Abstract
ObjectiveWe conducted a systematic review and meta-analysis to clarify the effects of different exercise modes (resistance training [RT], whole body vibration training [WBVT], and mixed training [MT, resistance training combined with other exercises such as balance, endurance and aerobic training]) on muscle strength (knee extension strength [KES]) and physical performance (Timed Up and Go [TUG], gait speed [GS] and the Chair Stand [CS]) in older people with sarcopenia.MethodAll studies published from January 2010 to March 2021 on the effects of exercise training in older people with sarcopenia were retrieved from 6 electronic databases: Pubmed, Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure (CNKI), and Wanfang Database. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Pooled analyses for pre- and post- outcome measurements were performed using Review Manager 5.4 with standardized mean differences (SMDs) and fixed-effect models.ResultTwenty-six studies (25 randomized controlled trails [RCTs] and one non-randomized controlled trail) were included in this study with 1191 older people with sarcopenia (mean age 60.6 ± 2.3 to 89.5 ± 4.4). Compared with a control group, RT and MT significantly improved KES (RT, SMD = 1.36, 95% confidence intervals [95% CI]: 0.71 to 2.02, p < 0.0001, I2 = 72%; MT, SMD = 0.62, 95% CI: 0.29 to 0.95, p = 0.0002, I2 = 56%) and GS (RT, SMD = 2.01, 95% CI: 1.04 to 2.97, p < 0.0001, I2 = 84%; MT, SMD = 0.69, 95% CI: 0.29 to 1.09, p = 0.008, I2 = 81%). WBVT showed no changes in KES (SMD = 0.65, 95% CI: − 0.02 to 1.31, p = 0.06, I2 = 80%) or GS (SMD = 0.12, 95% CI: − 0.15 to 0.39, p = 0.38, I2 = 0%). TUG times were significantly improved with all exercise training modes (SMD = -0.66, 95% CI: − 0.94 to − 0.38, p < 0.00001, I2 = 60%). There were no changes in CS times with any of the exercise training modes (SMD = 0.11, 95% CI: − 0.36 to 0.57, p = 0.65, I2 = 87%).ConclusionsIn older people with sarcopenia, KES and GS can be improved by RT and MT, but not by WBVT. All three training modes improved TUG times, but not improved CS times.
Highlights
Sarcopenia is an age-dependent geriatric syndrome characterized by skeletal muscle mass loss, muscle strength and/or declines in physical performance [1].A meta-analysis in 2020 indicated that the prevalence of sarcopenia was 9–10% in community-dwelling individuals, 30–50% in nursing-home individuals and 23–24% in hospitalized individuals [2]
The results of our studies showed that resistance training (RT) can improve knee extension strength (KES), Timed Up and Go (TUG) times and gait speed (GS), but not Chair Stand (CS) times; Whole Body Vibration training (WBVT) have a positive effect on TUG times, but did not have a significant effect on KES, GS and CS times; The effect of mixed training (MT) is similar with RT, which can improve KES, TUG times and GS, but not CS times
In older people with sarcopenia, the findings show that resistance training (RT) and mixed training (MT) exercise training modes have positive effects on knee extension strength (KES) and physical performance tests of the Timed Up and Go (TUG) and gait speed (GS), but did not improve performance in the Chair Stand (CS)
Summary
Sarcopenia is an age-dependent geriatric syndrome characterized by skeletal muscle mass loss, muscle strength and/or declines in physical performance [1].A meta-analysis in 2020 indicated that the prevalence of sarcopenia was 9–10% in community-dwelling individuals, 30–50% in nursing-home individuals and 23–24% in hospitalized individuals [2]. Sarcopenia is associated with several adverse outcomes, including falls and secondary fractures [3, 4], pulmonary insufficiency [5], sleep disorders [6], cognitive impairment [7], poor quality of health-life [8] and premature mortality [9], all of which bring significant medical and economic burdens. Sarcopenia increases the risk of hospitalization of older people [10, 11]. In 2000, the costs for sarcopenia-related conditions in the United States was $18.5 billion, which represented 1.5% of the annual medical expenditures [13]. The prevention and treatment for sarcopenia is important to maintain physical function and improve health outcomes for older people and to reduce medical expenditures associated with sarcopenia
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