ABSTRACT
The concept of health span is an emerging topic in recent years, with a truly palpable relevance to public health. With ageing comes a loss of skeletal muscle mass, strength, and performance, which is termed as sarcopenia. Sarcopenia is a major public health concern and poses a challenge to health-care systems. Modifiable lifestyle factors may be linked to the course of sarcopenia progression. Many countries developed diagnostic tools to accurately detect sarcopenia for its prevention, delay, or treatment. However, to date, there is no sufficient information regarding the status of sarcopenia in Saudi Arabia. The review aims to discuss sarcopenia and relevant updates in research and literature, the association with modifiable lifestyle factors, the implications of sarcopenia in a rapidly developing country such as Saudi Arabia, and the current state and need for research in Saudi Arabia in this domain along with future directions in combating this disease.
ABSTRACT
BACKGROUND: Stroke and its associated complications are a major cause of long-term disability worldwide, with spasticity being a common and severe issue. Physical therapy, involving stretching exercises and electrical stimulation, is crucial for managing spasticity. Therefore, this study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) combined with a conventional rehabilitation program (CRP) on plantarflexor muscle spasticity and walking performance among individuals with chronic stroke. METHODS: A pilot randomized clinical trial (RCT) with two groups (active NMES and placebo) was conducted at the physical therapy departments of King Fahad Specialist Hospital, Buraydah, and Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia (November 2020). The assessor and participants were blinded for the group assignment. The active NMES group received exercise and stimulation at the dorsiflexor muscles on the paretic leg for 30 min for 12 sessions. The placebo group received exercise and sham stimulation at the same position and duration as the active group. Of interest were the outcomes for plantarflexor muscle spasticity measured by the modified Ashworth scale (MAS), gait speed measured by 10 m walk test (10-MWT), and functional mobility measured by functional ambulatory category (FAC). RESULTS: Nineteen participants were randomized into active NMES (n = 10) and sham NMES (n = 9) groups, with no significant baseline differences. Within the active NMES group, significant improvements were observed in MAS (p = 0.008), 10-MWT (p = 0.028), and FAC (p = 0.046), while only 10-MWT time improved significantly in the sham NMES group (p = 0.011). Between-group analysis showed that only MAS was significantly lower in the active NMES group (p = 0.006). Percent change analysis indicated a significantly higher increase in percent change for MAS in the active NMES group compared to the sham NMES group (p = 0.035), with no significant differences in other outcome measures. CONCLUSIONS: This study showed that NMES in the active group led to significant improvements in spasticity, walking performance, and functional ambulation. Further research is needed to determine the ideal parameters, protocols, and patient selection criteria for NMES interventions in stroke rehabilitation.
ABSTRACT
BACKGROUND: Sarcopenia is an age-related muscular disease manifesting as a loss of muscle function and mass-leads to detrimental consequences at both individual and community levels. Modifiable lifestyle factors (such as physical behaviors and nutritional habits) may be involved in sarcopenia etiology. European Working Group on Sarcopenia in Older Population (EWGOSP2) established a cut-off point for sarcopenia diagnosis based on the European population and they recommend the use of a regional normative population. However, no sufficient data on sarcopenia prevalence is presently available in Saudi Arabia. Therefore, this project aims to define appropriate reference values from healthy Saudi young adults (Phase I) and to investigate the prevalence of sarcopenia in Saudi Arabia (Phase II) and examine selected modifiable lifestyle correlates of sarcopenia (Phase I, II). METHODS: The project will involve two phases. Phase I will include 1532 healthy Saudi young adults aged between 20-40 years. While, Phase II will include 1532 Saudi older adults aged ≥50 years. The study will measure vital signs, anthropometrics, muscle mass using bioelectrical impedance analysis and dual-energy X-ray absorptiometry, muscle strength using handgrip strength and maximal isometric strength, physical function using short physical performance battery, and 6-minute walk test to measure aerobic endurance. To explore the associations between lifestyle behaviors with sarcopenia indices, physical activity, sedentary behaviour and sleep will be evaluated subjectively using Global Physical Activity Questionnaire and Pittsburgh Sleep Quality Index and objectively via ActivPAL accelerometers. A three-day dietary food record will also be used to evaluate dietary intake. Additionally, EuroQOL five-dimension questionnaire will be utilized to assess health-related quality of life. DISCUSSION: The study will have significant implications in recognizing the prevalence of sarcopenia in Saudi population, which will guide our future interventional studies aimed at early prevention and treatment of this disease.
