Abstract
BackgroundEngaging 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. AimsThis 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. MethodsSix databases were searched from their inception to June 21st, 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. ResultsA 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). ConclusionsHigher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
Highlights
Low physical activity (PA) and high sedentary behavior (SB) present a global health challenge and they are important in older adult populations as PA declines and SB increases with increasing age (Arnardottir et al, 2013; Ortlieb et al, 2014; Reid and Fielding, 2012)
Full texts were assessed of 1,017 articles and 112 articles were included (Fig. 1); all extracted data are provided in tables in Appendix C (Tables C1-C5), which are synthesized in Figs. 2-4 and in figures in Appendix D
Other articles included community dwelling pop ulations selected for specific disease and included chronic obstructive pulmonary disorder (n = 14), osteoarthritis (n = 6), diabetes (n = 3), limited mobility (n = 3), any chronic disease (n = 1), HIV (n = 1), interstitial lung disease (n = 1), peripheral artery disease (n = 1), global cognitive impairment (n = 1), aortic stenosis (n = 1), stroke (n = 1), chronic idiopathic axonal polyneuropathy (n = 1), and polio (n = 1)
Summary
Low physical activity (PA) and high sedentary behavior (SB) present a global health challenge and they are important in older adult populations as PA declines and SB increases with increasing age (Arnardottir et al, 2013; Ortlieb et al, 2014; Reid and Fielding, 2012). PA is defined as any bodily movement produced by skeletal muscle that requires energy expenditure (Caspersen et al, 1985), while SB is defined as periods of waking activity that produce little or no energy expenditure (Tremblay, 2012; Tremblay et al, 2017) Both PA and SB can be most accurately captured by objective devices such as accelerometers or pe dometers, which can capture the incidental, unstructured, and light-intensity movement characterizing the majority of PA in older adults that can otherwise be subject to significant bias when self-reported (Amagasa et al, 2017; Lee and Shiroma, 2014; Lohne- Seiler et al, 2014). Methods: Six databases were searched from their inception to June 21st, 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. Conclusions: Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, with the chair stand test
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