vastus
lateralis cross-sectional area ;7 to 8% (ES = 0.37) (assessed
by ultrasonography) after 20 sessions (10 weeks). Conversely,
some studies reported no increase of muscle mass or fat-free
mass, despite strength improvements in aging subjects
(4,31,41). With the limited capacity for hypertrophy in the
elderly population (3), strategies that successfully result in
increases in fat-free mass should be developed.
In addition, in our current data set, a slightly greater ES for
MSP compared with TP was in accordance with the initial
hypothesis that mixing different patterns of motor unit
recruitment, and metabolic and mechanical stresses within
the same session would result in greater adaptations. The
current periodization models produced a gain of 2.6% (ES =
0.09) and 4.8% (ES = 0.26) in lower-limb fat-free mass for the
TP and MSP groups, respectively.
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It is important to acknowledge limitations in this study
design, including the short training period (9 weeks) may not
be long enough to observe differences in the effectiveness of
periodization models, because the study subjects were
untrained in the beginning of the intervention, which
increases their responsiveness to any type of volumematched RT. In addition, the dropouts (n = 15) reduced
the sample size and statistical power; it could be argued that
between-group statistical differences were possibly undetected because of type II error. However, the calculation of
ESs provided additional information for between-group
comparisons. In addition, this study used valid methods of
evaluation, and test-retest measurements showed high
reproducibility, resulting in reliable data. In summary, the
MSP and TP models resulted in increased strength, power,
functional task performance, and lower-limb fat-free mass in
aging adults. The MSP group showed higher ESs for leg
press and seated leg curl 5RM, lower-limb fat-free mass,
up-and-down stairs; and TUG after the training periods vs.
the TP group over 9 weeks of RT in aging adults.
PRACTICAL APPLICATIONS
This result of this research has valuable applications for RT
prescription in older adults. First, both the suggested
periodization models can be used to counteract the effects
of advancing age in muscular strength, power, functional
task performance, and lower-limb fat-free mass. The difference observed in the magnitude of ESs between models
suggests that the MSP model could be an alternative for
better results. However, the use of the TP model can be
considered an alternative over subsequent training periods to
avoid adaptation plateaus and promote training adherence.
ACKNOWLEDGMENTS
The authors thank the Foundation for Research Support of
the State of Amazonas (FAPEAM) for PhD scholarship
conceded to ESB and Coordination for the Improvement of
Higher Education Personnel (CAPES) for MSc scholarship
conceded to LBRO and PhD scholarship conceded to
BMM. Dr. RS would thank the Brazilian National Board
for Scientific and Technological Development (CNPq).
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