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

Abstract

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

Malnutrition as a Strong Predictor of the Onset of Sarcopenia

“…This overlap between malnutrition and sarcopenia is observed throughout their management. Indeed, the treatment of sarcopenia is based on a combined intervention of nutritional therapies and resistance training, with a higher influence of the second one, particularly high-intensity resistance training (i.e., 80% 1-Repetition Maximum) to gain maximal strength or low-intensity resistance training (≤50% 1 RM) to induce strength gains [42]. The therapeutic interventions for malnutrition have been recently revisited and updated in the ESPEN guidelines of clinical nutrition and hydration in geriatrics [6] and are mostly based on food fortification [6], which is more feasible to be administered in older people than the recommended management of sarcopenia [42,43].…”

“…Indeed, the treatment of sarcopenia is based on a combined intervention of nutritional therapies and resistance training, with a higher influence of the second one, particularly high-intensity resistance training (i.e., 80% 1-Repetition Maximum) to gain maximal strength or low-intensity resistance training (≤50% 1 RM) to induce strength gains [42]. The therapeutic interventions for malnutrition have been recently revisited and updated in the ESPEN guidelines of clinical nutrition and hydration in geriatrics [6] and are mostly based on food fortification [6], which is more feasible to be administered in older people than the recommended management of sarcopenia [42,43]. Our findings might be of interest in the development of early therapeutic interventions targeted at individuals who meet malnutrition criteria but are free from sarcopenia at baseline [43,44] in relation to the concept of "impactability", a term used in public health management strategies "to identify patients who are most likely to benefit from a therapeutic intervention" [45].…”

<p>The Favorable Effects of a High-Intensity Resistance Training on Sarcopenia in Older Community-Dwelling Men with Osteosarcopenia: The Randomized Controlled FrOST Study</p>

“…Many studies have already proven the positive effects of resistance training (RT) combined with a protein-rich diet on sarcopenia. [21][22][23][24][25][26] A standardized treatment approach that can be applied to a wide range of sarcopenic patients and includes a validated training protocol has yet to be defined. The training should be time-efficient, considering reasons for abstaining from recommended exercise doses have been time restriction and little enthusiasm 27,28 and cost-efficient in the face of the high and growing prevalence of sarcopenia 29 and the resulting financial burden for stakeholders.…”

High Intensity Resistance Exercise Training to Improve Body Composition and Strength in Older Men With Osteosarcopenia. Results of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

“…A comparable effect was observed for thigh lean mass (3.7%; Table 3). Reviewing the present literature, we rank this finding in the upper range of corresponding studies (review in Peterson et al, 2011;Stewart et al, 2014;Beckwee et al, 2019). One may argue that our results on LBM are higher due to the adjuvant protein supplementation.…”

“…Resistance exercise combined with protein supplementation might be the most promising candidate to counteract age-related muscle loss (Hurley et al, 2011) and sarcopenia (Rosenberg, 1989). In summary, a recent umbrella review (Beckwee et al, 2019) found a "high quality of evidence" for a significant effect of exercise on muscle mass and strength in the area of sarcopenia prevention and treatment. However, considering the enormous heterogeneity of the underlying studies with respect to type, methods and composition of resistance exercise, it is difficult to derive precise exercise recommendations (Gentil et al, 2017).…”