A review of the components of exercise prescription for sarcopenic older adults

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Key summary points

Aim

To synthesize the details of the exercises prescribed for the improvement of muscle mass/muscle strength/physical performance among sarcopenic older adults.

Findings

Frequency, intensity, duration, type, mode, and progression while prescribing resistance, aerobic, balance, and flexibility exercises for sarcopenic older adults were identified and reported.

Message

A multicomponent exercise program targeting muscle strength, aerobic, balance, and flexibility are recommended and tailored as per the existing fitness level and targeted outcomes for sarcopenic older adults.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-022-00693-7.

Abstract

Purpose

To synthesize the details of the exercises/exercise program prescribed for the improvement of muscle mass/muscle strength/physical performance among sarcopenic older adults.

Methods

A systematic literature search was conducted in five electronic databases and the details of exercises such as single component or multicomponent exercise program, frequency/week, intensity, duration of the exercise program, type of exercises, progression, adverse events reported, outcome measures used, and whether technology or other educational aids were used to deliver the program were extracted.

Results

A total of 10,045 records were identified and 27 records were included. Resistance exercises were included in all the studies, with the frequency ranging from 1 to 5/week, intensity ranging from 20 to 80% of 1 repetition maximum (RM), or 6–14 points on ratings of perceived exertion (RPE), and duration per session ranging from 20 to 75 min. The intensity of aerobic exercises ranged from 50 to 70% of heart rate max or a level of 7–17 in RPE with a duration ranging from 6 to 30 min per session for 2–5 days/week. For balance exercises, the intensity was mentioned as the level of effort 3 on a scale of 10, and the time duration per session ranged from 5 to 30 min for a frequency of 2/3 per week.

Conclusion

This review synthesized the components of exercise prescription for sarcopenic older adults which would help practitioners and researchers in selecting the frequency, intensity, duration, type, mode, and progression while prescribing exercises.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-022-00693-7.

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Sarcopenia: revised European consensus on definition and diagnosis

Alfonso Cruz-Jentoft, Gulistan Bahat, Jürgen Bauer … (2018)

Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

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Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment

Liang-Kung Chen, Jean Woo, Prasert Assantachai … (2020)

Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.

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Sarcopenia: origins and clinical relevance.

Irwin H. Rosenberg (1997)

This presentation reflects on the origins of the term sarcopenia. The Greek roots of the word are sarx for flesh and penia for loss. The term actually describes important changes in body composition and related functions. Clearly defining sarcopenia will allow investigators to appropriately classify patients and examine underlying pathogenic mechanisms and will allow funding agencies to appropriately target research funds to a taxonomically distinct syndrome.

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Author and article information

Contributors

Prabal Kumar: prabal.kumar2@learner.manipal.edu , kprabal000@gmail.com

Shashikiran Umakanth: shashikiran.u@manipal.edu

N. Girish:

ORCID: http://orcid.org/0000-0003-2181-5332

girish.n@manipal.edu , girish_darsana@yahoo.co.in

Journal

Journal ID (nlm-ta): Eur Geriatr Med

Journal ID (iso-abbrev): Eur Geriatr Med

Title: European Geriatric Medicine

Publisher: Springer International Publishing (Cham )

ISSN (Print): 1878-7649

ISSN (Electronic): 1878-7657

Publication date (Electronic): 2 September 2022

Publication date PMC-release: 2 September 2022

Publication date (Print): 2022

Volume: 13

Issue: 6

Pages: 1245-1280

Affiliations

[1 ]GRID grid.411639.8, ISNI 0000 0001 0571 5193, Department of Physiotherapy, Manipal College of Health Professions, , Manipal Academy of Higher Education, ; Manipal, Karnataka India

[2 ]GRID grid.411639.8, ISNI 0000 0001 0571 5193, Department of Medicine, Dr. TMA Pai Hospital, , Manipal Academy of Higher Education, ; Manipal, Karnataka India

Author information

N. Girish http://orcid.org/0000-0003-2181-5332

Article

Publisher ID: 693

DOI: 10.1007/s41999-022-00693-7

PMC ID: 9722805

PubMed ID: 36050581

SO-VID: 24edb1e9-3b2b-4188-b55a-f38f569fc813

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 16 May 2022

Date accepted : 15 August 2022

Funding

Funded by: Manipal Academy of Higher Education, Manipal

Open Access :

Open access funding provided by Manipal Academy of Higher Education, Manipal

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Keywords: sarcopenia,exercise,older adults,resistance

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Keywords: sarcopenia, exercise, older adults, resistance

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A review of the components of exercise prescription for sarcopenic older adults

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Supplementary Information

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Most cited references 53

Sarcopenia: revised European consensus on definition and diagnosis

Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment

Sarcopenia: origins and clinical relevance.

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