The aim of this chapter is to give an overview about the aging processes in the neural and muscuo-skeletal system at cellular and tissue level to highlight the demand for physiotherapy interventions. Searching the relevant literature published in the last decade, it was found that the loss of muscle mass (myofiber atrophy and decrease in the number of myofibers) is associated with decreased regeneration capacity of the skeletal muscle, deterioration of the neural control and bone remodeling as well as the impaired microcirculation leading to insufficient adaptation to the physical exercises. In the management of the aging-related deterioration of the skeletal muscle (sarcopenia), the first tool is the resistance training that improves the muscle mass and power as well as the functional outcomes regarding the mobility and physical performance. The endurance (aerobic) training improves the cardiovascular and respiratory status providing better blood supply to the skeletal muscle and exerts some effects directly to the skeletal muscle and bone (increases the mitochondrial functions, improves the bone remodeling). The combination of aerobic and resistance training seems to be more effective against the sarcopenia and osteopenia. The balance training gives additional benefits, so (together with increased muscle power and performance) improves the quality of life.
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