Zhang Yanjie, Zou Liye, Chen Si-Tong, Bae Jun Hyun, Kim Dae Young, Liu Xiaolei, Song Wook
Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea.
Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen, China.
Front Med (Lausanne). 2021 May 19;8:649748. doi: 10.3389/fmed.2021.649748. eCollection 2021.
Sarcopenia is a muscle disease in loss of muscle strength, mass, and function associated with aging. Although protective effects of exercise on muscle mass and function are generally recognized, research findings in sarcopenic adults are inconsistent. It is necessary to conduct a systematic review to determine the effects of exercise on muscle strength, body composition, and physical performance in older adults with sarcopenia, and to examine the potential moderators including sociodemographic characteristics and exercise-related factors. Six electronical academic databases (Medline, Embase, CINAHL, Scopus, Cochrane Library, and SPORTDiscus) were used to retrieve the eligible studies from inception to May 2020. Two reviewers independently selected and extracted the data from each included study, and effect sizes were calculated by employing random-effect models with 95% confidential interval (CI). The Physiotherapy Evidence Database (PEDro) scale was used to assess study quality. Seventeen studies (985 participants with sarcopenia, aged 67.6-86 years) were included in this review study. The meta-analytic results showed significant improvements in muscle strength [grip strength, SMD = 0.30, 95% CI (0.15, 0.45), = 6%, < 0.01; knee extension, SMD = 0.32, 95% CI (0.15, 0.50), = 0%, < 0.01; and chair and stand, SMD = 0.56, 95% CI (0.30, 0.81), = 36%, < 0.01], in physical performance [timed up and go, SMD = 0.74, 95% CI (0.48, 1.00), = 0%, < 0.01; and gait speed, SMD = 0.59, 95% CI (0.35, 0.82), = 62%, < 0.01], and in body composition [skeletal muscle mass index, SMD = 0.37, 95% CI (0.15, 0.58), = 16%, < 0.01; and appendicular skeletal muscle, SMD = 0.31, 95% CI (0.13, 0.49), = 20%, < 0.01]. However, there were no significant differences in other body composition (SMD = 0.20-0.36). Additionally, meta-regression revealed that the higher percent of female participants was significantly associated with improved gait speed (β = 0.0096, = 0.03) and decreased skeletal muscle mass index (β = -0.0092, = 0.01). The current meta-analysis suggests that exercise is a beneficial therapy, which has protective effects for older adults with sarcopenia. Some beneficial effects may be moderated by gender and exercise intensity.
肌肉减少症是一种与衰老相关的肌肉疾病，表现为肌肉力量、质量和功能的丧失。尽管运动对肌肉质量和功能的保护作用已得到普遍认可，但关于肌肉减少症成年人的研究结果并不一致。有必要进行一项系统综述，以确定运动对患有肌肉减少症的老年人的肌肉力量、身体成分和身体表现的影响，并研究包括社会人口学特征和运动相关因素在内的潜在调节因素。使用六个电子学术数据库（Medline、Embase、CINAHL、Scopus、Cochrane图书馆和SPORTDiscus）检索从数据库建立到2020年5月的符合条件的研究。两名评审员独立从每项纳入研究中选择并提取数据，并采用具有95%置信区间（CI）的随机效应模型计算效应量。使用物理治疗证据数据库（PEDro）量表评估研究质量。本综述研究纳入了17项研究（985名患有肌肉减少症的参与者，年龄在67.6至86岁之间）。荟萃分析结果显示，肌肉力量[握力，标准化均数差（SMD）=0.30，95%CI（0.15，0.45），P=6%，P<0.01；膝关节伸展，SMD=0.32，95%CI（0.15，0.50），P=0%，P<0.01；从椅子上站起，SMD=0.56，95%CI（0.30，0.81），P=36%，P<0.01]、身体表现[计时起立行走测试，SMD=0.74，95%CI（0.48，1.00），P=0%，P<0.01；步速，SMD=0.59，95%CI（0.35，0.82），P=62%，P<0.01]和身体成分[骨骼肌质量指数，SMD=0.37，95%CI（0.15，0.58），P=16%，P<0.01；四肢骨骼肌，SMD=0.31，95%CI（0.13，0.49），P=20%，P<0.01]均有显著改善。然而，其他身体成分方面无显著差异（SMD=0.20 - 0.36）。此外，荟萃回归显示，女性参与者比例较高与步速改善（β=0.0096，P=0.03）和骨骼肌质量指数降低（β=-0.0092，P=0.01）显著相关。当前的荟萃分析表明，运动是一种有益的治疗方法，对患有肌肉减少症的老年人具有保护作用。一些有益效果可能受性别和运动强度的调节。
