scholarly journals Effects of Physical Exercise Programs on Sarcopenia Management, Dynapenia, and Physical Performance in the Elderly: A Systematic Review of Randomized Clinical Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Renato Gorga Bandeira de Mello ◽  
Roberta Rigo Dalla Corte ◽  
Joana Gioscia ◽  
Emilio Hideyuki Moriguchi
Keyword(s):  
Clinical Trials ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Muscle Mass ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
The Elderly ◽  
Muscle Quality ◽  
Exercise Programs ◽  
Pubmed Database

Introduction. Sarcopenia is a prevalent condition in the elderly population, imposing a significant impact over their functional ability as well as their quality of life. Furthermore, it is associated with greater incidence of major geriatric outcomes, as reduced mobility, falls, loss of independence, cognitive impairment, and all-cause mortality. Physical Exercise Programs directed to improve muscle mass and its function may be key to reduce sarcopenia consequences. However, a significant heterogeneity is found in clinical trials, especially as a consequence of different exercise protocols applied to research subjects. Objectives. To access the effects of physical exercise programs compared to no exercise interventions to improve sarcopenia components and its determinants in sarcopenic elder individuals. Methods. A systematic review was conducted in the Pubmed database to identify randomized clinical trials (RCTs) which tested the effects of physical exercise programs to manage sarcopenia components in sarcopenic elder individuals. Two independent reviewers assessed the studies’ eligibility according to specified inclusion criteria in a four-step strategy. Data regarding population characteristics, muscle mass, muscle quality, muscle strength, and muscle function were extracted from each one of the included studies. Assessment of quality and individual studies risk of bias were assessed through Cochrane Risk of Bias Tool®. Assuming theoretical expected heterogeneity among studies, especially regarding different physical exercise programs and different outcome measurements, authors decided to be conservative and present study results in descriptive tables. Results. Search strategy retrieved 298 papers on PubMed database. Three more were identified through manual search, being 301 studies revised for inclusion. 278 were excluded during title/abstract review. After further evaluation of 23 full-texts, 5 RCTs were included. All 5 trials tested the efficacy of isolated exercise programs to improve sarcopenia components in the elderly compared to no physical intervention. Resistance training was the main intervention component in all included trials compared to inactive control groups (health education mainly). Physical training improved muscle strength, muscle quality, and muscle function compared to inactive control groups. Considering muscle mass, no differences were demonstrated. Data meta-analysis was not possible to be performed due to high heterogeneity among trials and small number of studies for each outcome comparison. Conclusion. Heterogeneity among trials and small number of RCTs limited robust conclusions and data meta-analysis. However, resistance training protocols can improve muscle strength and physical performance in elders previously diagnosed with sarcopenia, although its effect size and clinical impact are barely relevant.

scholarly journals The Effects of Physical Exercise on Balance and Prevention of Falls in Older People: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (8) ◽  
pp. 2595 ◽  
Author(s):  
Giuseppe Francesco Papalia ◽  
Rocco Papalia ◽  
Lorenzo Alirio Diaz Balzani ◽  
Guglielmo Torre ◽  
Biagio Zampogna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Randomized Clinical Trials ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Elderly ◽  
Risk Of Bias ◽  
Number Of Patients

The aims of this systematic review and meta-analysis were to evaluate the effects of physical exercise on static and dynamic balance in the elderly population, and to analyze the number of falls and fallers. A systematic literature search was conducted using PubMed–Medline, Cochrane Central, and Google Scholar to select randomized clinical trials that analyzed the role of exercise on balance and fall rate in patients aged 65 or older. Sixteen articles were included in this review. Applying the Cochrane risk-of-bias tool, three studies were determined to be at low risk of bias, nine at unclear risk of bias, and four at high risk of bias. The meta-analysis showed improvements in dynamic balance (p = 0.008), static balance (p = 0.01), participants’ fear of falling (p = 0.10), balance confidence (p = 0.04), quality of life (p = 0.08), and physical performance (p = 0.30) in patients who underwent physical exercise compared to controls. The analysis of the total numbers of falls showed a decreased likelihood of falls in patients who participated in exercise programs (p = 0.0008). Finally, the number of patients who fell at least once was significantly reduced in the intervention group (p = 0.02). Physical exercise is an effective treatment to improve balance and reduce fall rates in the elderly.

scholarly journals A Review on Aging, Sarcopenia, Falls, and Resistance Training in Community-Dwelling Older Adults

2022 ◽  
Vol 19 (2) ◽  
pp. 874
Author(s):  
Filipe Rodrigues ◽  
Christophe Domingos ◽  
Diogo Monteiro ◽  
Pedro Morouço
Keyword(s):  
Resistance Training ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Muscle Mass ◽  
Well Being ◽  
The Elderly ◽  
Community Dwelling ◽  
Narrative Review ◽  
Current Evidence ◽  
Resistance Training Program

As aging continues to grow in our society, sarcopenia and associated fall risk is considered a public health problem since falling is the third cause of chronic disability. Falls are negatively related to functionality and independence and positively associated with morbidity and mortality. The cost of treatment of secondary injuries related to falls is high. For example, one in ten fall incidents leads to bone fractures and several other comorbidities. As demonstrated by several experimental studies, adopting a more active lifestyle is critical for reducing the number of fall episodes and their consequences. Therefore, it is essential to debate the proven physical exercise methods to reduce falls and fall-related effects. Since muscle mass, muscle strength, bone density, and cartilage function may play significant roles in daily activities, resistance training may positively and significantly affect the elderly. This narrative review aimed to examine current evidence on existing resistance training using resistance machines and bodyweight or low-cost equipment for the elderly and how they are related to falls and fall-related consequences. We provide theoretical links between aging, sarcopenia, and falls linking to resistance training and offer practical suggestions to exercise professionals seeking to promote regular physical exercise to promote quality of life in this population. Exercise programs focusing on strength may significantly influence muscle mass and muscle strength, minimizing functional decline and risk of falling. Resistance training programs should be customized to each elderly according to age, sex, and other fundamental and individual aspects. This narrative review provides evidence to support recommendations for practical resistance training in the elderly related to intensity and volume. A properly designed resistance training program with adequate instructions and technique is safe for the elderly. It should include an individualized approach based on existing equipment (i.e., body weight, resistance machines). Existing literature shows that exercise performance towards 2–3 sets of 1–2 exercises per major muscle group, performing 5–8 repetitions or achieving intensities of 50–80% of 1RM, 2–3 times per week should be recommended, followed by training principles such as periodization and progression. Bearing this in mind, health and exercise professionals should combine efforts focusing on efficient strategies to reduce falls among the elderly and promote higher experiences of well-being at advanced stages in life.

scholarly journals Envelhecimento saudável e atividade física: uma revisão sistemática sobre os efeitos do exercício nas doenças cardiovasculares

2017 ◽  
Vol 27 (1) ◽  
pp. 25837 ◽  
Author(s):  
André Luiz Estrela ◽  
Moisés Evandro Bauer
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Cardiovascular Diseases ◽  
Muscle Strength ◽  
Exercise Training ◽  
Physical Exercise ◽  
Elderly Patients ◽  
The Elderly

Aims: To perform a systematic review of randomized controlled trials that assess the benefits of physical exercise (regular or competitive) for the health of the elderly and prevention of cardiovascular diseases.Methods: Publications in PubMed, Web of Science, Library of Congress, Cochrane, and in databases with records of clinical trials between 2005 and 2016, and also in the proceedings of major congresses on cardiovascular diseases in the elderly were investigated using the terms defined in accordance with the "patient, intervention, comparison, and outcome" methodology. The following key words were used: physical effort, exercise, exercise therapy, physical activity, physical fitness, resistance training, cardiovascular disease, C-reactive protein, dyslipidemia, heart failure, cardiac insufficiency, revascularization, cardiac stent and heart transplant. Only randomized clinical trials with individuals aged over 60 years were included. The articles were assessed independently by two reviewers.Results: A total of 3,672 studies were assessed and 24 that met the inclusion criteria were selected. Most of these studies had small sample sizes and showed physical exercise as health-promoting. Only 16 studies reported the relationship of adherence to physical exercise as a preventive factor against cardiovascular diseases. The outcome measures included quality of life, physical ability or fitness status, muscle strength, heart rate, psychological aspects, inflammatory and nutritional markers, and progression of cardiovascular diseases. There is strong evidence that aerobic exercise improves physical fitness, muscle strength, and the quality of life of elderly patients with cardiovascular disease.Conclusions: The benefits of exercise training for elderly patients with cardiovascular disease are well established, supporting the prescription of exercise training for their regular treatments. Interventions that use exercise need to be progressively included in cardiovascular treatment regimens, although the best exercise protocol for patients with cardiovascular disease is not yet fully established.

scholarly journals High-dose trivalent influenza vaccine: safety and immunogenicity

2020 ◽  
Author(s):  
Raúl Ortiz de Lejarazu ◽  
◽  
Federico Martinón Torres ◽  
Ángel Gil de Miguel ◽  
Javier Díez Domingo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Influenza Vaccine ◽  
Randomized Clinical Trials ◽  
Standard Dose ◽  
Meta Analysis ◽  
Influenza Virus Infection ◽  
The Elderly ◽  
The United States ◽  
High Dose ◽  
Trivalent Influenza Vaccine

Adults aged 65 years or older suffer the most severe health effects of seasonal flu. Although the influenza vaccine is effective in preventing influenza virus infection and its complications, it is not as effective in the elderly due to age-associated immunosenescence phenomenon. Since 2009, a high-dose trivalent influenza vaccine has been approved in the United States for the immunization of people ≥ 65 years with an antigen concentration four times higher than the standard vaccine. Multiple clinical trials carried out over different seasons, and using different methodologies, have shown that the high-dose trivalent influenza vaccine is not only more effective, but it also has a similar safety profile and is more immunogenic than the standard dose vaccine in the prevention of flu and its complications in the elderly. This document reviews the current scientific evidence on the safety and immunogenicity of high-dose influenza vaccine in people aged 65 years and over, and includes information from randomized clinical trials, observational studies with data from real clinical practice, and systematic reviews, and meta-analysis.

Abstract 345: Effects of Physical Exercise on Blood Pressure of Patients With Chronic Kidney Disease on Hemodialysis: Meta-analysis of Randomized Clinical Trials

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Kátia B Scapini ◽  
Oscar A Moraes ◽  
Graciele Sbruzzi ◽  
Ivana Moraes-Silva ◽  
Camila P Leguisamo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Clinical Trials ◽  
Kidney Disease ◽  
Physical Exercise ◽  
Aerobic Exercise ◽  
Randomized Clinical Trials ◽  
Aerobic Training ◽  
Meta Analysis ◽  
Esrd Patients

Background: The incidence of End Stage Renal Disease (ESRD) has increased in recent years. Hypertension is a well described complication of chronic kidney disease. Its incidence in hemodialysis patients is approximately 80% and there is substantial evidence of the relationship between high blood pressure and cardiovascular risk in this population. Objective: To systematically review the effects of physical exercise on blood pressure of patients with ESRD undergoing hemodialysis (HD). METHODS: MEDLINE, EMBASE, COCHRANE CENTRAL and LILACS databases were searched for trials published between January 1980 and August 2011. Only randomized clinical trials (RCTs) with adult patients diagnosed with ESRD on HD comparing aerobic exercise, resistance training or combined resistance and aerobic training with the control group were eligible. The selection of studies, data extraction and assessment of methodological quality were performed by two independent reviewers. The meta-analysis was conducted using the random effects model. Results: Our search found 1.034 articles, from which 12 RCTs (389 participants) met the eligibility criteria and were included. We observed that combined resistance and aerobic training (six RCTs) reduces the systolic (-5.84 mmHg; 95% CI: -9.8, -1.88) and the diastolic blood pressure (-3.90 mmHg; 95% CI: -6.20, -1.60); however, the same was not observed with aerobic exercise (six RCTs) (SBP: -0.84 mmHg, 95% CI: -7.18, 5.51 and DBP: 0.68 mmHg, 95% CI: -3.38, 4.74). Probably, the absence of blood pressure decrease with aerobic exercise was due to the small sample size of those studies, the inclusion of both hypertensive and non hypertensive patients and the lack of information whether there was a control of the dosage of antihypertensive medication during follow-up. Conclusions: Combined resistance and aerobic training reduces the blood pressure of ESRD patients on HD and, therefore, can be recommended as an adjuvant non-pharmacological intervention in the treatment of ESRD patients on HD. Sources of Funding: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

scholarly journals The Efficacy and Safety of Acupuncture for Treating Osteoporotic Vertebral Compression Fracture- (OVCF-) Induced Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jia-Liang Li ◽  
Sha Rong ◽  
Zhen Zhou ◽  
Xiao-Bo Zhang ◽  
Zhao-hui Tang ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Bone Density ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Compression Fracture ◽  
The Elderly ◽  
Control Treatment ◽  
Vertebral Compression Fractures ◽  
Control Group ◽  
Efficacy And Safety

Background. Osteoporotic vertebral compression fractures (OVCFs) are common health issues in the elderly that cause chronic pain in over one-third of patients. This study was sought to evaluate the efficacy and safety of acupuncture for alleviating pain caused by OVCFs. Methods. We performed a search of 8 electronic databases for publications from the inception to 30th March 2021. Eligible studies were randomized clinical trials (RCTs) that evaluated the effect of acupuncture for the treatment of OVCFs. Two investigators evaluated literature quality and extracted data independently. RevMan V.5.4.1 was used for data analyses, with pooled risk estimates presented as mean difference (MD) or relative risk (RR) along with corresponding 95% confidence intervals (CIs), as appropriate. Results. Fourteen RCTs involving 1,130 patients were included in this meta-analysis. Compared with the control group, acupuncture showed a greater benefit on pain reduction caused by OVCFs (1 week: MD = −1.26, 95% CI: (−1.82,−0.70); 1 month: MD = −1.63, 95% CI: (−1.82,−1.43); 6 months: MD = −1.13, 95% CI: (−1.55, −0.70)). Acupuncture treatment was also associated with fewer adverse events, lower ODI index, and higher bone density than the control group (safety: (RR: 0.30, 95% CI: 0.12–0.75); ODI: MD = −3.19, 95% CI: (−5.20, −1.19); bone density: MD = 0.15, 95% CI: (0.05, 0.26)). The GRADE quality of these results was assessed as low or very low. Conclusions. Compared with the control treatment, acupuncture was more effective and safer in relieving the pain caused by OVCF and made a greater improvement on patient’s ODI score and bone density. Given the low level of our study evidence, future high-quality studies are needed to verify our study findings.

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