Resistance Training and Nutritional Supplementation in Older Adults with Sarcopenia after Acute Disease: A Feasibility Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.2.1. Inclusion Criteria
2.2.2. Exclusion Criteria
2.3. Settings
2.4. Intervention
2.5. Primary Outcome
2.6. Secondary Outcomes
2.7. Other Variables
2.8. Statistical Analysis
3. Results
- (a)
- The reasons for permanent treatment discontinuation were deterioration in general condition (two participants in each group), supplement had an unpleasant taste (two participants in each group), lack of interest in continuing (one participant in the control group), moving out of the city (one participant in the control group), fear of being infected by Coronavirus disease (COVID-19) (one participant in the control group); and lack of family support for attending the program (the second reason for one participant in the control group).
- (b)
- Treatment interruption: Among the participants who completed 70% or more of the intervention, six participants (18.8%, four participants in the intervention group and two participants in the control group) interrupted the exercise program, while four (12.5%, two participants in each group) interrupted the supplementation. The causes were exacerbated chronic low back pain, COVID-19 onset, pulmonary disease exacerbation, and holidays. No significant differences were found between the groups.
- (c)
- Exercise dose modification: Six participants (18.8%, three participants in each group) required modification of some parameter of the progressive resistance exercise program; the reasons for this are listed in Table 5.
- (d)
- Early termination: Nine participants (28.1%) ended participation earlier than planned for the following reasons: sudden onset of COVID-19 (two patients in the intervention group and one in the control group), exacerbation of chronic disease (one patient in the control group), and reasons unrelated to the intervention, such as holidays and vacations (four in the intervention group and one in the control group).
- (e)
- Re-scheduling of missed sessions: Six participants rescheduled 21 sessions (18.8%, three patients in each group).
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total Sample (n = 32) | |
---|---|
Age (years), (mean ± SD) | 81.6 ± 9.3 |
Sex, women (%) | 24 (75%) |
Body mass index (kg/m2), (mean ± SD) | 24.2 ± 4.5 (women); 21.6 ± 3.3 (men) |
Handgrip strength (kg), (mean ± SD) | 12.9 ± 4.2 (women); 22.7 (± 4.1) (men) |
Fat-free mass index (kg/m2), (mean ± SD) | 12.9 ± 1.8 (women); 14.0 ± 2.0 (men) |
Physical performance: | |
Short Physical Performance Battery (/12), (mean ± SD) | 7.2 ± 2.9 |
4 m gait speed (m/s), (mean ± SD) | 0.7 ± 0.3 |
Severe sarcopenia (n, %) | 26 (81.3%) |
Malnutrition according to GLIM criteria (n, %) | 17 (63%) |
Charlson comorbidity index, (mean ± SD) | 5 ± 2 |
Barthel index (/100), (mean ± SD) | 91 ± 11 |
Lawton index (/8), (mean ± SD) | 6 ± 2 |
Quality of Life—SarQoL (/100), (mean ± SD) | |
SarQoL D1: Physical and mental health | 63.9 ± 17.4 |
SarQoL D2: Locomotion | 56.4 ± 21.0 |
SarQoL D3: Body composition | 65.0 ± 20.0 |
SarQoL D4: Functionality | 62.8 ± 19.4 |
SarQoL D5: Activities of daily living | 48.1 ± 22.8 |
SarQoL D6: Leisure activities | 31.2 ± 21.4 |
SarQoL D7: Fears | 71.9 ± 24.2 |
Overall QoL score | 57.1 ± 17.1 |
Changes in Women after a 12-Week Intervention Based on an Intragroup Intention-to-Treat Analysis | ||||||
---|---|---|---|---|---|---|
Intervention Group (n = 14): | Control Group (n = 10): | |||||
Baseline | 12-Week Follow-Up | p | Baseline | 12-Week Follow-Up | p | |
Physical performance | ||||||
SPPB—Balance test (/4) | 2.4 (SD 1.2) | 3.3 (SD 0.8) | 0.068 | 3.7 (SD 0.7) | 3.2 (SD 0.8) | 0.104 |
SPPB—Gait speed test (/4) | 2.3 (SD 1.1) | 2.9 (SD 1.2) | 0.193 | 2.2 (SD 1.5) | 2.4 (SD 1.3) | 0.169 |
SPPB—Chair stand test (/4) | 1.1 (SD 0.7) | 1.8 (SD 1.0) | 0.045 | 1.7 (SD 1.5) | 1.8 (SD 1.4) | 0.347 |
Total SPPB (/12) | 5.9 (SD 2.6) | 8.0 (SD 2.3) | 0.025 | 7.6 (SD 3.3) | 7.4 (SD 3.4) | 0.681 |
4 m gait speed test (m/s) | 0.6 (SD 0.3) | 0.7 (SD 0.2) | 0.419 | 0.6 (SD 0.3) | 0.7 (SD 0.3) | 0.485 |
Muscle strength | ||||||
Handgrip (kg) | 12.4 (SD 4.0) | 16.1 (SD 3.9) | 0.042 | 14.8 (SD 3.8) | 15.8 (SD 4.0) | 0.012 |
Intergroup Analysis of Changes in Primary Outcomes in Women after the 12-Week Intervention | ||||||
Intervention Group (n = 14) | Control Group (n = 10) | Mean Difference (95%CI) | p | |||
Physical performance | ||||||
SPPB—Balance test (/4) | 0.9 (SD 1.4) | −0.4 (0.7) | 1.3 (0.3 to 2.4) | 0.018 | ||
SPPB—Gait speed test (/4) | 0.6 (SD 1.3) | 0.2 (0.4) | 0.4 (0.4 to −0.6) | 0.42 | ||
SPPB—Chair stand test (/4) | 0.7 (SD 0.9) | 0.1 (0.3) | 0.6 (−0.1 to 1.3) | 0.092 | ||
Total SPPB (/12) | 2.1 (SD 2.5) | −0.1 (0.8) | 2.2 (0.4 to 4.0) | 0.021 | ||
4 m gait speed test (m/s) | 0.1 (SD 0.3) | 0.3 (0.8) | −0.2 (−0.7 to 0.3) | 0.409 | ||
Muscle strength | ||||||
Handgrip (kg) | 3.7 (SD 5.6) | 1.0 (0.9) | 2.8 (−0.8 to 6.4) | 0.119 |
Components 1 | Questions to Be Considered | Expected Answer | Reported Answer | Actions to Address Potential Barriers 1 |
---|---|---|---|---|
Technology | Is the required equipment available? | Yes | Yes | - |
Are staff properly trained to conduct the intervention? | Yes | Yes | - | |
Economics | Are all the costs well defined? | Yes | Yes | - |
Is the intervention expensive? | No | No | - | |
Is the time cost acceptable? | Yes | Unknown | Transportation costs should be affordable for patients. | |
Legal requirements | Does the intervention conflict with legal requirements? | No | No | - |
Are the standards of good clinical practice followed? | Yes | Yes | - | |
Operational needs | Is the intervention properly defined? | Yes | Yes | - |
Do patients and relatives accept the intervention? | Yes | Unknown | Relatives must be involved in the rehabilitation process. | |
Does patient enrollment represent a barrier to the accomplishment of the research objectives? | No | Yes | Educational strategies are needed to promote the importance and benefit of participating in research studies. | |
Is a third party required to attend the intervention program? | No | Yes | The known benefits of exercise should be explained to the patients and their relatives. | |
Are there any social limitations to the participation of older adults? | No | Yes | Additional support from professionals and relatives could be necessary. | |
Are training costs assessed? | No | No | ||
Scheduling | Given our current experience, is the intervention realistic in a post-hospitalization period? | Yes | Unknown | The patient should be informed about the need for timely treatment of sarcopenia. |
Will the intervention result in meaningful benefits for patients? | Yes | Unknown | The benefits of HMB for the patient have been studied in a parallel research study. |
Total Sample (n = 32) | |
---|---|
Tolerability, n (%) | |
Permanent treatment discontinuation | 11 (34.4) |
Treatment interruption: exercise | 6 (18.8) |
Treatment interruption: supplementation | 4 (12.5) |
Exercise dose modification | 6 (18.8) |
Early termination | 9 (28.1) |
Re-scheduling of missed sessions | 6 (18.8) |
Lost to follow-up | 14 (43.8) |
Attendance (number of attended sessions)/36, (mean ± SD) | 23 ± 12.0 |
Nutritional compliance (number of sachets)/84, (mean ± SD) | 56 ± 32.6 |
Safety (n, %) | |
Adverse events | 21 (65.6) |
Adverse reactions to resistance exercise | 7 (21.9) |
Adverse reactions to nutritional supplementation | 0 |
Unexpected adverse reactions | 0 |
Serious adverse reactions | 0 |
Type of Modification of Resistance Exercise | Explanation |
---|---|
| Pain: Patient with osteoarthrosis of the shoulder and sequelae of right humerus fracture. |
| Weakness: Fatigue due to physical decline. |
| Pain associated with exercise. |
| Pain associated with exercise. |
| Weakness: upper limb lymphedema. |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Meza-Valderrama, D.; Sánchez-Rodríguez, D.; Peña, Y.C.; Ramírez-Fuentes, C.; Muñoz-Redondo, E.; Morgado-Pérez, A.; Ortíz-Agurto, N.; Finis-Gallardo, P.; Marco, E. Resistance Training and Nutritional Supplementation in Older Adults with Sarcopenia after Acute Disease: A Feasibility Study. Nutrients 2024, 16, 3053. https://doi.org/10.3390/nu16183053
Meza-Valderrama D, Sánchez-Rodríguez D, Peña YC, Ramírez-Fuentes C, Muñoz-Redondo E, Morgado-Pérez A, Ortíz-Agurto N, Finis-Gallardo P, Marco E. Resistance Training and Nutritional Supplementation in Older Adults with Sarcopenia after Acute Disease: A Feasibility Study. Nutrients. 2024; 16(18):3053. https://doi.org/10.3390/nu16183053
Chicago/Turabian StyleMeza-Valderrama, Delky, Dolores Sánchez-Rodríguez, Yulibeth Curbelo Peña, Cindry Ramírez-Fuentes, Elena Muñoz-Redondo, Andrea Morgado-Pérez, Norma Ortíz-Agurto, Paola Finis-Gallardo, and Ester Marco. 2024. "Resistance Training and Nutritional Supplementation in Older Adults with Sarcopenia after Acute Disease: A Feasibility Study" Nutrients 16, no. 18: 3053. https://doi.org/10.3390/nu16183053