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Journal of Cachexia, Sarcopenia and... Feb 2022Sarcopenia is defined as the loss of muscle mass and strength. Despite the seriousness of this disease, a single diagnostic criterion has not yet been established. Few... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sarcopenia is defined as the loss of muscle mass and strength. Despite the seriousness of this disease, a single diagnostic criterion has not yet been established. Few studies have reported the prevalence of sarcopenia globally, and there is a high level of heterogeneity between studies, stemmed from the diagnostic criteria of sarcopenia and the target population. The aims of this systematic review and meta-analysis were (i) to identify and summarize the diagnostic criteria used to define sarcopenia and severe sarcopenia and (ii) to estimate the global and region-specific prevalence of sarcopenia and severe sarcopenia by sociodemographic factors.
METHODS
Embase, MEDLINE, and Web of Science Core Collections were searched using relevant MeSH terms. The inclusion criteria were cross-sectional or cohort studies in individuals aged ≥18 years, published in English, and with muscle mass measured using dual-energy x-ray absorptiometry, bioelectrical impedance, or computed tomography (CT) scan. For the meta-analysis, studies were stratified by diagnostic criteria (classifications), cut-off points, and instruments to assess muscle mass. If at least three studies reported the same classification, cut-off points, and instrument to measure muscle mass, they were considered suitable for meta-analysis. Following this approach, 6 classifications and 23 subgroups were created. Overall pooled estimates with inverse-variance weights obtained from a random-effects model were estimated using the metaprop command in Stata.
RESULTS
Out of 19 320 studies, 263 were eligible for the narrative synthesis and 151 for meta-analysis (total n = 692 056, mean age: 68.5 years). Using different classifications and cut-off points, the prevalence of sarcopenia varied between 10% and 27% in the studies included for meta-analysis. The highest and lowest prevalence were observed in Oceania and Europe using the European Working Group on Sarcopenia in Older People (EWGSOP) and EWGSOP2, respectively. The prevalence ranged from 8% to 36% in individuals <60 years and from 10% to 27% in ≥60 years. Men had a higher prevalence of sarcopenia using the EWGSOP2 (11% vs. 2%) while it was higher in women using the International Working Group on Sarcopenia (17% vs. 12%). Finally, the prevalence of severe sarcopenia ranged from 2% to 9%.
CONCLUSIONS
The prevalence of sarcopenia and severe sarcopenia varied considerably according to the classification and cut-off point used. Considering the lack of a single diagnostic for sarcopenia, future studies should adhere to current guidelines, which would facilitate the comparison of results between studies and populations across the globe.
Topics: Absorptiometry, Photon; Adolescent; Adult; Aged; Electric Impedance; Female; Hand Strength; Humans; Male; Prevalence; Sarcopenia
PubMed: 34816624
DOI: 10.1002/jcsm.12783 -
Sports Medicine (Auckland, N.Z.) Nov 2016A number of resistance training (RT) program variables can be manipulated to maximize muscular hypertrophy. One variable of primary interest in this regard is RT... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A number of resistance training (RT) program variables can be manipulated to maximize muscular hypertrophy. One variable of primary interest in this regard is RT frequency. Frequency can refer to the number of resistance training sessions performed in a given period of time, as well as to the number of times a specific muscle group is trained over a given period of time.
OBJECTIVE
We conducted a systematic review and meta-analysis to determine the effects of resistance training frequency on hypertrophic outcomes.
METHODS
Studies were deemed eligible for inclusion if they met the following criteria: (1) were an experimental trial published in an English-language refereed journal; (2) directly compared different weekly resistance training frequencies in traditional dynamic exercise using coupled concentric and eccentric actions; (3) measured morphologic changes via biopsy, imaging, circumference, and/or densitometry; (4) had a minimum duration of 4 weeks; and (5) used human participants without chronic disease or injury. A total of ten studies were identified that investigated RT frequency in accordance with the criteria outlined.
RESULTS
Analysis using binary frequency as a predictor variable revealed a significant impact of training frequency on hypertrophy effect size (P = 0.002), with higher frequency being associated with a greater effect size than lower frequency (0.49 ± 0.08 vs. 0.30 ± 0.07, respectively). Statistical analyses of studies investigating training session frequency when groups are matched for frequency of training per muscle group could not be carried out and reliable estimates could not be generated due to inadequate sample size.
CONCLUSIONS
When comparing studies that investigated training muscle groups between 1 to 3 days per week on a volume-equated basis, the current body of evidence indicates that frequencies of training twice a week promote superior hypertrophic outcomes to once a week. It can therefore be inferred that the major muscle groups should be trained at least twice a week to maximize muscle growth; whether training a muscle group three times per week is superior to a twice-per-week protocol remains to be determined.
Topics: Exercise; Humans; Hypertrophy; Muscle Fatigue; Muscle Strength; Muscle, Skeletal; Resistance Training
PubMed: 27102172
DOI: 10.1007/s40279-016-0543-8 -
Nutrients Feb 2023The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body... (Meta-Analysis)
Meta-Analysis Review
The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body composition (BC) requirements must be adapted to the present. The aim of this systematic review and meta-analysis was to describe the anthropometric, BC, and somatotype characteristics of professional MSP and to compare the values reported according to the methods and equations used. We systematically searched Embase, PubMed, SPORTDiscus, and Web of Science following the PRISMA statement. Random-effects meta-analysis, a pooled summary of means, and 95% CI (method or equation) were calculated. Random models were used with the restricted maximum likelihood (REML) method. Seventy-four articles were included in the systematic review and seventy-three in the meta-analysis. After comparing the groups according to the assessment method (kinanthropometry, bioimpedance, and densitometry), significant differences were found in height, fat mass in kilograms, fat mass percentage, and fat-free mass in kilograms ( = 0.001; < 0.0001). Taking into account the equation used to calculate the fat mass percentage and ∑skinfolds, significant differences were observed in the data reported according to groups ( < 0.001). Despite the limitations, this study provides useful information that could help medical technical staff to properly assess the BC of professional MSP, providing a range of guidance values for the different BC.
Topics: Humans; Male; Soccer; Body Composition; Anthropometry; Somatotypes
PubMed: 36904159
DOI: 10.3390/nu15051160 -
Sports Medicine (Auckland, N.Z.) Apr 2015Maximizing the hypertrophic response to resistance training (RT) is thought to be best achieved by proper manipulation of exercise program variables including exercise... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Maximizing the hypertrophic response to resistance training (RT) is thought to be best achieved by proper manipulation of exercise program variables including exercise selection, exercise order, length of rest intervals, intensity of maximal load, and training volume. An often overlooked variable that also may impact muscle growth is repetition duration. Duration amounts to the sum total of the concentric, eccentric, and isometric components of a repetition, and is predicated on the tempo at which the repetition is performed.
OBJECTIVE
We conducted a systematic review and meta-analysis to determine whether alterations in repetition duration can amplify the hypertrophic response to RT.
METHODS
Studies were deemed eligible for inclusion if they met the following criteria: (1) were an experimental trial published in an English-language refereed journal; (2) directly compared different training tempos in dynamic exercise using both concentric and eccentric repetitions; (3) measured morphologic changes via biopsy, imaging, and/or densitometry; (4) had a minimum duration of 6 weeks; (5) carried out training to muscle failure, defined as the inability to complete another concentric repetition while maintaining proper form; and (6) used human subjects who did not have a chronic disease or injury. A total of eight studies were identified that investigated repetition duration in accordance with the criteria outlined.
RESULTS
Results indicate that hypertrophic outcomes are similar when training with repetition durations ranging from 0.5 to 8 s.
CONCLUSIONS
From a practical standpoint it would seem that a fairly wide range of repetition durations can be employed if the primary goal is to maximize muscle growth. Findings suggest that training at volitionally very slow durations (>10s per repetition) is inferior from a hypertrophy standpoint, although a lack of controlled studies on the topic makes it difficult to draw definitive conclusions.
Topics: Adaptation, Physiological; Humans; Muscle Fatigue; Muscle Strength; Muscle, Skeletal; Resistance Training; Time Factors
PubMed: 25601394
DOI: 10.1007/s40279-015-0304-0 -
Osteoporosis International : a Journal... Apr 2016Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important... (Review)
Review
Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. [Table: see text] Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.
Topics: Absorptiometry, Photon; Aging; Body Composition; Bone Density; Bone Development; Evidence-Based Medicine; Exercise; Humans; Life Style; Nutritional Physiological Phenomena; Osteoporosis; Osteoporotic Fractures; Tomography, X-Ray Computed; Weight-Bearing
PubMed: 26856587
DOI: 10.1007/s00198-015-3440-3 -
Journal of Strength and Conditioning... Sep 2017Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and... (Meta-Analysis)
Meta-Analysis Review
Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and meta-analysis. J Strength Cond Res 31(9): 2599-2608, 2017-Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric vs. eccentric training in healthy adults after regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English-language refereed journal; (b) directly compared concentric and eccentric actions without the use of external implements (i.e., blood pressure cuffs) and all other RT variables equivalent; (c) measured morphologic changes using biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; (d) had a minimum duration of 6 weeks; and (e) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared with concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; 95% confidence interval: -0.03 to 0.52; p = 0.076). The mean percent change in muscle growth across studies favored eccentric compared with concentric actions (10.0% vs. 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program, as both have shown to be effective in increasing muscle hypertrophy.
Topics: Adult; Biopsy; Electric Impedance; Exercise; Female; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Randomized Controlled Trials as Topic; Resistance Training
PubMed: 28486337
DOI: 10.1519/JSC.0000000000001983 -
International Journal of Environmental... Jun 2021Anthropometrics are a set of direct quantitative measurements of the human body's external dimensions, which can be used as indirect measures of body composition. Due to... (Review)
Review
Anthropometrics are a set of direct quantitative measurements of the human body's external dimensions, which can be used as indirect measures of body composition. Due to a number of limitations of conventional manual techniques for the collection of body measurements, advanced systems using three-dimensional (3D) scanners are currently being employed, despite being a relatively new technique. A systematic review was carried out using Pubmed, Medline and the Cochrane Library to assess whether 3D scanners offer reproducible, reliable and accurate data with respect to anthropometrics. Although significant differences were found, 3D measurements correlated strongly with measurements made by conventional anthropometry, dual-energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP), among others. In most studies (61.1%), 3D scanners were more accurate than these other techniques; in fact, these scanners presented excellent accuracy or reliability. 3D scanners allow automated, quick and easy measurements of different body tissues. Moreover, they seem to provide reproducible, reliable and accurate data that correlate well with the other techniques used.
Topics: Absorptiometry, Photon; Anthropometry; Body Composition; Humans; Plethysmography; Reproducibility of Results; Somatotypes
PubMed: 34201258
DOI: 10.3390/ijerph18126213 -
Journal of Neurosurgery. Spine Apr 2023Osteoporosis has significant implications in spine fusion surgery, for which reduced spinal bone mineral density (BMD) can result in complications and poorer outcomes.... (Review)
Review
OBJECTIVE
Osteoporosis has significant implications in spine fusion surgery, for which reduced spinal bone mineral density (BMD) can result in complications and poorer outcomes. Currently, dual-energy x-ray absorptiometry (DEXA) is the gold standard for radiographic diagnosis of osteoporosis, although DEXA accuracy may be limited by the presence of degenerative spinal pathology. In recent years, there has been an evolving interest in using alternative imaging, including CT and MRI, to assess BMD. In this systematic review of the literature, the authors assessed the use and effectiveness of MRI, opportunistic CT (oCT), and quantitative CT (qCT) to measure BMD.
METHODS
In accordance with the PRISMA guidelines, the authors conducted a systematic search for articles posted on PubMed between the years 2000 and 2022 by using the keywords "opportunistic CT, quantitative CT, MRI" AND "bone density" AND "spine." Inclusion criteria consisted of articles written in English that reported studies pertaining to human or cadaveric subjects, and studies including a measure of spinal BMD. Articles not related to spinal BMD, osteoporosis, or spinal surgery or reports of studies that did not include the use of spinal MRI or CT were excluded. Key study outcomes were extracted from included articles, and qualitative analysis was subsequently performed.
RESULTS
The literature search yielded 302 articles. Forty-two articles reported studies that met the final inclusion criteria. Eighteen studies utilized MRI protocols to correlate spinal BMD with vertebral bone quality scores, M-scores, and quantitative perfusion markers. Eight studies correlated oCT with spinal BMD, and 16 studies correlated qCT with spinal BMD. With oCT and qCT imaging, there was consensus that Hounsfield unit (HU) values > 160 demonstrated significant reduction in risk of osteoporosis, whereas HU values < 110 were significantly correlated with osteoporosis.
CONCLUSIONS
Osteoporosis is increasingly recognized as a significant risk factor for complications after spinal fusion surgery. Consequently, preoperative assessment of BMD is a critical factor to consider in planning surgical treatment. Although DEXA has been the gold standard for BMD measurement, other imaging modalities, including MRI, oCT, and qCT, appear to be viable alternatives and may offer cost and time savings.
Topics: Humans; Bone Density; Absorptiometry, Photon; Tomography, X-Ray Computed; Osteoporosis; Spine; Lumbar Vertebrae; Retrospective Studies
PubMed: 36609369
DOI: 10.3171/2022.11.SPINE22875 -
Gerontology 2022The measurement of appendicular muscle mass is essential for the diagnosis of sarcopenia. Ultrasonography is an accurate and convenient method used to evaluate muscle... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The measurement of appendicular muscle mass is essential for the diagnosis of sarcopenia. Ultrasonography is an accurate and convenient method used to evaluate muscle mass.
OBJECTIVE
The aim of the study was to evaluate the diagnostic value of ultrasonography for appendicular muscle mass in sarcopenia in older adults and find out proper ultrasound parameters.
METHODS
Medline, Embase, Cochrane, and Web of Science databases were searched for relevant articles. Published studies on the validity and/or reliability of ultrasonography for quantifying muscle mass of the limbs in sarcopenia in the older population were included. A systematic review was conducted based on specific muscles and reference methods. A meta-analysis was conducted to assess the validity and reliability of the ultrasonography.
RESULTS
Forty articles were included in this review. There were nine, nine, nine, and four studies included in the qualitative synthesis for a diagnostic test, correlation coefficient, intra-class reliability, and inter-class reliability, respectively. The diagnostic value of rectus femoris (RF) or gastrocnemius (GM) thickness on ultrasonography for sarcopenia or low muscle mass was moderate (the area under summary receiver operating characteristic curve [SROC] = 0.76, 95% confidence interval [CI]: 0.72-0.79, SROC = 0.80, 95% CI: 0.76-0.83, respectively). The pooled correlation between muscle mass on dual-energy X-ray (DXA) or bioelectrical impedance analysis (BIA) and muscle thickness (MT) on ultrasound was moderate (r = 0.56, 95% CI: 0.49-0.62). There was a low-to-moderate correlation between muscle mass on DXA or BIA and cross-sectional area (CSA) on ultrasound (r = 0.267-0.584). The correlation was high to very high between muscle mass from DXA and the ultrasound-predicted formula (r = 0.85-0.963). The CSA from ultrasound had a high or very high correlation with that from computed tomography or magnetic resonance imaging (r = 0.826, intra (inter)-correlation coefficient [ICC] = 0.998-0.999). The respective meta-analyses showed good inter-rater and intra-rater reliabilities (ICC > 0.9).
CONCLUSION
Ultrasonography is a reliable and valid diagnostic method for the quantitative assessment of appendicular muscle mass in sarcopenia in older people. The thickness and CSA of the RF or GM seem to be proper ultrasound parameters to predict muscle mass in sarcopenia. Multicenter studies with large samples and the application of new ultrasonic techniques will be the future research directions.
Topics: Absorptiometry, Photon; Aged; Body Composition; Humans; Muscle, Skeletal; Quadriceps Muscle; Reproducibility of Results; Sarcopenia; Ultrasonography
PubMed: 35878591
DOI: 10.1159/000525758 -
The Oncologist Feb 2020The loss of muscle mass, known as sarcopenia, is a natural process of aging that is associated with adverse health outcomes regardless of age. Because cancer is a... (Review)
Review
BACKGROUND
The loss of muscle mass, known as sarcopenia, is a natural process of aging that is associated with adverse health outcomes regardless of age. Because cancer is a disease of aging, interest in sarcopenia and its potential impact in multiple cancer populations has increased significantly. Bioelectrical impedance analysis (BIA) is a guideline-accepted method for sarcopenia detection. This systematic review assesses the literature pertaining to BIA use in the detection of sarcopenia in adults with cancer.
MATERIALS AND METHODS
In this systematic review, a search of the literature for randomized controlled trials and observational studies was conducted using MEDLINE, Cochrane CENTRAL, and EMBASE, through July 15, 2019. The study is registered at Prospero (CRD 42019130707). For study inclusion, patients had to be aged 18 years or older and diagnosed with solid or hematological neoplasia, and BIA had to be used to detect sarcopenia.
RESULTS
Through our search strategy, 5,045 articles were identified, of which 24 studies were selected for inclusion in the review (total number of 3,607 patients). In five studies, BIA was rated comparable to axial computed tomography (CT) scan, calf circumference, or grip strength for sarcopenia screening. In 14 studies, BIA-identified sarcopenia was associated with adverse clinical outcomes.
CONCLUSION
BIA is an accurate method for detecting sarcopenia in adults with cancer prior to treatment and is a viable alternative to CT, dual-energy x-ray absorptiometry, and magnetic resonance imaging in oncology clinical practice.
IMPLICATIONS FOR PRACTICE
Bioelectrical impedance analysis (BIA) is an attractive method for identifying sarcopenic patients in clinical practice because it provides an affordable, noninvasive test that can be completed within a few minutes during a clinic visit. BIA does not require highly skilled personnel, and results are immediately available. This systematic review summarizes the literature pertaining to BIA assessment of sarcopenia in adults with cancer, with a focus on its use in diverse cancer populations.
Topics: Absorptiometry, Photon; Adult; Body Composition; Electric Impedance; Humans; Neoplasms; Sarcopenia
PubMed: 32043785
DOI: 10.1634/theoncologist.2019-0600