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

OBJECTIVES: 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. DESIGN: We used the method of a systematic umbrella-review. Based on the level of evidence, we formulated specific recommendations for clinical practice. METHODS: Two 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. RESULTS: We identified 14 systematic reviews or meta-analyses, encompassing four exercise categories: resistance training, resistance training + nutritional supplementation, multimodal exercise programmes and bloodflow restriction training. Importantly, very few systematic reviews or meta-analyses clearly mentioned baseline sarcopenia status. There is high quality evidence for a positive and significant effect of resistance training on muscle mass, muscle strength, and physical performance. The added effect of nutritional supplementation for resistance training on muscle function appears limited. Blood flow restriction training is a novel training method that has a significant impact on muscle strength. CONCLUSION: Since sarcopenia is affecting all skeletal muscles in the body, we recommend training the large muscle groups in a total body approach. Although low-intensity resistance training (≤50% 1RM) is sufficient to induce strength gains, we recommend a high-intensity resistance training program (i.e. 80% 1RM) to obtain maximal strength gains. Multimodal exercises and blood flow restriction resistance training may be considered as well.

Evaluation of appendicular lean mass using bio impedance in persons aged 80+: A new equation based on the BUTTERFLY-study.

BACKGROUND: To date, the accuracy of bio-impedance (BIA) to assess body composition & sarcopenia in persons aged 80 and over remains unclear. OBJECTIVE: We aimed to evaluate the agreement between dual energy X-ray absorptiometry (DXA) and BIA equations to determine lean mass, as well as their suitability to identify sarcopenia. DESIGN: 174 community dwelling well-functioning persons (83 women, 91 men) aged 80 and over were included. Appendicular lean mass (ALM) was predicted using BIA-based equations available in literature, and compared to DXA outcomes. Through cross-validation and stepwise multiple linear regression, a new ALM-formula was generated suitable for this population. RESULTS: Literature-based BIA equations systematically overestimated ALM. The new prediction formula that we propose for the 80+ is: ALM = 0,827+(0,19*Impedance Index)+(2,101*Sex)+(0,079*Weight); R2 = 0,888; SEE = 1,450 kg. Sarcopenia classification based on our new BIA equation for ALM showed better agreement with DXA (k ≥ 0,454) compared to literature-based BIA equations (k < 0,368). CONCLUSIONS: Despite the high correlation between both methods, literature-based BIA equations consistently overestimate ALM compared to DXA in persons aged 80 and over. We proposed a new equation for ALM, reaching higher agreement with DXA and thus improving the accuracy of BIA for this specific age group.

Lack of impairment of kinaesthetic sensibility in cervicogenic headache patients.

To compare the cervical kinaesthetic sensibility of cervicogenic headache (CEH) patients and asymptomatic controls, the head repositioning accuracy of 10 CEH patients and 23 asymptomatic controls was measured. Should an impaired kinaesthetic sensibility be demonstrated, its assessment could be of diagnostic value in the evaluation of patients with suspected CEH. Additionally, specific exercises to improve cervical kinaesthesia could be prescribed. Kinaesthetic sensibility was assessed using a head repositioning task: subjects were asked to relocate their heads as accurately as possible to a previously memorized head position following an active movement (flexion, extension and left and right rotations). The repositioning error was registered using a validated magnetic tracking device (Flock of Birds). No significant differences were found between the asymptomatic controls and the CEH patients (independent-samples T-test, P < 0.05). We conclude that cervical kinaesthetic sensibility is not impaired in non-traumatic CEH. The use of kinaesthetic assessment and treatment in this patient group seems to be limited.