Sáez de Asteasu Mikel L, Martínez-Velilla Nicolás, Zambom-Ferraresi Fabricio, García-Alonso Yesenia, Galbete Arkaitz, Ramírez-Vélez Robinson, Cadore Eduardo L, Izquierdo Mikel
Navarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
J Cachexia Sarcopenia Muscle. 2024 Dec;15(6):2586-2594. doi: 10.1002/jcsm.13602. Epub 2024 Oct 13.
Hospitalization exacerbates sarcopenia and physical dysfunction in older adults. Whether tailored inpatient exercise prevents acute sarcopenia is unknown. This study aimed to examine the effect of a multicomponent exercise programme on muscle and physical function in hospitalized older adults. We hypothesized that participation in a brief tailored exercise regimen (i.e., 3-5 days) would attenuate muscle function and structure changes compared with usual hospital care alone.
This randomized clinical trial with blinded outcome assessment was conducted from May 2018 to April 2021 at Hospital Universitario de Navarra, Spain. Participants were 130 patients aged 75 years and older admitted to an acute care geriatric unit. Patients were randomized to a tailored 3- to 5-day exercise programme (n = 64) or usual hospital care (control, n = 66) consisting of physical therapy if needed. The coprimary endpoints were between-group differences in changes in short physical performance battery (SPPB) score and usual gait velocity from hospital admission to discharge. Secondary endpoints included changes in rectus femoris echo intensity, cross-sectional area, thickness and subcutaneous and intramuscular fat by ultrasound.
Among 130 randomized patients (mean [SD] age, 87.7 [4.6] years; 57 [44%] women), the exercise group increased their mean SPPB score by 0.98 points (95% CI, 0.28-1.69 points) and gait velocity by 0.09 m/s (95% CI, 0.03-0.15 m/s) more than controls (both p < 0.01). No between-group differences were observed in any ultrasound muscle outcomes. There were no study-related adverse events.
Three to 5 days of tailored multicomponent exercise provided functional benefits but did not alter muscle or fat architecture compared with usual hospital care alone among vulnerable older patients. Brief exercise may help prevent acute sarcopenia during hospitalization.
ClinicalTrials.gov identifier: NCT04600453.
住院会加剧老年人的肌肉减少症和身体功能障碍。量身定制的住院锻炼能否预防急性肌肉减少症尚不清楚。本研究旨在探讨多组分锻炼计划对住院老年人肌肉和身体功能的影响。我们假设，与单纯的常规医院护理相比，参与简短的量身定制锻炼方案（即3 - 5天）将减轻肌肉功能和结构的变化。
本随机临床试验于2018年5月至2021年4月在西班牙纳瓦拉大学医院进行，采用盲法评估结果。参与者为130名年龄在75岁及以上入住急性护理老年病房的患者。患者被随机分为量身定制的3至5天锻炼计划组（n = 64）或常规医院护理组（对照组，n = 66），后者根据需要包括物理治疗。共同主要终点是从入院到出院期间，两组在简短体能状况量表（SPPB）评分和通常步态速度变化方面的组间差异。次要终点包括通过超声测量的股直肌回声强度、横截面积、厚度以及皮下和肌内脂肪的变化。
在130名随机分组的患者中（平均[标准差]年龄为87.7[4.6]岁；57名[44%]为女性），锻炼组的平均SPPB评分比对照组提高了0.98分（95%置信区间，0.28 - 1.69分），步态速度提高了0.09 m/s（95%置信区间，0.03 - 0.15 m/s）（均p < 0.01）。在任何超声肌肉指标方面均未观察到组间差异。没有与研究相关的不良事件。
与单纯的常规医院护理相比，3至5天的量身定制多组分锻炼对脆弱的老年患者有功能益处，但未改变肌肉或脂肪结构。简短锻炼可能有助于预防住院期间的急性肌肉减少症。
ClinicalTrials.gov标识符：NCT04600453。
