Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations

Synergistic effects of elastic band and vibration training on muscle strength, balance, and mobility in older women with a history of falls: a randomised controlled trial

Objective

This study aimed to investigate the effects of combined elastic band resistance training (EBRT) and whole-body vibration training (WBVT) on lower limb isokinetic muscle strength, balance and physical performance in older women with history of falls.

Methods

A total of 102 older women with a history of falls was randomly assigned to the elastic band group (n = 28), vibration group (n = 28), elastic band plus vibration group (n = 28) and control group (n = 28) for a 12-week program. All groups performed identical exercises (half squats, static squats, left/right lunges) thrice weekly. The control group trained on a flat ground without elastic bands or vibration; the elastic band group used elastic bands on the flat ground, while the vibration and combined groups exercised on a vibration platform. Training parameters included 3 sets × 10 repetitions with 20-s rest intervals.

Results

Post-intervention, knee flexion peak torque increased by 9.7% (p < 0.05). Total length (TL), elliptical area (EA), total offset index (TAI), timed up and go test (TUG) and five times sit-to-stand test (FTSST) decreased by 16.2%, 14.2%, 21.9%, 16.9% and 14.0%, respectively; and modified fall efficacy scale (MFES) increased by 17.6% (p < 0.01) in the elastic band group. Knee extension peak torque increased by 16.3% (p < 0.05). TL, EA, TAI, TUG and FTSST decreased by 14.8%, 12.2%, 18.9%, 12.3% and 11.5%, respectively; and MFES increased by 16.2% in the vibration group (p < 0.01). Hip and knee flexion and knee and ankle extension peak torque increased by 19.5%, 18.8%, 30.2% and 30.1% (p < 0.01), respectively, in the elastic band plus vibration group. TAI, TL, EA, TUG and FTSST decreased by 28.5%, 24.6%, 38.3%, 22.4% and 29.0%, respectively, and MFES increased by 42.1% in the elastic band plus vibration group (p < 0.01). The elastic band plus vibration group demonstrated greater improvements in knee and ankle strength compared to single interventions, while the elastic band and vibration groups showed smaller changes (p < 0.05). Additionally TL, EA, TAI, TUG, and FTSST all decreased, while MFES increased (p < 0.05).

Conclusion

The combined EBRT and WBVT can enhance knee and ankle isokinetic muscle strength, improve balance ability and physical performance and reduce fear of falls by a greater degree than single interventions. EBRT and WBVT had limited effects on improving lower limb isokinetic muscle strength but enhanced balance ability, physical performance, and reduced fear of falls in older women with a history of falls. Both training modalities showed similar effects.

Construction of an Exercise Intervention Program for Patients with Sarcopenic Obesity: A Delphi Method Study

Purpose

Construct an exercise intervention program for patients with sarcopenic obesity.

Material and Methods

Based on the COM-B theoretical model and evidence-based principles, the program was constructed using qualitative methods of literature analysis and Delphi method. The Delphi panel consisted of 15 experts from the fields of clinical medicine, rehabilitation medicine, medical technology, and nursing.

Results

Fifteen experts were consulted, and the consultation recovery rate was 100%; the authority coefficient of the 1st round was 0.83, with coefficients of variation ranging from 0.00 to 0.27, and importance scores ranging from (4.13±1.13) to (5±0); the authority coefficient of the 2nd round was 0.82, with coefficients of variation ranging from 0.00 to 0.20, and importance scores ranging from (4.53±0.64) to (5±0); Kendall's harmony coefficient was 0.102, 0.115, respectively, and the differences were statistically significant(P < 0.05). The constructed exercise intervention program for patients with sarcopenic obesity included 4 primary indicators, 12 secondary indicators, and 28 tertiary indicators.

Conclusion

The constructed exercise intervention program for patients with sarcopenic obesity is scientific, feasible and generalizable, and can provide useful reference for related personnel to develop exercise programs for patients with sarcopenic obesity.

Sarcopenic obesity does not impair lower limb strength and physical performance in sufficiently active older adults: a cross-sectional study

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance.

The Effects of Different Exercise Training Types on Body Composition and Physical Performance in Older Adults with Sarcopenic Obesity: A Systematic Review and Meta-Analysis

OBJECTIVES

To carry out a systematic review and meta-analysis to verify the effects of different exercise training types on body composition and physical performance in older adults with sarcopenic obesity (SO).

DESIGN

Systematic review and meta-analysis.

SETTING AND PARTICIPANTS

Older adults (≥60 years).

METHODS

Database searches were performed in MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, and LILACS on January 10th, 2023. We included: randomized and/or controlled clinical trials; physical exercise as an intervention; analysis of body composition and/or muscle function; and sarcopenic obesity diagnosis. We used the Risk of Bias 2 tool and PEDro scale. The GRADE certainty of evidence was also performed.

RESULTS

Fourteen studies were included in the systematic review and nine studies in the meta-analysis. A decrease in body fat (%) favoring the exercise group was identified (SMD: -0.34 [95% CI: -0.53 to -0.16]; p=0.0003) (GRADE: ⊕⊕⊕◯ Moderate). Only resistance training showed fat reduction (SMD: -0.27 [95% CI: -0.48 to -0.06]; p=0.01). Increases in upper (SMD: 0.41 [95% CI: 0.04 to 0.78]; p=0.03) (GRADE: ⊕⊕◯◯ Low) and lower (SMD: 0.80 [95% CI: 0.22 to 1.39]; p=0.007) (GRADE: ⊕⊕⊕⊕ High) limb strength was identified with exercise. Chair stand test showed increases with exercise (SMD: 0.73 [95% CI: 0.40 to 1.07]; p<0.0001) (GRADE: ⊕⊕⊕⊕ High), especially for resistance training (SMD: 0.62 [95% CI: 0.21 to 1.02]; p=0.003) and combined training (SMD: 0.99 [95% CI: 0.40 to 1.57]; p=0.0005). The PEDro scale for the studies in our review ranged from 3 to 8 (mean = 5.8 (1.6)), meaning fair methodological quality, and most studies were overall judged with at least low/some concerns in terms of risk of bias.

CONCLUSION AND IMPLICATIONS

Overall, moderate to high certainty of evidence was found for body fat, lower limb strength, and chair stand test. On the other hand, low certainty of evidence was found for upper limb strength. Resistance, combined, and aerobic training evoked divergent results between the variables analyzed. Although promising, our results should be considered sparingly, but may guide additional exercise recommendations to improve specific health parameters in older adults with SO.