Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review

Jun 25, 2019The journal of nutrition, health & aging

Exercise to Prevent and Treat Age-Related Muscle Loss: A Review of Reviews

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Four exercise categories were identified from 14 systematic reviews or meta-analyses regarding interventions for sarcopenia in older adults.

Resistance training has a high-quality evidence for positively affecting muscle mass, muscle strength, and physical performance.
The additional benefits of nutritional supplementation combined with resistance training on muscle function are limited.
Blood flow restriction training may significantly enhance muscle strength.
Training large muscle groups using a total body approach is recommended for addressing sarcopenia.
While low-intensity resistance training (≤50% 1RM) can promote strength gains, high-intensity resistance training (80% 1RM) is advised for maximizing strength improvements.

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OBJECTIVES: The aim of this systematic review is to provide an overview of the efficacy of different exercise interventions to counter sarcopenia in older adults. This review will allow the Belgian Society of Gerontology and Geriatrics and other scientific societies to formulate specific exercise recommendations in their Clinical Guidelines for Sarcopenia.

DESIGN: We used the method of a systematic umbrella-review. Based on the level of evidence, we formulated specific recommendations for clinical practice.

METHODS: Two databases (Pubmed and Web Of Science) were searched systematically and methodological quality of the reviews was assessed. Extracted data was than mapped to an exercise category and an overall synthesis (bottom line statements) was formulated for each of these exercise categories. Subsequently, we assigned a rating of the quality of the evidence supporting each bottom line statement.

RESULTS: We identified 14 systematic reviews or meta-analyses, encompassing four exercise categories: resistance training, resistance training + nutritional supplementation, multimodal exercise programmes and bloodflow restriction training. Importantly, very few systematic reviews or meta-analyses clearly mentioned baseline sarcopenia status. There is high quality evidence for a positive and significant effect of resistance training on muscle mass, muscle strength, and physical performance. The added effect of nutritional supplementation for resistance training on muscle function appears limited. Blood flow restriction training is a novel training method that has a significant impact on muscle strength.

CONCLUSION: Since sarcopenia is affecting all skeletal muscles in the body, we recommend training the large muscle groups in a total body approach. Although low-intensity resistance training (≤50% 1RM) is sufficient to induce strength gains, we recommend a high-intensity resistance training program (i.e. 80% 1RM) to obtain maximal strength gains. Multimodal exercises and blood flow restriction resistance training may be considered as well.

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Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review

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