Kong Demin, Chen Jiangang
Graduate School, Kyungnam University, Changwon, South Gyeongsang, Republic of Korea.
College of P.E and Sports, Beijing Normal University, Beijing, China.
Front Physiol. 2025 Aug 25;16:1610138. doi: 10.3389/fphys.2025.1610138. eCollection 2025.
While exercise interventions are widely used for sarcopenia management, the comparative efficacy of different non-invasive treatments remains unclear. This network meta-analysis evaluated five interventions (aerobic training, resistance training, aerobi-resistance training, whole-body electrical stimulation, and electrical stimulation with protein supplementation) on body composition, physical function and quality of life in elderly sarcopenia patients.
Six databases, including PubMed, Embase and Web of Science, were systematically searched, and 22 randomized controlled trials with a total of 1062 elderly patients with sarcopenia were finally included. The outcome indicators were those related to the evaluation of body composition, physical function and quality of life. Net meta-analysis was performed using Stata 17.0 to assess the relative effectiveness of each intervention and to test the consistency of direct and indirect evidence.
ES&P (SMD = -3.33, 95% CI [-4.23, -2.44], p < 0.00001) and AT (SMD = -1.31, 95% CI [-1.83, -0.79], p < 0.00001, I = 58%) demonstrated significant effects in terms of fat reduction, RT achieved a significant effect in terms of muscle gain (SMD = 0.50, 95% CI [0.08, 0.91], p < 0.05, I = 42%), RAT was the most effective in terms of strength gains (SMD = 0.51, 95% CI [0.05, 0.98], p < 0.05, I = 0%), and RAT also demonstrated a favorable effect in terms of improving quality of life (SMD = 1.42, 95% CI [0.13, 2.70], p < 0.05, I = 55%).
ES & P and AT have good effect on fat reduction, RT has the best effect on increasing muscle, RAT is the most effective in improving strength, and AT is the best in improving quality of life. Different treatments have different effects on functional indicators, and clinics should personalize the selection of different interventions according to the patient's condition and combine multiple interventions to achieve the best recovery results.
虽然运动干预广泛用于肌肉减少症的管理，但不同非侵入性治疗的相对疗效仍不明确。这项网状Meta分析评估了五种干预措施（有氧运动训练、抗阻训练、有氧抗阻训练、全身电刺激以及补充蛋白质的电刺激）对老年肌肉减少症患者身体成分、身体功能和生活质量的影响。
系统检索了包括PubMed、Embase和Web of Science在内的六个数据库，最终纳入22项随机对照试验，共1062例老年肌肉减少症患者。结局指标为与身体成分、身体功能和生活质量评估相关的指标。使用Stata 17.0进行网状Meta分析，以评估每种干预措施的相对有效性，并检验直接和间接证据的一致性。
补充蛋白质的电刺激（标准化均值差=-3.33，95%置信区间[-4.23，-2.44]，p<0.00001）和有氧运动训练（标准化均值差=-1.31，95%置信区间[-1.83，-0.79]，p<0.00001，I=58%）在减脂方面显示出显著效果，抗阻训练在增加肌肉方面取得显著效果（标准化均值差=0.50，95%置信区间[0.08，0.91]，p<0.05，I=42%），有氧抗阻训练在增强力量方面最有效（标准化均值差=0.51，95%置信区间[0.05，0.98]，p<0.05，I=0%），并且有氧抗阻训练在改善生活质量方面也显示出良好效果（标准化均值差=1.42，95%置信区间[0.13，2.70]，p<0.05，I=55%）。
补充蛋白质的电刺激和有氧运动训练在减脂方面效果良好，抗阻训练在增加肌肉方面效果最佳，有氧抗阻训练在增强力量方面最有效，有氧运动训练在改善生活质量方面最佳。不同治疗方法对功能指标有不同影响，临床应根据患者病情个性化选择不同干预措施，并联合多种干预措施以获得最佳康复效果。
