Abstract
To systematically review and analyse the effects of exercise on morphological and neuromuscular muscle quality (MQ) outcomes in older adults and assess a range of possible moderators that may affect the impact of exercise on MQ outcomes. Using PRISMA guidelines, randomised controlled trials were searched in CINAHL, EMBASE, LILACS, PubMed, SciELO, Web of Science, MedNar, OpenGrey and OpenThesis databases. Eligible trials examined the effects of exercise interventions on morphological and neuromuscular MQ in older adults (≥ 60 years). Twenty-one trials (n = 973 participants) were included. Exercise significantly improved morphological MQ (effect size (ES) = 0.32, 95% CI 0.13–0.51, P < 0.001) with significant results maintained for studies assessing muscle density and intermuscular adipose tissue (ES = 0.45–0.52, P < 0.05). For neuromuscular MQ, exercise provided significant positive effects (ES = 0.49, 95% CI 0.29–0.69, P < 0.001) but only maintained for physically healthy participants (ES = 0.43, P < 0.001), resistance exercise interventions (ES = 0.64, P < 0.001), or studies assessing 1-RM or knee extensor isokinetic muscle strength relative to leg lean mass (ES = 0.48–0.62, P = 0.001). Associations between exercise duration and changes in MQ measures were not observed (P > 0.05). Supervised exercise interventions significantly improved different measures of MQ regardless of exercise duration, although these effects were small-to-moderate and not supported across all population-, exercise-, and methods-related features.
Highlights
To systematically review and analyse the effects of exercise on morphological and neuromuscular muscle quality (MQ) outcomes in older adults and assess a range of possible moderators that may affect the impact of exercise on MQ outcomes
The present systematic review and meta-analysis examining the effects of exercise on morphological and neuromuscular MQ outcomes in older adults produced three important findings
Significant exercise effects were observed on neuromuscular MQ outcomes and these were mainly derived from supervised resistance exercise in physically healthy older adults
Summary
To systematically review and analyse the effects of exercise on morphological and neuromuscular muscle quality (MQ) outcomes in older adults and assess a range of possible moderators that may affect the impact of exercise on MQ outcomes. Neuromuscular MQ is the force produced per unit of muscle mass and is assessed by the ratio between a wide range of muscle strength (e.g., one-repetition maximum (1-RM), isometric and isokinetic) and muscle size assessments (e.g., muscle thickness, cross-sectional area, muscle volume, and lean mass)[13] Both morphological and neuromuscular MQ maintenance or improvement are deemed important for older adults in order to preserve or enhance physical function and metabolic h ealth[8,9]. Muscle strength is augmented to a greater extent and faster than muscle size resulting in increased neuromuscular MQ16,18,21, this is conflicting with previous studies undertaking different assessment methods or assessing different muscles presenting no meaningful change following resistance exercise 19,20 It is unclear whether specific study characteristics such as the population included, assessment techniques, or even different intervention characteristics (e.g., exercise mode, alone or combined with nutrition programs) are influencing the magnitude of exercise effects on morphological and neuromuscular MQ features. Despite a previous meta-analysis examining exercise effects on intermuscular adipose tissue and muscle density in adults with different metabolic disorders[22], the lack of specific analyses involving older adults preclude determining the efficacy of exercise strategies in this population
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