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Age and Ageing Oct 2022Sarcopenia is a skeletal muscle disorder that commonly occurs with advancing age as well as with a number of long-term conditions. Recognition in clinical practice is...
Sarcopenia is a skeletal muscle disorder that commonly occurs with advancing age as well as with a number of long-term conditions. Recognition in clinical practice is relatively recent but important because of the association between sarcopenia and a range of adverse effects on health including impaired mobility, increased morbidity and mortality. Originally characterised as loss of muscle mass, the definition has evolved to focus on loss of skeletal muscle function, particularly strength, through a number of international definitions such as that of the European Working Group on Sarcopenia in Older People most recently revised in 2019. Progress in the decades ahead is likely to be seen with regard to use of routine health data, prescription of resistance exercise, translation of biology and epidemiology into first in man studies for new treatments, and focus on sarcopenia in low and middle-income countries. Immediate next steps include the newly formed Global Leadership Initiative on Sarcopenia to develop international consensus on definition and diagnosis.
Topics: Humans; Aged; Sarcopenia; Muscle Strength; Consensus; Geriatric Assessment; Muscle, Skeletal; Hand Strength
PubMed: 36273495
DOI: 10.1093/ageing/afac220 -
Journal of Sport and Health Science Mar 2022We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy.
METHODS
Meta-analyses of effect sizes (ESs) explored the effects of training to failure vs. non-failure on strength and hypertrophy. Subgroup meta-analyses explored potential moderating effects of variables such as training status (trained vs. untrained), training volume (volume equated vs. volume non-equated), body region (upper vs. lower), exercise selection (multi- vs. single-joint exercises (only for strength)), and study design (independent vs. dependent groups).
RESULTS
Fifteen studies were included in the review. All studies included young adults as participants. Meta-analysis indicated no significant difference between the training conditions for muscular strength (ES = -0.09, 95% confidence interval (95%CI): -0.22 to 0.05) and for hypertrophy (ES = 0.22, 95%CI: -0.11 to 0.55). Subgroup analyses that stratified the studies according to body region, exercise selection, or study design showed no significant differences between training conditions. In studies that did not equate training volume between the groups, the analysis showed significant favoring of non-failure training on strength gains (ES = -0.32, 95%CI: -0.57 to -0.07). In the subgroup analysis for resistance-trained individuals, the analysis showed a significant effect of training to failure for muscle hypertrophy (ES = 0.15, 95%CI: 0.03-0.26).
CONCLUSION
Training to muscle failure does not seem to be required for gains in strength and muscle size. However, training in this manner does not seem to have detrimental effects on these adaptations, either. More studies should be conducted among older adults and highly trained individuals to improve the generalizability of these findings.
Topics: Adaptation, Physiological; Aged; Humans; Hypertrophy; Muscle Strength; Muscle, Skeletal; Resistance Training; Young Adult
PubMed: 33497853
DOI: 10.1016/j.jshs.2021.01.007 -
Journal of Cachexia, Sarcopenia and... Feb 2020Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and... (Meta-Analysis)
Meta-Analysis Review
Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta-analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow-up. Meta-analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow-up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty-five articles were pooled into the meta-analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29-7.92)) and worsening IADL (1.28 (1.02-1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34-1.70); 1.59 (1.04-2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47-4.92); 2.33 (1.58-3.44) respectively) and IADL (3.09 (1.06-8.98); 1.93 (1.69-2.21) respectively). Low one leg balance (2.74 (1.31-5.72)), timed up and go (3.41 (1.86-6.28)), and chair stand test time (1.90 (1.63-2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Muscle Strength; Physical Functional Performance
PubMed: 31788969
DOI: 10.1002/jcsm.12502 -
PeerJ 2022Progressive overload is a principle of resistance training exercise program design that typically relies on increasing load to increase neuromuscular demand to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Progressive overload is a principle of resistance training exercise program design that typically relies on increasing load to increase neuromuscular demand to facilitate further adaptations. However, little attention has been given to another way of increasing demand-increasing the number of repetitions.
OBJECTIVE
This study aimed to compare the effects of two resistance training programs: (1) increasing load while keeping repetition range constant (2) increasing repetitions while keeping load constant. We aimed to compare the effects of these programs on lower body muscle hypertrophy, muscle strength, and muscle endurance in resistance-trained individuals over an 8-week study period.
METHODS
Forty-three participants with at least 1 year of consistent lower body resistance training experience were randomly assigned to one of two experimental, parallel groups: A group that aimed to increase load while keeping repetitions constant (LOAD: = 22; 13 men, nine women) or a group that aimed to increase repetitions while keeping load constant (REPS: = 21; 14 men, seven women). Subjects performed four sets of four lower body exercises (back squat, leg extension, straight-leg calf raise, and seated calf raise) twice per week. We assessed one repetition maximum (1RM) in the Smith machine squat, muscular endurance in the leg extension, countermovement jump height, and muscle thickness along the quadriceps and calf muscles. Between-group effects were estimated using analyses of covariance, adjusted for pre-intervention scores and sex.
RESULTS
Rectus femoris growth modestly favored REPS (adjusted effect estimate (CI), sum of sites: 2.8 mm [-0.5, 5.8]). Alternatively, dynamic strength increases slightly favored LOAD (2.0 kg [-2.4, 7.8]), with differences of questionable practical significance. No other notable between-group differences were found across outcomes (muscle thicknesses, <1 mm; endurance, <1%; countermovement jump, 0.1 cm; body fat, <1%; leg segmental lean mass, 0.1 kg), with narrow CIs for most outcomes.
CONCLUSION
Both progressions of repetitions and load appear to be viable strategies for enhancing muscular adaptations over an 8-week training cycle, which provides trainers and trainees with another promising approach to programming resistance training.
Topics: Male; Humans; Female; Muscle, Skeletal; Quadriceps Muscle; Resistance Training; Muscle Strength; Leg
PubMed: 36199287
DOI: 10.7717/peerj.14142 -
International Journal of Environmental... Nov 2022Resistance training is considered to be an efficient treatment for age-related sarcopenia and can improve muscle strength and quality in patients. However, there are... (Meta-Analysis)
Meta-Analysis Review
Resistance training is considered to be an efficient treatment for age-related sarcopenia and can improve muscle strength and quality in patients. However, there are currently no recommendations on resistance training parameters to improve muscle strength and quality in elderly patients with sarcopenia. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and included 13 eligible RCTs. Resistance training significantly improved grip strength, gait speed, and skeletal muscle index in patients with age-related sarcopenia, and kettlebell was found to be the most effective modality. However, it is noteworthy that the elastic band is also a recommended form of resistance training considering that the kettlebell intervention was tested in only one study, while the elastic band was confirmed by multiple studies. Elastic band training (Hedges's g = 0.629, 95%CI = 0.090-1.168, < 0.05) (40-60 min per session, more than three times per week for at least 12 weeks) was the most efficient training method. Thus, resistance training can significantly improve muscle strength and muscle quality in elderly patients with sarcopenia. In addition, moderate-intensity resistance training using elastic bands may be the best training prescription for elderly patients with sarcopenia.
Topics: Humans; Aged; Resistance Training; Sarcopenia; Muscle Strength; Muscle, Skeletal; Hand Strength
PubMed: 36497565
DOI: 10.3390/ijerph192315491 -
Sports Medicine (Auckland, N.Z.) Dec 2021Due to improvements in acute burn care over the last few decades, most patients with severe burns (up to 90% of the total body surface) survive. However, the metabolic... (Review)
Review
Due to improvements in acute burn care over the last few decades, most patients with severe burns (up to 90% of the total body surface) survive. However, the metabolic and cardiovascular complications that accompany a severe burn can persist for up to 3 years post injury. Accordingly, there is now a greater appreciation of the need for strategies that can hasten recovery and reduce long-term morbidity post burn. Rehabilitation exercise training (RET) is a proven effective treatment to restore lean body mass, glucose and protein metabolism, cardiorespiratory fitness, and muscle strength in burn survivors. Despite this, very few hospitals incorporate RET in programs to aid the rehabilitation of patients with severe burns. Given that RET is a safe and efficacious treatment that restores function and reduces post-burn morbidity, we propose that a long-term exercise prescription plan should be considered for all patients with severe burns. In this literature review, we discuss the current understanding of burn trauma on major organ systems, and the positive benefits of incorporating RET as a part of the long-term rehabilitation of severely burned individuals. We also provide burn-specific exercise prescription guidelines for clinical exercise physiologists.
Topics: Body Composition; Cardiorespiratory Fitness; Exercise; Exercise Therapy; Humans; Muscle Strength
PubMed: 34339042
DOI: 10.1007/s40279-021-01528-4 -
Age and Ageing Feb 2022Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes....
Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes. Currently, resistance exercise (RE) is recommended as the first-line treatment for counteracting the deleterious consequences of sarcopenia in older adults. However, whilst there is considerable evidence demonstrating that RE is an effective intervention for improving muscle strength and function in healthy older adults, much less is known about its benefits in older people living with sarcopenia. Furthermore, evidence for its optimal prescription and delivery is very limited and any potential benefits of RE are unlikely to be realised in the absence of an appropriate exercise dose. We provide a summary of the underlying principles of effective RE prescription (specificity, overload and progression) and discuss the main variables (training frequency, exercise selection, exercise intensity, exercise volume and rest periods) that can be manipulated when designing RE programmes. Following this, we propose that an RE programme that consists of two exercise sessions per week and involves a combination of upper- and lower-body exercises performed with a relatively high degree of effort for 1-3 sets of 6-12 repetitions is appropriate as a treatment for sarcopenia. The principles of RE prescription outlined here and the proposed RE programme presented in this paper provide a useful resource for clinicians and exercise practitioners treating older adults with sarcopenia and will also be of value to researchers for standardising approaches to RE interventions in future sarcopenia studies.
Topics: Aged; Humans; Muscle Strength; Muscle, Skeletal; Prescriptions; Resistance Training; Sarcopenia
PubMed: 35150587
DOI: 10.1093/ageing/afac003 -
Ageing Research Reviews May 2021Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and... (Meta-Analysis)
Meta-Analysis Review
The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis.
BACKGROUND
Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear.
AIMS
This systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults.
METHODS
Six databases were searched from their inception to June 21, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses.
RESULTS
A total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001).
CONCLUSIONS
Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
Topics: Aged; Aged, 80 and over; Exercise; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Sedentary Behavior
PubMed: 33607291
DOI: 10.1016/j.arr.2021.101266 -
Annals of Physical and Rehabilitation... Feb 2023To evaluate the effects of a home-based respiratory muscle training programme (inspiratory [IMT] or inspiratory/expiratory muscles [RMT]) supervised by... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the effects of a home-based respiratory muscle training programme (inspiratory [IMT] or inspiratory/expiratory muscles [RMT]) supervised by telerehabilitation on quality of life and exercise tolerance in individuals with long-term post-COVID-19 symptoms. The secondary objective was to evaluate the effects of these programmes on respiratory muscle function, physical and lung function, and psychological state.
METHODS
88 individuals with long-term symptoms of fatigue and dyspnoea after COVID-19 diagnosis were randomly (1:1 ratio) assigned to IMT, IMT, RMT or RMT groups for an 8-week intervention (40min/day, 6 times/week). Primary outcomes were quality of life (EuroQol-5D questionnaire) and exercise tolerance (Ruffier test). Secondary outcomes were respiratory muscle function (inspiratory/expiratory muscle strength; inspiratory muscle endurance), physical function (lower and upper limb strength [1-min Sit-to-Stand and handgrip force]), lung function (forced spirometry), and psychological status (anxiety/depression levels and post-traumatic stress disorder). All outcomes were measured pre-, intermediate- (4 week), and post-intervention.
RESULTS
At post-intervention, there was a statistically significant and large (d>0.90) improvement in quality of life, but not in exercise tolerance, in the RMT group compared with the RMT group. Both of the real training groups produced a statistically significant and large increase in inspiratory muscle strength and endurance (d≥0.80) and in lower limb muscle strength (d≥0.77) compared with the 2 sham groups. Expiratory muscle strength and peak expiratory flow showed a statistically significant and large (d≥0.87) increase in the RMT group compared with the other 3 groups.
CONCLUSION
Only an 8-week supervised home-based RMT programme was effective in improving quality of life, but not exercise tolerance, in individuals with long-term post-COVID-19 symptoms. In addition, IMT and RMT programmes were effective in improving respiratory muscle function and lower limb muscle strength, but had no impact on lung function and psychological status.
Topics: Humans; Quality of Life; COVID-19 Testing; Hand Strength; COVID-19; Breathing Exercises; Respiratory Muscles; Muscle Strength
PubMed: 36191860
DOI: 10.1016/j.rehab.2022.101709 -
Journal of Cachexia, Sarcopenia and... Dec 2022Sarcopenia is an age-related muscle disorder typically associated with a poor quality of life. Its definition has evolved over time, and several underlying causes of... (Review)
Review
Sarcopenia is an age-related muscle disorder typically associated with a poor quality of life. Its definition has evolved over time, and several underlying causes of sarcopenia in the elderly have been proposed. However, the exact mechanisms involved in sarcopenia, as well as effective treatments for this condition, are not fully understood. The purpose of this article was to conduct a comprehensive review of previous evidence regarding the definition, diagnosis, risk factors, and efficacy of plant-derived natural products for sarcopenia. The methodological approach for the current narrative review was performed using PubMed, Scopus, and Web of Science databases, as well as Google Scholar (up to March 2021) in order to satisfy our objectives. The substantial beneficial effects along with the safety of some plant-derived natural products including curcumin, resveratrol, catechin, soy protein, and ginseng on sarcopenia are reported in this review. Based on clinical studies, nutraceuticals and functional foods may have beneficial effects on physical performance, including handgrip and knee-extension strength, weight-lifting capacity, time or distance travelled before feeling fatigued, mitochondrial function, muscle fatigue, mean muscle fibre area, and total number of myonuclei. In preclinical studies, supplementation with herbs and natural bioactive compounds resulted in beneficial effects including increased plantaris mass, skeletal muscle mass and strength production, increased expression of anabolic factors myogenin, Myf5 and MyoD, enhanced mitochondrial capacity, and inhibition of muscle atrophy and sarcopenia. We found that several risk factors such as nutritional status, physical inactivity, inflammation, oxidative stress, endocrine system dysfunction, insulin resistance, history of chronic disease, mental health, and genetic factors are linked or associated with sarcopenia. The substantial beneficial effects of some nutraceuticals and functional foods on sarcopenia, including curcumin, resveratrol, catechin, soy protein, and ginseng, without any significant side effects, are reported in this review. Plant-derived natural products might have a beneficial effect on various components of sarcopenia. Nevertheless, due to limited human trials, the clinical benefits of plant-derived natural products remain inconclusive. It is suggested that comprehensive longitudinal clinical studies to better understand risk factors over time, as well as identifying a treatment strategy for sarcopenia that is based on its pathophysiology, be undertaken in future investigations.
Topics: Humans; Aged; Muscle Strength; Hand Strength; Biological Products; Quality of Life; Soybean Proteins; Sarcopenia
PubMed: 35961944
DOI: 10.1002/jcsm.13057