scholarly journals Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials

Author(s):  
Nan Chen ◽  
Xiangfeng He ◽  
Yuwei Feng ◽  
Barbara E. Ainsworth ◽  
Yu Liu

Abstract Objective We conducted a meta-analysis to analyze the effects of resistance training on measures of body composition, muscle strength, and muscle performance in older people with sarcopenia. Methods All randomized controlled trials on the effects of resistance training on outcome variables in older people with sarcopenia were searched on Pubmed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Data from January 2010 to October 2020 were reviewed. Two researchers extracted data and evaluated the quality of the studies that met the inclusion criteria independently. Meta-analysis for pre-post changes were calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). Results Fourteen studies meeting inclusion criteria included 561 healthy older adults (age 65.8 to 82.8) with sarcopenia. Compared with the control group, resistance training had positive effects on body fat mass (SMD = -0.53, 95% CI − 0.81 to − 0.25, p = 0.0002, I2 = 0%), handgrip strength (SMD = 0.81, 95%CI 0.35 to 1.27, p = 0.0005, I2 = 81%), knee extension strength (SMD = 1.26, 95% CI 0.72 to 1.80, p < 0.0001, I2 = 67%), gait speed (SMD = 1.28, 95%CI 0.36 to 2.19, p = 0.006, I2 = 89%), and the timed up and go test (SMD = -0.93, 95% CI − 1.30 to − 0.56, p < 0.0001, I2 = 23%). Resistance training had no effects on appendicular skeletal muscle mass (SMD = 0.25, 95% CI − 0.27 to 0.78, p = 0.35, I2 = 68%), skeletal muscle mass (SMD = 0.27, 95% CI − 0.02 to 0.56, p = 0.07, I2 = 0%) and leg lean mass (SMD = 0.12, 95% CI − 0.25 to 0.50, p = 0.52, I2 = 0%). Old people with sarcopenia of different ages, genders or diagnostic criteria and weights have different gains in muscle mass, handgrip strength, knee extension strength and muscle performance after different intervention duration, frequencies, mode and intensity resistance training. Conclusion Resistance training is an effective treatment to improve body fat mass, muscle strength, and muscle performance in healthy older people with sarcopenia.

2019 ◽  
Vol 109 (4) ◽  
pp. 1119-1132 ◽  
Author(s):  
Danielle E Bear ◽  
Anne Langan ◽  
Eirini Dimidi ◽  
Liesl Wandrag ◽  
Stephen D R Harridge ◽  
...  

ABSTRACT Background Loss of skeletal muscle mass and muscle weakness are common in a variety of clinical conditions with both wasting and weakness associated with an impairment of physical function. β-Hydroxy-β-methylbutyrate (HMB) is a nutrition supplement that has been shown to favorably influence muscle protein turnover and thus potentially plays a role in ameliorating skeletal muscle wasting and weakness. Objectives The aim of this study was to investigate the efficacy of HMB alone, or supplements containing HMB, on skeletal muscle mass and physical function in a variety of clinical conditions characterized by loss of skeletal muscle mass and weakness. Methods A systematic review and meta-analysis of randomized controlled trials reporting outcomes of muscle mass, strength, and physical function was performed. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. Outcome data were synthesized through meta-analysis with the use of a random-effects model and data presented as standardized mean differences (SMDs). Results Fifteen randomized controlled trials were included, involving 2137 patients. Meta-analysis revealed some evidence to support the effect of HMB alone, or supplements containing HMB, on increasing skeletal muscle mass (SMD = 0.25; 95% CI: –0.00, 0.50; z = 1.93; P = 0.05; I2 = 58%) and strong evidence to support improving muscle strength (SMD = 0.31; 95% CI: 0.12, 0.50; z = 3.25; P = 0.001; I2 = 0%). Effect sizes were small. No effect on bodyweight (SMD = 0.16; 95% CI: –0.08, 0.41; z = 1.34; P = 0.18; I2 = 67%) or any other outcome was found. No study was considered to have low risk of bias in all categories. Conclusion HMB, and supplements containing HMB, increased muscle mass and strength in a variety of clinical conditions, although the effect size was small. Given the bias associated with many of the included studies, further high-quality studies should be undertaken to enable interpretation and translation into clinical practice. The trial was registered on PROSPERO as CRD42017058517.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linqian Lu ◽  
Lin Mao ◽  
Yuwei Feng ◽  
Barbara E. Ainsworth ◽  
Yu Liu ◽  
...  

Abstract Objective We 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. Method All 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. Result Twenty-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%). Conclusions In 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.


2019 ◽  
Author(s):  
Karolina Talar ◽  
Tomas Vetrovsky ◽  
Ewa Kalamacka ◽  
Michal Steffl

Abstract Background: Resistance training (RT) is considered as an effective method to increase muscle strength and physical performance in elderly people. Methods: A search from the earliest record up to and including June 2019 was carried out using the following electronic databases: PubMed, Scopus and Web of Science. The search strategy employed combined the terms related to the population (e.g. ‘sarcopenia’, ‘frailty’) with terms for the intervention (e.g. ‘resistance training’, ‘strength training’). Results: 11 studies including 2691 subjects were included in our meta-analysis (aged 64-98). Training duration ranged from 8 to 48 weeks and intensity up to 80% of 1-RM. According to the meta-analyses, RT had statistically significant effect on all the measures except handgrip strength. In handgrip strength Effect size (ES) was 0.58 (95 % CI: - 0.10 to 1.26) p = 0.076 with the moderate heterogeneity (I 2 = 58.6%). ES in legs strength was 0.52 (95 % CI 0.11 to 0.92) p = 0.022, I 2 = 42.0 %. The biggest ES was in TUG test where ES was 0.90 (95 % CI 0.19 to 1.60) p = 0.022, however, there was a high heterogeneity I 2 = 89.6. The high ES was found also in FFM 0.69 (95 % CI 0.17 to 1.20) p = 0.025, and gait speed 0.41 (95 % CI 0.11 to 0.72) p = 0.017. In both cases, there was small heterogeneity I 2 = 13.2 % respective 38.3 %. The overall ES was estimated 0.67 (95 % CI 0.40 to 0.93) p <0.001. Nevertheless, the heterogeneity was high I 2 = 78.1 %.Conclusion: RT interventions in pre-frail, frail, pre-sarcopenic and sarcopenic older adults, provided evidence that RT has positive effects on most of the outcome measurements included in the current revision except handgrip strength.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 650
Author(s):  
Di-Ya Tu ◽  
Fa-Min Kao ◽  
Shih-Tzer Tsai ◽  
Tao-Hsin Tung

Purpose. This systematic review and meta-analysis was conducted to explore the effect of protein intake on the prevention and improvement of sarcopenia. Methods. We searched the Cochrane Library, PubMed, and EMBASE from inception to 20 May 2021. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Results. There were 12 studies that met the selection criteria among 53 eligible publications. The results of the study show that the protein intake has no significant effect on the physical performance—4 m gait speed, chair rise test, short physical performance battery, muscle mass—skeletal muscle mass index, and muscle strength—hand grip strength. Conclusion. Protein supplementation had no significant effect on 4 m gait speed and on improving skeletal muscle mass index, hand grip strength, chair rise test, and short physical performance battery. Additional randomized controlled trials are warranted to adequately assess the effect of protein supplementation on elderly sarcopenia.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1992
Author(s):  
Shu-Fen Chu ◽  
Tsan-Hon Liou ◽  
Hung-Chou Chen ◽  
Shih-Wei Huang ◽  
Chun-De Liao

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 835
Author(s):  
Mengqi Li ◽  
Si Zhao ◽  
Shuang Wu ◽  
Xiufen Yang ◽  
Hui Feng

Background: Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. Aims: The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). Methods: By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian–Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). Results: 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74–87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. Conclusions: The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.


2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
José Francisco Meneses-Echávez ◽  
Emilio González-Jiménez ◽  
Robinson Ramírez-Vélez

Objective. Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis.Design. A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale.Results. Nine studiesn=772were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD=-0.23; 95% CI: −0.37 to −0.09;P=0.001). These effects were also significant in patients undergoing chemotherapyP<0.0001. Nonsignificant differences were found for resistance training interventionsP=0.30. Slight evidence of publication bias was observedP=0.04. The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)).Conclusion. Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.


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