This study aims to investigate the impact of aerobic exercise on sarcopenic elderly to inform exercise prescriptions for this group.
In this case series, three sarcopenic patients (1 male, 2 female; mean age 68.7±4.0 years) were enrolled, diagnosed according to the 2019 Asian consensus criteria. All participants underwent an aerobic training program, consisting of sessions three times per week for 30-40 minutes over a 3-month period. The program included two outpatient rehabilitation sessions using a treadmill or cycle ergometer, and one home-based session each week. Moderate-intensity aerobic exercise was set at 40-60% of their VO₂ peak, determined through Cardiopulmonary Exercise Testing (CPET). Baseline assessments of muscle strength, mass, and physical function were conducted using grip strength, Dual-Energy X-ray Absorptiometry (DXA), and a 6-meter walk test. Post-intervention assessments were conducted following the 3-month training program.
After aerobic exercise training, appendicular skeletal muscle mass index (ASMI) showed slight increases, while handgrip strength improved significantly. In terms of ASMI, Patient A increased from 6.54 to 6.82 kg/m², Patient B from 4.87 to 4.93 kg/m², and Patient C remained stable from 4.67 to 4.65 kg/m². Handgrip strength improved for all patients, increasing from 23.5 to 32.0 kg for Patient A, from 15.5 to 16.5 kg for Patient B, and from 16.0 to 22.0 kg for Patient C. However, despite these improvements, Patient B continued to meet the diagnostic criteria for sarcopenia, as her handgrip strength remained below 18 kg, indicating both reduced muscle mass and strength. Walking speed remained above the standard value of 1 m/sec for all patients in both pre- and post-training assessments. Additionally, cardiac capacity showed improvement after aerobic training, particularly for Patient C, whose VO₂ peak increased from 16.9 to 21.3 ml/kg/min and maximum heart rate improved from 72% of predicted to 100%, progressing from mild functional aerobic impairment to normal levels.
Aerobic exercise over three months improved handgrip strength and cardiopulmonary capacity in this case series, but had minimal impact on muscle mass, as evidenced by slight increases in ASMI and persistent sarcopenia in one patient. Resistance training may be necessary to address muscle mass deficits more effectively, and larger studies are needed to determine optimal training protocols for muscle-specific improvements.
Although aerobic exercise benefits handgrip strength and cardiopulmonary capacity in sarcopenic elderly, future interventions should incorporate resistance training to better target muscle mass deficits, using aerobic exercise as complementary therapy to enhance overall outcomes.
Elderly
Aerobic exercise
