Muscle Strength and Balance Training in Sarcopenic Elderly: A Pilot Study with Randomized Controlled Trial

Abstract

In aging, there is a gradual decrease in muscle mass (sarcopenia) and muscle strength which contributes to a decline in physical functions, increased disability, frailty, and loss of independence. Physical activity can reduce functional decline due to aging. Randomized controlled trials (RCT) are needed to determine the effectiveness of different exercise stimuli on muscle strength and balance in the sarcopenic elderly. Forty male volunteers diagnosed with sarcopenia (CDCP) (70.9±5.2yrs) were enrolled in this study. A randomized, controlled trial, with blind assessment, was designed to study the effect of global sensorimotor, high intensity focused vibrational (intensity: 300Hz) and resistance training (intensity: 60-80% of maximum theoretical force, 10-12 repetitions for 3 sets) stimuli on muscle strength and balance confidence. The subjects were randomly assigned to three different training programs or a control group which was encouraged to maintain their habitual activity level. The training was performed for 12 weeks in all groups: 2 sessions/week in Gsm and Ret groups; 1 session/week for the first 8 weeks and 3 sessions/week for the last 4 weeks in Yam group. The main outcome was maximal force contraction of the lower limbs, and secondary outcomes were static and dynamic balance confidence. All the training regimens increased isometric strength. Both the sensorimotor and the vibrational training increased stability with a reduction of sway area and of ellipse surface (p<O.OI). Gait analysis showed a significant increase in the length of the half-step in all three groups (respectively 108%, p <0.01; 92% p< 0.01; 65% P <0.05). All the training programs implemented in the present investigation increase muscle strength. In addition, sensorimotor and vibrational training intervention aims to transfer these peripheral gains to the functional and more complex task of balance, in order to reduce the risk of falls.Normal aging produces progressive loss of skeletal muscle mass and function, or sarcopenia starting between the ages of 30 and 40, and with faster loss after the age of 75. The loss of muscle mass and the lower efficiency of muscular enzymes result in a reduction both in the peak force during isoinertial motion and at high angular velocities. Maximal isometric voluntary contraction is still maintained at 45 years ofage, but it decreases by 25% at age 65, and by 35% at the age of 70 years. In the following decades, this loss of strength is even more pronounced. Eventually, 40% of women between

Intervenciones Con Ejercicio Contra Resistencia en La Persona Adulta Mayor Diagnosticada Con Sarcopenia. Una Revisión Sistemática

“…Se analizaron seis estudios que cumplieron con los criterios de inclusión (Bellomo, Iodice, Maffulli, Maghradze, Coco, & Saggini, 2013;Kim et al, 2012;Maltais, Ladouceur, & Dionne, 2016;Shahar et al, 2013;Zdzieblik et al, 2015;Perreault et al, 2016) …”

“…Respecto a la fuerza muscular, con excepción de la intervención de Shahar et al (2013), que reportó una disminución de fuerza, medida mediante dinamometría, la mayoría de estudios también muestran mejorías en esta variable (Bellomo et al, 2013;Kim et al, 2012;Zdzieblik et al, 2015). Según Zdzieblik et al (2015), el incremento en la fuerza muscular puede estar asociado con una mayor cantidad de masa muscular.…”

“…De acuerdo con Bellomo et al (2013), la mejora en la función muscular contribuye a mejorar el balance estático que, a su vez, impacta positivamente en el balance dinámico e incrementa la habilidad para caminar, subir escaleras y otras funciones relacionadas con la calidad de vida.…”

“…Cinco de los estudios reportados muestran en promedio un aumento de 3.29 de porcentaje de cambio en variables relacionadas con la masa muscular (kg), con la excepción del estudio de Bellomo et al (2013), el cual no analizó esta variable (Tabla 6).…”

“…El estudio de Maltais et al (2016) muestra una mejoría en la velocidad de marcha habitual y el tiempo de levantarse y sentarse de una silla (SFT); sin embargo, no fue así con la velocidad de la marcha máxima y tiempo de ida y vuelta (SFT). Bellomo et al (2013) muestran mejoría en la longitud de la mitad de paso y disminución en el ancho del paso; Shahar et al (2013) muestran mejorías en las pruebas de función física del (SFT) y, finalmente, el estudio de Kim et al (2012) muestra mejorías en velocidad de la marcha habitual y máxima (Tabla 6).…”