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Wiedmaier-Barros J, Higueras-Fresnillo S, Sadarangani KP, Martínez-Gómez D. Associations of pattern-recognition-measured daily activities with sarcopenia and sarcopenic obesity in old age: The IMPACT65+ study. Exp Gerontol 2024; 194:112511. [PMID: 38964430 DOI: 10.1016/j.exger.2024.112511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/23/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Physical activity has shown beneficial effects for a good state of muscles in aging, but the specific activities of daily living that could be protective remains unclear. This study aimed to analyse the associations of different pattern-recognition-measured daily activities with sarcopenia and sarcopenic obesity in a sample of older adults. METHODS 200 community-dwelling older adults wore the Intelligent Device for Energy Expenditure and Activity for two consecutive days. Twelve major daily activities recorded were merged in to three common intensity categories: sedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). For physical performance measurements included, hand grip dynamometer and chair-stand tests were used. Skeletal muscle mass and fat mass were estimated by bioelectrical impedance analysis. Associations of daily activities with the study variables were examined using linear regression models. RESULTS There were no significant associations between total time spent in SB, LPA, or MVPA and sarcopenia. Sarcopenic obesity showed a negative association with total time spent in MVPA [ß (95%CI): -0.29 (-0.41, -0.17)]. Walk at a brisk pace was significatively associated with lower limb physical performance, muscle mass and fat mass % [ß (95%CI): 1.15 (0.40, 1.91); 1.45 (0.68, 2.22) and -2.63 (-4.12, -1.14) respectively]. Other MVPA activities were also significatively associated with the same sarcopenic obesity components [ß (95%CI): 4.65 (0.55, 8.75); 8.59 (4.51, 12.67) and -13.98 (-21.96, -5.99) respectively]. CONCLUSION Time spent in daily activities of moderate-to-vigorous intensity is negatively associated with sarcopenic obesity but not with sarcopenia.
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Affiliation(s)
- Julia Wiedmaier-Barros
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente, 3, 28049 Madrid, Spain.
| | - Sara Higueras-Fresnillo
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente, 3, 28049 Madrid, Spain
| | - Kabir P Sadarangani
- School of Kinesiology, Faculty of Health and Dentistry, Universidad Diego Portales, Chile. Av. Manuel Rodríguez Sur 253, 8370057, Santiago, Chile; Universidad Autónoma de Chile, Chile. Av. Pedro de Valdivia 425, 7500912, Providencia, R.M., Chile
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Crta. de Canto Blanco, 8, 28049 Madrid, Spain
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Schröder G, Flachsmeyer D, Bende A, Andresen JR, Andresen R, Schober HC. [Impact of osteoporosis on physical performance parameters of middle-aged and elderly individuals-a cross-sectional study]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:54-64. [PMID: 36445463 PMCID: PMC9842570 DOI: 10.1007/s00132-022-04329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Osteoporosis (OP) in the elderly is accompanied by reduced muscle mass and reduced muscle strength, also known as sarcopenia. This results in functional limitations and a high risk of falls and injuries. The determination of physical performance parameters such as grip strength and trunk strength on the one hand, and balance abilities on the other, provide information about the individual's general neuromuscular condition and serve as an indicator of physical performance in the elderly. The extent to which previous osteoporotic vertebral fractures (VFs) restrict an individual's physical performance has not been adequately investigated yet. MATERIAL AND METHODS In total, 118 persons, with a mean age of 71.5 ± 9 years, participated in the clinical trial (ethics committee approval number A2020-0041). Patients were divided into an OP group (58 patients) and a control group (CG; 60 patients). OP patients with (VFs) and without vertebral fractures (0VFs) were viewed separately in the subgroup analysis. Data concerning physical status, including hand grip strength (HGS), the chair-rising test (CRT), tandem stance (TS), tandem gait (TG), and single-leg stance (SLS) were available for all patients. All data were analyzed using SPSS, Version 23.0. RESULTS No significant difference (p > 0.05) was registered between the OP and CG groups with regard of HGS, CRT, TG, TS, and SLS. In the subgroup analysis, OP patients with VFs had a lower HGS than OP patients without 0 VFx (VFs 24.3 ± 10.2 kg vs. 0 VFs 29.7 ± 9.5 kg, p = 0.026). TS was maintained longer by OP patients 0 VFs (VFs 7.8 ± 3.2 s vs. 0 VFs 9.5 ± 1.8 s, p = 0.008). The latter were also able to maintain their balance in TG over more numerous steps (VFs 4.8 ± 3.0 vs. 0 VFs 6.7 ± 2.4, p = 0.011). In a regression analysis, body size, gender, and age were shown to be independent factors influencing HGS (p < 0.001). CONCLUSION Patient age, constitution, and gender have a relevant influence on HGS, with baseline conditions after diagnosed OP at comparable levels in this age group. In a subgroup of OP patients with VFs, there is a close relationship between bone and muscle with an increasing deterioration of the musculoskeletal system. For prophylaxis of osteosarcopenia, early training seems reasonable.
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Affiliation(s)
- Guido Schröder
- Klinik für Orthopädie und Unfallchirurgie, Warnow Klinik Bützow, Am Forsthof 3, 18246 Bützow, Deutschland
| | - Dirk Flachsmeyer
- Klinik für Orthopädie und Unfallchirurgie, Warnow Klinik Bützow, Am Forsthof 3, 18246 Bützow, Deutschland
| | - Anne Bende
- grid.10493.3f0000000121858338Medizinische Fakultät, Universität Rostock, Rostock, Deutschland
| | - Julian Ramin Andresen
- grid.6363.00000 0001 2218 4662Klinik für Unfall- und Wiederherstellungschirurgie, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Deutschland
| | - Reimer Andresen
- grid.9764.c0000 0001 2153 9986Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg, Heide, Deutschland
| | - Hans-Christof Schober
- grid.412642.70000 0000 9314 4417Klinik für Innere Medizin IV, Klinikum Südstadt Rostock, Akademisches Lehrkrankenhaus der Universität Rostock, Rostock, Deutschland
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Linhares DG, Borba-Pinheiro CJ, de Castro JBP, dos Santos AOB, dos Santos LL, Cordeiro LDS, Drigo AJ, Nunes RDAM, Vale RGDS. Effects of Multicomponent Exercise Training on the Health of Older Women with Osteoporosis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14195. [PMID: 36361073 PMCID: PMC9655411 DOI: 10.3390/ijerph192114195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to analyze the effects of multicomponent exercise training in older women with osteoporosis. We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO (number CRD42022331137). We searched MEDLINE (via PubMed), Web of Science, Scopus, and CINHAL databases for randomized experimental trials that analyzed the effects of physical exercise on health-related variables in older women with osteoporosis. The risk of bias in the studies was verified using the Cochrane Collaboration tool and the Jadad scale was used to assess the methodological quality of the studies. Fourteen randomized controlled trials were included, with a total of 544 participants in the experimental group and 495 in the control group. The mean age of all participants was 68.4 years. The studies combined two to four different exercise types, including strength, aerobic, balance, flexibility, and/or functional fitness training. The practice of multicomponent training with an average of 27.2 weeks, 2.6 sessions per week, and 45 min per session showed improvements in strength, flexibility, quality of life, bone mineral density, balance, and functional fitness and reduced the risk of falls in older women with osteoporosis. Multicomponent training was shown to be effective in improving health-related variables in older women with osteoporosis.
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Affiliation(s)
- Diego Gama Linhares
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | | | - Juliana Brandão Pinto de Castro
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | - Andressa Oliveira Barros dos Santos
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | - Luciano Lima dos Santos
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | - Lilliany de Souza Cordeiro
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | - Alexandre Janotta Drigo
- Stricto Sensu Post Graduate Program, São Paulo State University, São Paulo 13506-900, Brazil
| | - Rodolfo de Alkmim Moreira Nunes
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
| | - Rodrigo Gomes de Souza Vale
- Postgraduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
- Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro 20550-900, Brazil
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Vahedi H, Taft CM, Daum JR, Dabash S, McCulloch PC, Lambert BS. Pelvic region bone density, soft tissue mass, and injury frequency in female professional ballet dancers and soccer athletes. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:157-164. [PMID: 35784521 PMCID: PMC9219303 DOI: 10.1016/j.smhs.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/03/2022] Open
Abstract
We recently observed a high prevalence of low pelvic bone mineral density (BMD) in female professional ballet performers. Because this population is susceptible to musculoskeletal overuse injuries, we aimed to determine which regions of the pelvis may be at greatest risk compared to general population females (GENPOP) as well as professional female soccer players (SOCCER, a comparison to other elite athletes regularly subjected to high degrees of loading). Three groups of age-matched females [(GENPOP; n = 38, 27±1yrs), (BALLET; single company, n = 36, 26±3yrs), (SOCCER; single NWSL® club, n = 34, 25±1yrs)] consented to have their BMD and body composition assessed (DEXA, GE®). In addition to soft tissue and total and regional BMD analyses, a segmental analysis of the pelvis was performed to determine site-specific BMD for the iliac fossa, iliac fossa/iliac crest/ilium combined, pubic bone, ischium, and sacrum. A mixed-model ANOVA followed by a Tukey's post-hoc test was used to compare the groups (Type-I error; α = 0.05). The BALLET group had lower pelvic BMD for all measures (Avg.%Diff. = 15%-27%, p<0.001) compared to the SOCCER group and for the ischium (Avg.%Diff.= 8%; p=0.007) and sacrum (Avg.%Diff. = 7%; p = 0.028) compared to the GENPOP group. The BALLET group had lower lean mass for all measures compared to the other groups (Avg.%Diff. = 12%-18%; p < 0.01). Professional ballet performers exhibit reduced pelvic region soft tissue and site-specific BMD not previously detected using standard DEXA analyses. These findings highlight which pelvic regions may benefit from preventative strength training and/or nutritional interventions.
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An Up-Date of the Muscle Strengthening Exercise Effectiveness in Postmenopausal Women with Osteoporosis: A Qualitative Systematic Review. J Clin Med 2021; 10:jcm10112229. [PMID: 34063906 PMCID: PMC8196674 DOI: 10.3390/jcm10112229] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Osteoporosis (OP) is a systemic disease that is characterized by decreased bone density and quality. Purpose: The purpose of this systematic review was to determine the effects of muscle strengthening exercise in postmenopausal women with OP. Methods: A literature search was conducted systematically in MEDLINE, CINAHL, EMBASE databases for human studies up to 31 March 2021. Two researchers screened the articles against predefined inclusion criteria; a third resolved discrepancies. Articles were included if they assessed the effects of muscle strengthening exercise in postmenopausal women with OP. The protocol for this systematic review was registered on PROSPERO (CRD42021207917) and a qualitative systematic review was carried out following the PRISMA statement. Methodological quality was evaluated through the scientific validity scales PEDro. Finally, RTCs and NRCTs risk of bias was assessed with the Cochrane risk of bias tool (Risk of Bias-ROB 2.0) and ROBINS-1, respectively. Results: A total of 16 studies (1028 subjects) that met the different eligibility criteria previously established were selected. There is evidence of good methodological quality and a low to moderate risk of bias that supports that muscle strengthening exercise alone or in combination with other therapeutic modalities improves BMD (9, n = 401) in proximal femur and lumbar vertebra body, muscle strength (10, n = 558), balance (4, n = 159), functionality (7, n = 617), and quality of life (5, n = 291). CONCLUSIONS Exercise programs focused on muscle strengthening have benefits for all variables studied in postmenopausal women with OP.
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Zhu L, Wu W, Chen M, Xu D, Xu H, Liu L, Liu J, Zhu Z. Effects of Nonpharmacological Interventions on Balance Function in Patients with Osteoporosis or Osteopenia: A Network Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:6662510. [PMID: 34055018 PMCID: PMC8112948 DOI: 10.1155/2021/6662510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the clinical efficacy of nonpharmacological interventions in improving balance function of patients with osteoporosis or osteopenia using network meta-analysis (NMA). METHODS We searched seven databases (PubMed, the Cochrane Library, Embase, CKNI, Wanfang Data, VIP, and CBM) for relevant randomized controlled trials (RCTs) up to August 31, 2020. Berg Balance Scale (BBS) and Time Up and Go Test (TUGT) were used as outcome measures. Two researchers independently screened studies, collected data from the studies, and estimated risk of study bias. Divergence in the evaluation process was settled by consulting a third researcher. We used Stata 15.1 software for network meta-analysis (NMA). RESULTS We identified 10 eligible RCTs, with a total of 737 patients and four intervention methods, including traditional Chinese medicine (TCM) exercises, pulsed electromagnetic fields (PEMFs), strength training, and balance and strength training. The results revealed that all nonpharmacological interventions could improve balance function, but the effect of balance and strength training was better than other interventions. CONCLUSION Exercise can significantly improve the balance function of patients with osteoporosis and osteopenia, and balance combined with strength training has the best effect, followed by TCM exercises.
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Affiliation(s)
- Lu Zhu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Wenzhong Wu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Ming Chen
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Daoming Xu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Huaning Xu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Lanying Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Jing Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
| | - Zequan Zhu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
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Milk and Dairy Products: Good or Bad for Human Bone? Practical Dietary Recommendations for the Prevention and Management of Osteoporosis. Nutrients 2021; 13:nu13041329. [PMID: 33920532 PMCID: PMC8072827 DOI: 10.3390/nu13041329] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 01/05/2023] Open
Abstract
Osteoporosis affects women twice as often as men. Additionally, it is estimated that 0.3 million and 1.7 million people have hip fractures in the USA and Europe, respectively. Having a proper peak bone mass and keeping it as long as possible is especially important for osteoporosis prevention. One of the most important calcium sources is milk and dairy products. Breast milk is the best infant food, but milk should not be avoided later in life to prevent losing bone mass. On the other hand, more and more people limit their milk consumption and consume other dairy or non-dairy products. For example, they are usually replaced with plant beverages, which should be consumed carefully in several age groups. Additionally, an important element of milk and dairy products, as well as plant beverages, are probiotics and prebiotics, which may modulate bone turnover. Dietary recommendations focused on milk, and dairy products are an important element for the prevention of osteoporosis.
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Pinheiro MB, Oliveira J, Bauman A, Fairhall N, Kwok W, Sherrington C. Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Act 2020; 17:150. [PMID: 33239014 PMCID: PMC7690138 DOI: 10.1186/s12966-020-01040-4] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Various physical activity interventions for prevention and treatment of osteoporosis have been designed and evaluated, but the effect of such interventions on the prevention of osteoporosis in older people is unclear. The aim of this review was to investigate the association between physical activity and osteoporosis prevention in people aged 65 years and above. METHODS A systematic review was conducted and searches for individual studies were conducted in PubMed (January 2010 to March 2020) and for systematic reviews were conducted in PubMed, Embase, CINAHL and SPORTDiscus (January 2008 to July 2020). Records were screened according to the following eligibility criteria: i) population: adults aged 65 years and older; ii) exposure: greater volume, duration, frequency, or intensity of physical activity; iii) comparison: no physical activity or lesser volume, duration, frequency, or intensity of physical activity; iv) outcome: osteoporosis related measures (e.g., bone mineral density). The methodological quality of included studies was assessed and meta-analysis summarised study effects. The GRADE approach was used to rate certainty of evidence. RESULTS We included a total of 59 studies, including 12 observational studies and 47 trials. Within the included trials, 40 compared physical activity with no intervention controls, 11 compared two physical activity programs, and six investigated different doses of physical activity. Included studies suggest that physical activity interventions probably improve bone health among older adults and thus prevent osteoporosis (standardised effect size 0.15, 95% CI 0.05 to 0.25, 20 trials, moderate-certainty evidence, main or most relevant outcome selected for each of the included studies). Physical activity interventions probably improve lumbar spine bone mineral density (standardised effect size 0.17, 95% CI 0.04 to 0.30, 11 trials, moderate-certainty evidence) and may improve hip (femoral neck) bone mineral density (standardised effect size 0.09, 95% CI - 0.03 to 0.21, 14 trials, low-certainty evidence). Higher doses of physical activity and programs involving multiple exercise types or resistance exercise appear to be most effective. Typical programs for which significant intervention impacts were detected in trials were undertaken for 60+ mins, 2-3 times/week for 7+ months. Observational studies suggested a positive association between long-term total and planned physical activity on bone health. CONCLUSIONS Physical activity probably plays a role in the prevention of osteoporosis. The level of evidence is higher for effects of physical activity on lumbar spine bone mineral density than for hip. Higher dose programs and those involving multiple exercises and resistance exercises appear to be more effective.
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Affiliation(s)
- Marina B Pinheiro
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Juliana Oliveira
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Nicola Fairhall
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing Kwok
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Testa G, Vescio A, Zuccalà D, Petrantoni V, Amico M, Russo GI, Sessa G, Pavone V. Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review. J Clin Med 2020; 9:jcm9092997. [PMID: 32957453 PMCID: PMC7563874 DOI: 10.3390/jcm9092997] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Sarcopenia is defined as a progressive loss of muscle mass and muscle strength associated to increased adverse events, such as falls and hip fractures. The aim of this systematic review is to analyse diagnosis methods of sarcopenia in patients with hip fracture and evaluate prevention and treatment strategies described in literature. Methods: Three independent authors performed a systematic review of two electronic medical databases using the following inclusion criteria: Sarcopenia, hip fractures, diagnosis, treatment, and prevention with a minimum average of 6-months follow-up. Any evidence-level studies reporting clinical data and dealing with sarcopenia diagnosis, or the treatment and prevention in hip fracture-affected patients, were considered. Results: A total of 32 articles were found. After the first screening, we selected 19 articles eligible for full-text reading. Ultimately, following full-text reading, and checking of the reference list, seven articles were included. Conclusions: Sarcopenia diagnosis is challenging, as no standardized diagnostic and therapeutic protocols are present. The development of medical management programs is mandatory for good prevention. To ensure adequate resource provision, care models should be reviewed, and new welfare policies should be adopted in the future.
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Affiliation(s)
- Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
- Correspondence:
| | - Andrea Vescio
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
| | - Danilo Zuccalà
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
| | - Vincenzo Petrantoni
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
| | - Mirko Amico
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
| | - Giorgio Ivan Russo
- Department of General Surgery and Medical Surgical Specialties, Urology Section, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy;
| | - Giuseppe Sessa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
| | - Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, 95124 Catania, Italy; (A.V.); (D.Z.); (V.P.); (M.A.); (G.S.); (V.P.)
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Abstract
Individuals that maintain healthy skeletal tissue tend to live healthier, happier lives as proper muscle function enables maintenance of independence and actuation of autonomy. The onset of skeletal muscle decline begins around the age of 30, and muscle atrophy is associated with a number of serious morbidities and mortalities. Satellite cells are responsible for regeneration of skeletal muscle and enter a reversible non-dividing state of quiescence under homeostatic conditions. In response to injury, satellite cells are able to activate and re-enter the cell cycle, creating new cells to repair and create nascent muscle fibres while preserving a small population that can return to quiescence for future regenerative demands. However, in aged muscle, satellite cells that experience prolonged quiescence will undergo programmed cellular senescence, an irreversible non-dividing state that handicaps the regenerative capabilities of muscle. This review examines how periodic activation and cycling of satellite cells through exercise can mitigate senescence acquisition and myogenic decline.
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Affiliation(s)
- William Chen
- Sprott Centre for Stem Cell Research, Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada K1H 8L6.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
| | - David Datzkiw
- Sprott Centre for Stem Cell Research, Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada K1H 8L6.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
| | - Michael A Rudnicki
- Sprott Centre for Stem Cell Research, Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada K1H 8L6.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5
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Lo JHT, U KP, Yiu T, Ong MTY, Lee WYW. Sarcopenia: Current treatments and new regenerative therapeutic approaches. J Orthop Translat 2020; 23:38-52. [PMID: 32489859 PMCID: PMC7256062 DOI: 10.1016/j.jot.2020.04.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia is characterized by loss of muscle and reduction in muscle strength that contributes to higher mortality rate and increased incidence of fall and hospitalization in the elderly. Mitochondria dysfunction and age-associated inflammation in muscle are two of the main attributors to sarcopenia progression. Recent clinical trials on sarcopenia therapies such as physical exercise, nutraceutical, and pharmaceutical interventions have revealed that exercise is the only effective strategy shown to alleviate sarcopenia. Unlike nutraceutical and pharmaceutical interventions that showed controversial results in sarcopenia alleviation, exercise was found to restore mitochondria homeostasis and dampen inflammatory responses via a complex exchange of myokines and osteokines signalling between muscle and bone. However, as exercise have limited benefit to immobile patients, the use of stem cells and their secretome are being suggested to be novel therapeutics that can be catered to a larger patient population owing to their mitochondria restoration effects and immune modulatory abilities. As such, we reviewed the potential pros and cons associated with various stem cell types/secretome in sarcopenia treatment and the regulatory and production barriers that need to be overcome to translate such novel therapeutic agents into bedside application. Translational potential: This review summarizes the causes underlying sarcopenia from the perspective of mitochondria dysfunction and age-associated inflammation, and the progress of clinical trials for the treatment of sarcopenia. We also propose therapeutic potential of stem cell therapy and bioactive secretome for sarcopenia.
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Affiliation(s)
- Jessica Hiu-Tung Lo
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China.,Stem Cells and Regenerative Medicine Laboratory, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China
| | - Kin Pong U
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China.,Stem Cells and Regenerative Medicine Laboratory, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China
| | - Tszlam Yiu
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China.,Stem Cells and Regenerative Medicine Laboratory, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China
| | - Michael Tim-Yun Ong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China
| | - Wayne Yuk-Wai Lee
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China.,Stem Cells and Regenerative Medicine Laboratory, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR China
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Chen X, Yang W, Wang X. Balance training can enhance hip fracture patients' independence in activities of daily living: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e19641. [PMID: 32311935 PMCID: PMC7440254 DOI: 10.1097/md.0000000000019641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/08/2020] [Accepted: 02/26/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We conducted this meta-analysis to analyze the effectiveness of balance training in improving postoperative rehabilitation outcomes in hip fracture surgery patients. METHODS The Cochrane Library, Web of Science, Embase, and PubMed electronic databases were searched from their inception to December 2018. We selected prospective clinical control analyses and high-quality randomized controlled trials (RCTs) following the inclusion standards. We used Stata 12.0 to perform the meta-analysis. Where possible, the standard mean difference (SMD) with the 95% confidence interval (CI) was determined using a random effects model. RESULTS Ten RCTs involving 955 hips (balance training = 487, control = 468) published between 2002 and 2019 were assessed for eligibility of inclusion in the meta-analysis. Balance training was shown to remarkably improve the aspects of quality of life associated with physical health (standard mean difference [SMD], 2.20; 95% CI, 1.63-2.78, P = .000), a fast gait speed (SMD, 1.01; 95% CI, 0.25-1.77, P = .009), and balance (SMD = 0.26, 95% CI: [0.12, 0.41], P = .000). Moreover, the balance training group showed increases in independence in activities of daily living (ADLs), performance task scores, and health-related quality of life (HRQoL) scores compared with the control group (P < .05). CONCLUSION According to the present meta-analysis, balance training improves one's independence in activities of daily living, performance tasks, lower limb strength, gait, and total physical function compared with no balance training. More high-quality RCTs with large sample sizes are required for the identification of the best balance training program after hip fracture.
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Wu JQ, Mao LB, Wu J. Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2019; 14:83. [PMID: 30894205 PMCID: PMC6425661 DOI: 10.1186/s13018-019-1125-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 03/11/2019] [Indexed: 11/22/2022] Open
Abstract
Background To investigate whether the clinical effects of balance training were improved in hip fracture patients. Methods Electronic databases which included PubMed, Embase, Web of Science, and the Cochrane Library up to December 2018 were searched. High-quality randomized controlled trials (RCTs) and prospective clinical controlled studies were selected based on inclusion criteria. Stata 12.0 was used for the meta-analysis. Standard mean difference (SMD) with 95% confidence interval (CI) was used to assess the effects. Results Finally, 9 studies with 872 patients (balance training = 445, control = 427) were included in our meta-analysis (published between 1997 and 2018). Compared with the control group, balance training group showed a significant increase in overall function (SMD = 0.59, 95% CI [0.25, 0.93], P = 0.001), gait speed (SMD = 0.63, 95% CI [0.19, 1.07], P = 0.005), lower limb strength (SMD = 0.73, 95% CI [0.50, 0.95], P = 0.000), activities of daily living (ADLs) (SMD = 0.97, 95% CI [0.61, 1.34], P = 0.000), performance task scores (SMD = 0.41, 95% CI [0.21, 0.61], P = 0.000), and health-related quality of life (HRQoL) scores (SMD = 0.32, 95% CI [0.16, 0.47], P = 0.000). Conclusions Our meta-analysis revealed that the balance training group has improved overall physical functioning, gait, lower limb strength, performance task, and activity of daily living than the control group. More high-quality and large-scale RCTs are needed to identify the optimal regimen of balance training after hip fracture.
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Affiliation(s)
- Jia-Qi Wu
- Rehabilitation Department, Jingjiang People's Hospital, Jingjiang, Taizhou, Jiangsu Province, China
| | - Lin-Bo Mao
- Rehabilitation Department, Jingjiang People's Hospital, Jingjiang, Taizhou, Jiangsu Province, China
| | - Jian Wu
- Institute Office, Jingjiang People's Hospital, No. 28, Zhongzhou road, Jingjiang, Taizhou, 214500, Jiangsu Province, China.
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Wu JQ, Mao LB, Wu J. Efficacy of exercise for improving functional outcomes for patients undergoing total hip arthroplasty: A meta-analysis. Medicine (Baltimore) 2019; 98:e14591. [PMID: 30855443 PMCID: PMC6417520 DOI: 10.1097/md.0000000000014591] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The objective of this meta-analysis was aimed to illustrate the functional outcomes of exercise for total hip arthroplasty (THA) patients. METHODS In July, 2018, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on exercise for functional outcomes for THA patients were retrieved. The primary endpoint was walking speed. Other outcomes included physical activity scale, Harris hip score, pain scores, abduction strength, and the length of hospital stay. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary. RESULTS Ten clinical studies with 441 patients were ultimately included in the meta-analysis. Compared with the control group, exercise was associated with an increase of the walking speed by 0.15 m/s than control group (weighted mean difference [WMD] 0.15; 95% confidence interval [CI] 0.08, 0.22; P = .000). Also, exercise group could also increase Harris hip score (WMD 8.49; 95% CI 5.19, 11.78; P = .000) and abduction strength than control group (WMD 9.75; 95% CI 5.33, 14.17; P = .000). What is more, exercise has a beneficial role in reducing the pain scores (WMD -1.32; 95% CI -2.07, -0.57; P = .001) and the length of hospital stay (WMD -0.68; 95% CI -1.07, -0.29; P = .001) than the control group. However, there was no significant difference between the physical activity scale (WMD -2.13; 95% CI -6.31, 2.05; P = .317). CONCLUSIONS Compared with control group in the management of THA, postoperative exercise has a better pain relief and clinical outcomes. Considering the beneficial of the postoperative exercise, we take a positive attitude toward use exercise for patients with THA.
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Affiliation(s)
| | | | - Jian Wu
- Institute Office, Jingjiang People's Hospital, Jingjiang, Taizhou, Jiangsu Province, China
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Tung HT, Chen KM, Yao CT, Kuo CC, Hsu HF. Self-evaluation by community older adults on the applicability of the healthy beat acupunch exercise program. Complement Ther Med 2019; 42:59-64. [PMID: 30670283 DOI: 10.1016/j.ctim.2018.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 10/30/2018] [Indexed: 11/29/2022] Open
Abstract
Objectives To evaluate the applicability of the Healthy Beat Acupunch (HBA) exercise program for older adults at community care centers and to explore their perceived impacts and suggestions for program protocol after six months of HBA exercises. Design & setting This prospective and descriptive study recruited 113 older adults from four community care centers. Intervention The HBA exercises were conducted 3 times a week, 40 min per session, for six months. Main outcome measures The program evaluation focused on four criteria: simplicity, safety, suitability, and helpfulness of the three phases of the HBA program using a 10-point ladder scale. The semi-structured interviews were focused on the participants' exercise experiences, perceived impacts on their health, and suggestions for the HBA program protocol. Results The average scores of the four criteria in each phase of the program ranged between 9.59 and 9.98 points. Participants reported an increase in their limb flexibility (n = 31) and that they were more relaxed (n = 26) and more energetic (n = 26) after engaging in the HBA exercises. Most of the participants suggested that the HBA program should be offered three times a week, 40 min per session, with 30 people in a group, and led by instructors who were professional, hardworking, easygoing, and enthusiastic, regardless of gender and age. Conclusions The HBA program was rated at a high level of simplicity, safety, suitability, and helpfulness by community older adults, which indicated that the program was considered as appropriate and applicable for the older population.
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Affiliation(s)
- Hsiao-Ting Tung
- Department of Nursing, Kaohsiung Armed Forces General Hospital, 2 Zhongzheng 1st Rd., Lingya District, Kaohsiung, 80284, Taiwan; College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Department of Medical Research, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Chang-Chih Kuo
- College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Hui-Fen Hsu
- Center of Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
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