Sex-related differences in neuromuscular and biological adaptations to power training in older adults The role of creatine supplementation
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Abstract
The aim of the present study was to analyze the modulatory role of sex in neuromuscular and biological adaptations induced by a power training program in older adults, as well as to explore the potential additional effect of creatine supplementation. A total of 99 participants (47 men and 52 women; 67.93 ± 1.30 years) were randomly assigned to training or control conditions, with or without supplementation. Neuromuscular performance was assessed through knee extension at 180°/s, together with biomarkers related to neuroplasticity (brain-derived neurotrophic factor [BDNF]), inflammation (interleukin-6 [IL-6] and tumor necrosis factor alpha [TNF-α]), and enzymatic antioxidant defense (glutathione peroxidase [GPx]), before and after the intervention. Power training induced significant improvements in neuromuscular performance, with large to very large effect sizes. At the biological level, consistent adaptations were observed, characterized by increases in BDNF and GPx activity and reductions in IL-6, whereas TNF-α showed a more moderate and variable response. Regarding sex differences, differential patterns were identified in the neuromuscular response, with variations in the magnitude of adaptation between men and women depending on the supplementation condition. In contrast, biological responses were generally similar between sexes, although specific trends were observed in some biomarkers. Overall, the results suggest that sex acts as a modulator of neuromuscular adaptations to power training in older adults, whereas biological adaptations appear to be more homogeneous. Creatine supplementation may exert a modest but consistent enhancing effect on some responses, although its contribution seems secondary to the exercise stimulus.
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