{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:52:09Z","timestamp":1786981929021,"version":"build-2736575974"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019629","name":"Universidad de Burgos","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019629","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["GeroScience"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sarcopenia is a major contributor to frailty and functional decline among older adults. Combining exercise with nutritional strategies such as creatine monohydrate (CRE) and \u03b2-hydroxy-\u03b2-methylbutyrate (HMB) supplementation may help to preserve strength and independence. To evaluate the effects of 6-week CRE\u2009+\u2009HMB supplementation combined with an integral physical conditioning (IPC) program on functional strength and body composition in physically active older adults. In a randomized, double-blind, placebo-controlled crossover trial, 30 older adults (20 men, 10 women;\u2009\u2265\u200960\u00a0years) completed two 6-week intervention periods (CRE\u2009+\u2009HMB or placebo) separated by a 3-week washout. The IPC program performed in both conditions consisted of four supervised weekly sessions combining strength, power, multicomponent circuits, high-intensity interval and moderate intensity continuous training), performed at 40\u2013100% training heart rate (THR) and 20\u201390% one-repetition maximum (1RM) and structured as warm-up, main part and cooldown. Functional strength and body composition (bioelectrical impedance analysis) were assessed pre- and post-intervention, respectively. Significant time\u2009\u00d7\u2009group interactions were observed for fat mass, fat-free mass, total muscle mass, skeletal muscle mass, appendicular skeletal muscle mass, muscle mass index, skeletal muscle index and ALM\/BMI (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The CRE\u2009+\u2009HMB group showed reductions in fat mass and body fat percentage, with slight numerical increases in muscle parameters, whereas the placebo group exhibited opposite trends. However, within-group changes were not statistically significant. In contrast, CRE\u2009+\u2009HMB significantly improved multiple functional strength outcomes, including leg\/back strength, arm flexion strength, upper-body endurance (dumbbell flexion, push-ups, isometric hold) and core endurance (crunches). Regression analyses suggested that these improvements were largely independent of changes in muscle mass, supporting a potential neuromuscular mechanism. Six weeks of CRE\u2009+\u2009HMB supplementation combined with IPC enhanced functional strength and endurance in active older adults, largely independent of changes in muscle mass. This combined approach represents a promising strategy for preserving functional capacity and promoting healthy ageing.\n                  <\/jats:p>","DOI":"10.1007\/s11357-025-01889-y","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:02:48Z","timestamp":1760112168000},"page":"4457-4475","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Combined creatine and HMB co-supplementation improves functional strength independent of muscle mass in physically active older adults: a randomized crossover trial"],"prefix":"10.1007","volume":"48","author":[{"given":"Rafael","family":"Ramos-Hern\u00e1ndez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Miguel-Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Mart\u00ednez-Ferr\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Fern\u00e1ndez-L\u00e1zaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Busto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Mielgo-Ayuso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"issue":"1","key":"1889_CR1","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruy\u00e8re O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16\u201331. https:\/\/doi.org\/10.1093\/ageing\/afy169.","journal-title":"Age Ageing"},{"issue":"1","key":"1889_CR2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169548","volume":"12","author":"C Beaudart","year":"2017","unstructured":"Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruy\u00e8re O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS ONE. 2017;12(1):e0169548. https:\/\/doi.org\/10.1371\/journal.pone.0169548.","journal-title":"PLoS ONE"},{"issue":"8","key":"1889_CR3","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.jamda.2013.05.021","volume":"14","author":"J Bauer","year":"2013","unstructured":"Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE study group. J Am Med Dir Assoc. 2013;14(8):542\u201359. https:\/\/doi.org\/10.1016\/j.jamda.2013.05.021.","journal-title":"J Am Med Dir Assoc"},{"issue":"8","key":"1889_CR4","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1519\/JSC.0000000000003230","volume":"33","author":"MS Fragala","year":"2019","unstructured":"Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, et al. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019\u201352. https:\/\/doi.org\/10.1519\/JSC.0000000000003230.","journal-title":"J Strength Cond Res"},{"issue":"3","key":"1889_CR5","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.arr.2010.03.004","volume":"9","author":"MD Peterson","year":"2010","unstructured":"Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9(3):226\u201337. https:\/\/doi.org\/10.1016\/j.arr.2010.03.004.","journal-title":"Ageing Res Rev"},{"key":"1889_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/1743-7075-8-68","volume":"8","author":"L Breen","year":"2011","unstructured":"Breen L, Phillips SM. Skeletal muscle protein metabolism in the elderly: interventions to counteract the \u201canabolic resistance\u201d of ageing. Nutr Metab (Lond). 2011;8:68. https:\/\/doi.org\/10.1186\/1743-7075-8-68.","journal-title":"Nutr Metab (Lond)"},{"issue":"2","key":"1889_CR7","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1089\/rej.2012.1397","volume":"16","author":"EL Cadore","year":"2013","unstructured":"Cadore EL, Rodr\u00edguez-Ma\u00f1as 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;16(2):105\u201314. https:\/\/doi.org\/10.1089\/rej.2012.1397.","journal-title":"Rejuvenation Res"},{"issue":"11","key":"1889_CR8","doi-asserted-by":"publisher","DOI":"10.3390\/nu13113757","volume":"13","author":"EEP Dos Santos","year":"2021","unstructured":"Dos Santos EEP, de Ara\u00fajo RC, Candow DG, Forbes SC, Guijo JA, de Almeida Santana CC, et al. Efficacy of creatine supplementation combined with resistance training on muscle strength and muscle mass in older females: a systematic review and meta-analysis. Nutrients. 2021;13(11):3757. https:\/\/doi.org\/10.3390\/nu13113757.","journal-title":"Nutrients"},{"key":"1889_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s12970-017-0173-z","volume":"14","author":"RB Kreider","year":"2017","unstructured":"Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. https:\/\/doi.org\/10.1186\/s12970-017-0173-z.","journal-title":"J Int Soc Sports Nutr"},{"issue":"4","key":"1889_CR10","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1519\/1533-4287(2003)017<0822:eocsar>2.0.co;2","volume":"17","author":"ES Rawson","year":"2003","unstructured":"Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res. 2003;17(4):822\u201331. https:\/\/doi.org\/10.1519\/1533-4287(2003)017<0822:eocsar>2.0.co;2.","journal-title":"J Strength Cond Res"},{"issue":"2","key":"1889_CR11","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1152\/physiolgenomics.00157.2007","volume":"32","author":"A Safdar","year":"2008","unstructured":"Safdar A, Yardley NJ, Snow R, Melov S, Tarnopolsky MA. Global and targeted gene expression and protein content in skeletal muscle of young men following short-term creatine monohydrate supplementation. Physiol Genomics. 2008;32(2):219\u201328. https:\/\/doi.org\/10.1152\/physiolgenomics.00157.2007.","journal-title":"Physiol Genomics"},{"issue":"16","key":"1889_CR12","doi-asserted-by":"publisher","first-page":"1917","DOI":"10.1016\/j.lfs.2003.11.036","volume":"75","author":"RVT Santos","year":"2004","unstructured":"Santos RVT, Bassit RA, Caperuto EC, Costa Rosa LFBP. The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30 km race. Life Sci. 2004;75(16):1917\u201324. https:\/\/doi.org\/10.1016\/j.lfs.2003.11.036.","journal-title":"Life Sci"},{"issue":"4","key":"1889_CR13","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1002\/jcsm.12208","volume":"8","author":"M Hole\u010dek","year":"2017","unstructured":"Hole\u010dek M. Beta-hydroxy-beta-methylbutyrate supplementation and skeletal muscle in healthy and muscle-wasting conditions. J Cachexia Sarcopenia Muscle. 2017;8(4):529\u201341. https:\/\/doi.org\/10.1002\/jcsm.12208.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"11","key":"1889_CR14","doi-asserted-by":"publisher","first-page":"2911","DOI":"10.1113\/jphysiol.2013.253203","volume":"591","author":"DJ Wilkinson","year":"2013","unstructured":"Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, et al. Effects of leucine and its metabolite \u03b2-hydroxy-\u03b2-methylbutyrate on human skeletal muscle protein metabolism. J Physiol. 2013;591(11):2911\u201323. https:\/\/doi.org\/10.1113\/jphysiol.2013.253203.","journal-title":"J Physiol"},{"issue":"11","key":"1889_CR15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141757","volume":"10","author":"L Berton","year":"2015","unstructured":"Berton L, Bano G, Carraro S, Veronese N, Pizzato S, Bolzetta F, et al. Effect of oral beta-hydroxy-beta-methylbutyrate (HMB) supplementation on physical performance in healthy old women over 65 years: an open label randomized controlled trial. PLoS ONE. 2015;10(11):e0141757. https:\/\/doi.org\/10.1371\/journal.pone.0141757.","journal-title":"PLoS ONE"},{"issue":"10","key":"1889_CR16","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.3390\/nu11102528","volume":"11","author":"J Fern\u00e1ndez-Landa","year":"2019","unstructured":"Fern\u00e1ndez-Landa J, Calleja-Gonz\u00e1lez J, Le\u00f3n-Guere\u00f1o P, Caballero-Garc\u00eda A, C\u00f3rdova A, Mielgo-Ayuso J. Effect of the combination of creatine monohydrate plus HMB supplementation on sports performance, body composition, markers of muscle damage and hormone status: a systematic review. Nutrients. 2019;11(10):2528. https:\/\/doi.org\/10.3390\/nu11102528.","journal-title":"Nutrients"},{"issue":"1","key":"1889_CR17","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010193","volume":"12","author":"J Fern\u00e1ndez-Landa","year":"2020","unstructured":"Fern\u00e1ndez-Landa J, Fern\u00e1ndez-L\u00e1zaro D, Calleja-Gonz\u00e1lez J, Caballero-Garc\u00eda A, Mart\u00ednez AC, Le\u00f3n-Guere\u00f1o P, et al. Effect of ten weeks of creatine monohydrate plus HMB supplementation on athletic performance tests in elite male endurance athletes. Nutrients. 2020;12(1):193. https:\/\/doi.org\/10.3390\/nu12010193.","journal-title":"Nutrients"},{"issue":"1","key":"1889_CR18","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3390\/biom10010140","volume":"10","author":"J Fern\u00e1ndez-Landa","year":"2020","unstructured":"Fern\u00e1ndez-Landa J, Fern\u00e1ndez-L\u00e1zaro D, Calleja-Gonz\u00e1lez J, Caballero-Garc\u00eda A, C\u00f3rdova A, Le\u00f3n-Guere\u00f1o P, et al. Long-term effect of combination of creatine monohydrate plus \u03b2-hydroxy \u03b2-methylbutyrate (HMB) on exercise-induced muscle damage and anabolic\/catabolic hormones in elite male endurance athletes. Biomolecules. 2020;10(1):140. https:\/\/doi.org\/10.3390\/biom10010140.","journal-title":"Biomolecules"},{"issue":"10","key":"1889_CR19","doi-asserted-by":"publisher","first-page":"2857","DOI":"10.1519\/jsc.0b013e3181e840f3","volume":"24","author":"BJ Schoenfeld","year":"2010","unstructured":"Schoenfeld BJ. The mechanisms of muscle hypertrophy and their application to resistance training. J Strength Cond Res. 2010;24(10):2857\u201372. https:\/\/doi.org\/10.1519\/jsc.0b013e3181e840f3.","journal-title":"J Strength Cond Res"},{"issue":"7","key":"1889_CR20","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1113\/jp277250","volume":"597","author":"A Del Vecchio","year":"2019","unstructured":"Del Vecchio A, Casolo A, Negro F, Scorcelletti M, Bazzucchi I, Enoka R, et al. The increase in muscle force after 4 weeks of strength training is mediated by adaptations in motor unit recruitment and rate coding. J Physiol. 2019;597(7):1873\u201387. https:\/\/doi.org\/10.1113\/jp277250.","journal-title":"J Physiol"},{"key":"1889_CR21","doi-asserted-by":"publisher","unstructured":"Jones B, Kenward MG. Design and analysis of cross-over trials. 3rd ed. Boca Raton: CRC Press; 2014. https:\/\/doi.org\/10.1201\/B17537.","DOI":"10.1201\/B17537"},{"issue":"7","key":"1889_CR22","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1249\/mss.0b013e318213fefb","volume":"43","author":"CE Garber","year":"2011","unstructured":"Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334\u201359. https:\/\/doi.org\/10.1249\/mss.0b013e318213fefb.","journal-title":"Med Sci Sports Exerc"},{"key":"1889_CR23","doi-asserted-by":"publisher","unstructured":"Aagaard P, Simonsen EB, Andersen JL, Magnusson P, Dyhre-Poulsen P. Increased rate of force development and neural drive of human skeletal muscle following resistance training. J Appl Physiol. 2002;93:1318\u201326. https:\/\/doi.org\/10.1152\/japplphysiol.00283.2002","DOI":"10.1152\/japplphysiol.00283.2002"},{"issue":"5","key":"1889_CR24","doi-asserted-by":"publisher","first-page":"303","DOI":"10.2165\/00007256-198805050-00002","volume":"5","author":"J Karvonen","year":"1988","unstructured":"Karvonen J, Vuorimaa T. Heart rate and exercise intensity during sports activities: practical application. Sports Med. 1988;5(5):303\u201311. https:\/\/doi.org\/10.2165\/00007256-198805050-00002.","journal-title":"Sports Med"},{"issue":"1","key":"1889_CR25","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1080\/07303084.1993.10606684","volume":"64","author":"M Brzycki","year":"1993","unstructured":"Brzycki M. Strength testing\u2014predicting a one-rep max from reps-to-fatigue. J Phys Educ Recreat Dance. 1993;64(1):88\u201390. https:\/\/doi.org\/10.1080\/07303084.1993.10606684.","journal-title":"J Phys Educ Recreat Dance"},{"issue":"1","key":"1889_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-021-00386-8","volume":"8","author":"JWD Lea","year":"2022","unstructured":"Lea JWD, O\u2019Driscoll JM, Hulbert S, et al. Convergent validity of ratings of perceived exertion during resistance exercise in healthy participants: a systematic review and meta-analysis. Sports Med. 2022;8(1):2. https:\/\/doi.org\/10.1186\/s40798-021-00386-8.","journal-title":"Sports Med"},{"key":"1889_CR27","doi-asserted-by":"publisher","first-page":"23","DOI":"10.2478\/hukin-2020-0011","volume":"74","author":"ER Helms","year":"2020","unstructured":"Helms ER, Kwan K, Sousa CA, Cronin JB, Storey AG, Zourdos MC. Methods for regulating and monitoring resistance training. J Hum Kinet. 2020;74:23\u201342. https:\/\/doi.org\/10.2478\/hukin-2020-0011.","journal-title":"J Hum Kinet"},{"issue":"2","key":"1889_CR28","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13804","volume":"16","author":"T T\u00f8ien","year":"2025","unstructured":"T\u00f8ien T, Berg OK, Modena R, Brobakken MF, Wang E. Heavy strength training in older adults: implications for health, disease and physical performance. J Cachexia Sarcopenia Muscle. 2025;16(2):e130804. https:\/\/doi.org\/10.1002\/jcsm.13804.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"5","key":"1889_CR29","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1093\/gerona\/60.5.638","volume":"60","author":"NJ De Vos","year":"2005","unstructured":"De Vos NJ, Singh NA, Ross DA, Stavrinos TM, Orr R, Singh MAF. Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol A Biol Sci Med Sci. 2005;60(5):638\u201347. https:\/\/doi.org\/10.1093\/gerona\/60.5.638.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"1889_CR30","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2022.104838","volume":"104","author":"N Labata-Lezaun","year":"2023","unstructured":"Labata-Lezaun N, Gonz\u00e1lez-Rueda V, Llurda-Almuzara L, L\u00f3pez-de-Celis C, Rodr\u00edguez-Sanz J, Bosch J, et al. Effectiveness of multicomponent training on physical performance in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2023;104:104838. https:\/\/doi.org\/10.1016\/j.archger.2022.104838.","journal-title":"Arch Gerontol Geriatr"},{"key":"1889_CR31","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1186\/s13102-025-01176-5","volume":"17","author":"H Sert","year":"2025","unstructured":"Sert H, Gulbahar Eren M, Gurcay B, et al. The effectiveness of a high-intensity interval exercise on cardiometabolic health and quality of life in older adults: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2025;17:128. https:\/\/doi.org\/10.1186\/s13102-025-01176-5.","journal-title":"BMC Sports Sci Med Rehabil"},{"issue":"2","key":"1889_CR32","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1037\/0882-7974.20.2.272","volume":"20","author":"Y Netz","year":"2005","unstructured":"Netz Y, Wu MJ, Becker BJ, Tenenbaum G. Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging. 2005;20(2):272\u201384. https:\/\/doi.org\/10.1037\/0882-7974.20.2.272.","journal-title":"Psychol Aging"},{"issue":"7","key":"1889_CR33","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1007\/s40279-018-0916-2","volume":"48","author":"B Van Hooren","year":"2018","unstructured":"Van Hooren B, Peake JM. Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries and the long-term adaptive response. Sports Med. 2018;48(7):1575\u201395. https:\/\/doi.org\/10.1007\/s40279-018-0916-2.","journal-title":"Sports Med"},{"key":"1889_CR34","doi-asserted-by":"publisher","unstructured":"Kim M, Shinkai S, Murayama H, Mori S. Comparison of segmental multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for the assessment of body composition in a community-dwelling older population. Geriatr Gerontol Int. 2015;15:1013\u201322. https:\/\/doi.org\/10.1111\/ggi.12384","DOI":"10.1111\/ggi.12384"},{"key":"1889_CR35","doi-asserted-by":"publisher","unstructured":"Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40:423\u20139. https:\/\/doi.org\/10.1093\/ageing\/afr051","DOI":"10.1093\/ageing\/afr051"},{"key":"1889_CR36","doi-asserted-by":"publisher","unstructured":"Yang S, Wu W, Zhang C, Wang D, Chen C, Tang Y, Li K, Xu J, Luo F. Reliability and validity of three isometric back extensor strength assessments with different test postures. J Int Med Res.2019;48:300060519885268. https:\/\/doi.org\/10.1177\/0300060519885268","DOI":"10.1177\/0300060519885268"},{"key":"1889_CR37","doi-asserted-by":"publisher","unstructured":"Romero-Franco N, Fern\u00e1ndez-Dom\u00ednguez JC, Monta\u00f1o-Munuera JA, Romero-Franco J, Jim\u00e9nez-Reyes P. Validity and reliability of a low-cost dynamometer to assess maximal isometric strength of upper limb. J Sports Sci. 2019;37:1787\u201393. https:\/\/doi.org\/10.1080\/02640414.2019.1594570","DOI":"10.1080\/02640414.2019.1594570"},{"key":"1889_CR38","doi-asserted-by":"publisher","unstructured":"Clemons JM. Construct validity of a modification of the flexed arm hang test. J Strength Cond Res. 2014;28:3523\u201330. https:\/\/doi.org\/10.1519\/jsc.0000000000000601","DOI":"10.1519\/jsc.0000000000000601"},{"key":"1889_CR39","unstructured":"Kellner P, Neubauer J, Pol\u00e1ch M. Objectivity of push-up tests and technique assessment. J Phys Educ Sport. 2021;21:1629\u201334."},{"key":"1889_CR40","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1093\/ije\/22.3.512","volume":"22","author":"JM Martin-Moreno","year":"1993","unstructured":"Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernandez-Rodriguez JC, Salvini S, Willett WC. Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol. 1993;22:512\u20139.","journal-title":"Int J Epidemiol."},{"key":"1889_CR41","doi-asserted-by":"publisher","unstructured":"Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults: a meta-analysis. Med Sci Sports Exerc. 2014;46:1194\u2013203. https:\/\/doi.org\/10.1249\/mss.0000000000000220","DOI":"10.1249\/mss.0000000000000220"},{"key":"1889_CR42","doi-asserted-by":"publisher","unstructured":"Brownstein CG, Casolo A, Del Vecchio A, Ansdell P. The knowns and unknowns of neural adaptations to resistance training. Eur J Appl Physiol. 2021;121:675\u201385. https:\/\/doi.org\/10.1007\/s00421-020-04567-3","DOI":"10.1007\/s00421-020-04567-3"},{"key":"1889_CR43","doi-asserted-by":"publisher","unstructured":"Unhjem R, Lundestad R, Fimland MS, Mosti MP, Wang E. Strength training-induced responses in older adults: attenuation of descending neural drive with age. Age (Dordr). 2015;37:47. https:\/\/doi.org\/10.1007\/s11357-015-9784-y","DOI":"10.1007\/s11357-015-9784-y"},{"key":"1889_CR44","doi-asserted-by":"publisher","unstructured":"Suetta C, Aagaard P, Rosted A, Jakobsen AK, Duus B, Kjaer M, Magnusson SP. Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse. J Appl Physiol. 2004;97:1954\u201361. https:\/\/doi.org\/10.1152\/japplphysiol.01234.2003","DOI":"10.1152\/japplphysiol.01234.2003"},{"key":"1889_CR45","doi-asserted-by":"publisher","unstructured":"Del Favero S, Roschel H, Artioli G, Ugrinowitsch C, Tricoli V, Costa A, Barroso R, Negrelli AL, Otaduy MC, Da Costa Leite C, Lancha-Junior AH, Gualano B. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids. 2012;42:2299\u2013305. https:\/\/doi.org\/10.1007\/s00726-011-0972-5","DOI":"10.1007\/s00726-011-0972-5"},{"key":"1889_CR46","doi-asserted-by":"publisher","unstructured":"Candow DG, Vogt E, Johannsmeyer S, Forbes SC, Farthing JP. Strategic creatine supplementation and resistance training in healthy older adults. Appl Physiol Nutr Metab. 2015;40:689\u201394. https:\/\/doi.org\/10.1139\/apnm-2014-0498","DOI":"10.1139\/apnm-2014-0498"},{"key":"1889_CR47","doi-asserted-by":"publisher","unstructured":"Branch JD. Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab. 2003;13:198\u2013226. https:\/\/doi.org\/10.1123\/ijsnem.13.2.198","DOI":"10.1123\/ijsnem.13.2.198"},{"key":"1889_CR48","doi-asserted-by":"publisher","unstructured":"Aagaard P, Suetta C, Caserotti P, Magnusson SP, Kj\u00e6r M. Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scand J Med Sci Sports. 2010;20:49\u201364. https:\/\/doi.org\/10.1111\/j.1600-0838.2009.01084.x","DOI":"10.1111\/j.1600-0838.2009.01084.x"},{"key":"1889_CR49","doi-asserted-by":"publisher","unstructured":"Piasecki M, Ireland A, Jones DA, McPhee JS. Age-dependent motor unit remodelling in human limb muscles. Biogerontology. 2016;17:485\u201396. https:\/\/doi.org\/10.1007\/s10522-015-9627-3","DOI":"10.1007\/s10522-015-9627-3"},{"key":"1889_CR50","doi-asserted-by":"publisher","unstructured":"Landi F, Calvani R, Cesari M, Tosato M, Martone AM, Ortolani E, et al. Sarcopenia: an overview on current definitions, diagnosis and treatment. Curr Protein Pept Sci. 2017;18: [Epub ahead of print]. https:\/\/doi.org\/10.2174\/1389203718666170607113459","DOI":"10.2174\/1389203718666170607113459"}],"container-title":["GeroScience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01889-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11357-025-01889-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01889-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:09:14Z","timestamp":1783764554000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11357-025-01889-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["1889"],"URL":"https:\/\/doi.org\/10.1007\/s11357-025-01889-y","relation":{},"ISSN":["2509-2723"],"issn-type":[{"value":"2509-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]},"assertion":[{"value":"16 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in this study were in accordance with the ethical standards of the institutional and\/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethics Committee of the University of Burgos (approval code: IR 24\/2023) and was registered at ClinicalTrials.gov (Identifier: NCT05951439). Written informed consent was obtained from all participants prior to enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}