Effects of exercise improves muscle strength and fat mass in patients with high fracture risk: A randomized control trial.

Journal of the Formosan Medical Association = Taiwan yi zhi. 2018;117(7):572-582
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Sarcopenia is the loss of muscle mass, strength and function related to ageing. It can lead to problems such as reduced mobility and an increased risk of falls in older people. Regular exercise may slow down the deterioration of muscle, but there is no consensus on what type of exercise is best. This study, carried out in Taiwan, aimed to compare different types of exercise on the fat free mass, muscle strength and physical performance in adults over the age of 50 who were at a high risk of bone fractures. The participants were split into two groups and assigned to either the integrated care (IC) or lower extremity exercise (LEE) group for 12 weeks. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise which included upper- and lower-body training with resistance bands and balance training, while the LEE group performed machine-based leg exercises. Fat free mass, muscle strength, and physical performance were measured at the start and end of the study. Both groups demonstrated significant improvements in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators), with the two exercises regimes giving similar results. Both men and women saw similar benefits from regular exercise. The authors concluded that both regimes were equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required less equipment and therefore could be more financially feasible in a community setting.

Abstract

BACKGROUND The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC) model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE) in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX®)) ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point) or fall (≧2 falls in previous year). METHODS Patients were assigned randomized to participate in either IC or LEE group (n = 55 each) for 3 months. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise while the LEE group performed machine-based low extremities exercise. Fat free mass, muscle strength, and physical performance were measured at their baseline and 3-months follow-up. RESULTS Mean age was 73.8 ± 7 years with 69.1% women. Entire cohort demonstrated significant increment in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators). However, between group differences were not significant. CONCLUSION With regular supervise exercise; both groups are equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required fewer resources and thus more financially feasible in a community setting.

Lifestyle medicine

Fundamental Clinical Imbalances : Structural
Patient Centred Factors : Mediators/Exercise
Environmental Inputs : Physical exercise
Personal Lifestyle Factors : Exercise and movement
Functional Laboratory Testing : Imaging
Bioactive Substances : None

Methodological quality

Jadad score : 3
Allocation concealment : No

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