Efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass: a prospective longitudinal clinical trial

Abstract

Low muscle mass is a common condition among older adults that adversely affects strength, physical performance and quality of life. This study aimed to investigate the efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass, which was defined as appendicular skeletal mass (ASM) measured by bioimpedance analysis lower than 5.7 kg/m2 in females, and lower than 7.0 kg/m2 in males. This home-based resistance exercise program targets 10 muscles with a frequency of 3–5 days/week for 24 weeks. ASM, grip strength, gait speed and functional reach were measured at baseline, 3 and 6 months. The same four outcomes were then remeasured at 9 months to assess long-term effects. A total of 112 participants (average age: 70 years) were recruited. The mean difference between baseline and 6 months was statistically significant for all outcomes, including ASM [0.12 kg/m2: 95% confidence interval (CI), 0.05–0.18; P = 0.001], gait speed (0.19 meter/s: 95% CI, 0.14–0.25; P < 0.001), grip strength (2.06 kg: 95% CI, 1.32–2.80; P < 0.001), and functional reach distance (4.18 cm: 95% CI, 3.18–5.18; P < 0.001). Change over time for all main outcomes from baseline to 9 months also showed statistically significant improvement. The most commonly reported adverse events were muscle pain, joint pain and fatigue. The majority of participants (90–93%) had good exercise compliance, even at the end of the study. In conclusion, this 24-week simple home-based resistance exercise program significantly improved all main outcomes with low adverse events, and most participants continued the program after the end of the intervention.

A review of the components of exercise prescription for sarcopenic older adults

“…Nine studies used Asian Working Group for Sarcopenia 2014 (AWGS 2014) criteria [15][16][17][18][19][20][21][22][23], one study each used AWGS 2016 [24] and AWGS 2019 criteria [25], six studies used European Working Group for Sarcopenia in Older People (EWGSOP 2010) criteria [26][27][28][29][30][31], one study used EWG-SOP 2019 criteria [32], one study used Center for Disease Control and Prevention criteria [33], one used International Working Group on Sarcopenia (IWGS) along with EWG-SOP 2010 criteria [34] and seven studies did not report any of the above-mentioned criteria [35][36][37][38][39][40][41].…”

“…Of the 27 studies on resistance exercises, 9 studies (n = 9) used repetition maximum (RM) criteria [18,25,27,29,30,32,36,37,40], whereas 10 studies (n = 10) used rating of perceived exertion (RPE) [15,19,21,23,26,28,31,38,39,41] criteria to quantify the intensity of resistance training. One study each (n = 1) used OMNI-RES scale (OMNI-Rating of perceived Exertion scale) [34],…”

“…Among the included studies, n = 4 were study protocols and n = 23 were completed studies. Of these 23 studies, n = 15 studies did not assess for any adverse events [16,18,20,21,23,27,[33][34][35][36][37][38][39][40][41], n = 5 studies reported no adverse events [15,17,24,28,30], and only n = 3 studies reported adverse events because of exercise intervention [19,26,31]. Muscle pain, joint pain, fatigue, vertigo, and fall were the commonly reported events.…”

“…Twenty-seven studies, which used exercise intervention in single- and multicomponent modes, were included in this review. Out of 27, in 16 studies ( n = 16), the exercise intervention was given as a single component with all studies using resistance exercise [ 15 , 19 – 23 , 25 – 27 , 29 , 31 , 32 , 34 , 37 , 38 , 40 ], while the remaining 11 studies ( n = 11) administered multicomponent exercise intervention [ 16 – 18 , 24 , 28 , 30 , 33 , 35 , 36 , 39 , 41 ]. Among the multicomponent exercise interventions, resistance exercise plus balance exercise were administered in four studies ( n = 4) [ 16 , 18 , 28 , 41 ]; resistance exercise plus aerobic exercise in three studies ( n = 3) [ 24 , 30 , 36 ], resistance exercise plus aerobic exercise plus balance exercise in one study ( n = 1) [ 39 ]; resistance exercise plus aerobic exercise plus balance exercise plus flexibility exercise in two studies ( n = 2) [ 17 , 33 ]; resistance exercise plus balance exercise plus aerobic exercise plus endurance exercise in one study ( n = 1) [ 35 ].…”

“…Among the multicomponent exercise interventions, resistance exercise plus balance exercise were administered in four studies ( n = 4) [ 16 , 18 , 28 , 41 ]; resistance exercise plus aerobic exercise in three studies ( n = 3) [ 24 , 30 , 36 ], resistance exercise plus aerobic exercise plus balance exercise in one study ( n = 1) [ 39 ]; resistance exercise plus aerobic exercise plus balance exercise plus flexibility exercise in two studies ( n = 2) [ 17 , 33 ]; resistance exercise plus balance exercise plus aerobic exercise plus endurance exercise in one study ( n = 1) [ 35 ]. In 25 studies ( n = 25), a supervised exercise program [ 15 , 17 , 18 , 20 – 41 ], in one study ( n = 1) an unsupervised exercise program [ 16 ], and in one study, ( n = 1) an initial training was administered and then participants performed exercise unsupervised [ 19 ].…”