Hybrid Exercise Program for Sarcopenia in Older Adults: The Effectiveness of Explainable Artificial Intelligence-Based Clinical Assistance in Assessing Skeletal Muscle Area

Abstract

Background: Sarcopenia is a geriatric syndrome characterized by decreased skeletal muscle mass and function with age. It is well-established that resistance exercise and Yi Jin Jing improve the skeletal muscle mass of older adults with sarcopenia. Accordingly, we designed an exercise program incorporating resistance exercise and Yi Jin Jing to increase skeletal muscle mass and reverse sarcopenia in older adults. Additionally, machine learning simulations were used to predict the sarcopenia status after the intervention. Method: This randomized controlled trial assessed the effects of sarcopenia in older adults. For 24 weeks, 90 older adults with sarcopenia were divided into intervention groups, including the Yi Jin Jing and resistance training group (YR, n = 30), the resistance training group (RT, n = 30), and the control group (CG, n = 30). Computed tomography (CT) scans of the abdomen were used to quantify the skeletal muscle cross-sectional area at the third lumbar vertebra (L3 SMA). Participants’ age, body mass, stature, and BMI characteristics were analyzed by one-way ANOVA and the chi-squared test for categorical data. This study explored the improvement effect of three interventions on participants’ L3 SMA, skeletal muscle density at the third lumbar vertebra (L3 SMD), skeletal muscle interstitial fat area at the third lumbar vertebra region of interest (L3 SMFA), skeletal muscle interstitial fat density at the third lumbar vertebra (L3 SMFD), relative skeletal muscle mass index (RSMI), muscle fat infiltration (MFI), and handgrip strength. Experimental data were analyzed using two-way repeated-measures ANOVA. Eleven machine learning models were trained and tested 100 times to assess the model’s performance in predicting whether sarcopenia could be reversed following the intervention. Results: There was a significant interaction in L3 SMA (p < 0.05), RSMI (p < 0.05), MFI (p < 0.05), and handgrip strength (p < 0.05). After the intervention, participants in the YR and RT groups showed significant improvements in L3 SMA, RSMI, and handgrip strength. Post hoc tests showed that the YR group (p < 0.05) yielded significantly better L3 SMA and RSMI than the RT group (p < 0.05) and CG group (p < 0.05) after the intervention. Compared with other models, the stacking model exhibits the best performance in terms of accuracy (85.7%) and F1 (75.3%). Conclusion: One hybrid exercise program with Yi Jin Jing and resistance exercise training can improve skeletal muscle area among older adults with sarcopenia. Accordingly, it is possible to predict whether sarcopenia can be reversed in older adults based on our stacking model.

Effect of a moderate-intensity comprehensive exercise program on body composition, muscle strength, and physical performance in elderly females with sarcopenia

“…Generally speaking, skeletal muscle mass represents a crucial of strength, endurance, and physical performance. A previous 24-week combined resistance exercise and Yi Jin Jing had a positive effect on increasing skeletal muscle mass and delaying sarcopenia in the elderly [ 21 ], which confirmed our results findings.…”

Non-Pharmacological Strategies for Managing Sarcopenia in Chronic Diseases

“… 145 Furthermore, Wei et al conducted a study in which they combined RT with Yijin Jing exercises in elderly patients with sarcopenia. 146 Their findings indicated that this combined exercise regimen resulted in improved muscle area compared to RT alone and the control group.…”

Cardio-oncology rehabilitation: are we ready?

“…There is growing evidence that telemedicine in cardio-oncology is effective and well tolerated, even in older patients. 105–107 Telemedicine approaches are effective and safe in older cancer patients, with increasing use of artificial intelligence. 108–110 However, patients’ social skills and social networks, especially in the last decades of life and in independent patients, need to be carefully assessed.…”