Abstract
Older adults with knee osteoarthritis (KOA) are at high risk of sarcopenia. Protein-rich nutritional composition supplementation (PS) combined with resistance exercise training (RET) improves muscle gains and facilitates physical activity in older adults. However, whether PS augments the effects of RET on muscle mass and PA in patients with KOA remains unclear. Therefore, this study identified the effects of PS on sarcopenic indices and PA in older women with KOA subjected to an RET program. Eligible older women aged 60–85 years and diagnosed as having KOA were randomly assigned to either the experimental group (EG) or the control group (CG). Both groups performed RET twice a week for 12 weeks. The EG received additional PS during this period. Outcome measures included appendicular lean mass index, walking speed, physical activity, and scores on the Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC). All measures were tested at baseline and after intervention. With participant characteristics and baseline scores as covariates, analysis of variance was performed to identify between-group differences in changes in all outcome measures after intervention. Statistical significance was defined as p < 0.05. Compared with the CG, the EG achieved greater changes in appendicular lean mass index (adjusted mean difference (aMD) = 0.19 kg/m2, p < 0.01), physical activity (aMD = 30.0 MET-hour/week, p < 0.001), walking speed (aMD = 0.09 m/s, p < 0.05), and WOMAC global function (aMD = −8.21, p < 0.001) after intervention. In conclusion, PS exerted augmentative effects on sarcopenic indices, physical activity, and perceived global WOMAC score in older women with KOA through 12 weeks of RET.
Highlights
Knee osteoarthritis (KOA) is one of the most prevalent musculoskeletal diseases in older adults [1], with negative effects on both individuals’ physical well-being and public health [2]
Given that lean leg mass is closely associated with muscle power in KOA [22] and that low levels of skeletal muscle mass are closely associated with physical difficulties and poor health status in elderly patients [23,24], sarcopenia may be independently associated with muscle weakness and physical decline over the course of KOA, which further highlights the role of muscle in the genesis and management of KOA [25,26]
All included participants were randomly allocated to the experimental group (EG) (n = 36) or control group (CG) (n = 36) after they provided informed consent at pretest
Summary
Knee osteoarthritis (KOA) is one of the most prevalent musculoskeletal diseases in older adults [1], with negative effects on both individuals’ physical well-being and public health [2]. Several observational studies have indicated that patients with KOA have a significantly lower percentage of lean body mass than their counterparts without this condition [16,18,19]. Lee et al observed that a low skeletal muscle mass index value in the legs is an independent risk factor for KOA [20]; Kim et al indicated that the skeletal muscle mass index is significantly negatively associated with the Kellgren-Lawrence classification for KOA [10]. Given that lean leg mass is closely associated with muscle power in KOA [22] and that low levels of skeletal muscle mass are closely associated with physical difficulties and poor health status in elderly patients [23,24], sarcopenia may be independently associated with muscle weakness and physical decline over the course of KOA, which further highlights the role of muscle in the genesis and management of KOA [25,26]. The maintenance of muscle strength and the prevention of sarcopenia are critical for enabling older adults with KOA to perform activities of daily living independently
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