Liao C-D1,2, Tsauo J-Y2, Liou T-H1,3,4
1Taipei Medical University, Shuang Ho Hospital, Department of Physical Medicine and Rehabilitation, Taipei, Taiwan, 2National Taiwan University, School and Graduate Institute of Physical Therapy, Taipei, Taiwan, 3Taipei Medical University, Graduate Institute of Injury Prevention and Control, Taipei, Taiwan, 4Taipei Medical University, School of Medicine, College of Medicine, Department of Physical Medicine and Rehabilitation, Taipei, Taiwan
Background: Aging is accompanied by skeletal muscle mass loss which is a common characteristic of sarcopenia and frailty and can be effectively improved by resistance exercise training (RET) or multicomponent exercise training (MET). Nutrient supply, such as protein supplement (PS), has been recommended for additional lean mass and strength regain in individuals receiving RET. Whether PS combined with exercise intervention exert any benefit on augmentation of muscular and functional performance in elder people with sarcopenia or frailty remains unclear.
Purpose: The purpose of this study was to identify the effect of PS in combination with exercise intervention on body composition and physical function for older adults with sarcopenia or frailty.
Methods: A comprehensive search of online databases including Medline, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), and the search engine of Google Scholar was performed to identify randomized controlled trials (RCT) that reported the efficacy of PS combined with RET or MET on lean mass gain, strength gain, and physical mobility in elder people with sarcopenia or frailty. The included RCTs were analyzed through meta-analysis and risk of bias assessment.
Results: Thirty seven RCTs were included in the analysis with a mean (range/total) PEDro score of 7.6 (5-9/10). Participants with additional PS had significantly greater gain in whole body and appendicular lean mass with a standard mean difference (SMD) of 0.40 [95% confidence interval (CI) 0.29-0.52; p 0.00001; heterogeneity (I2) = 28%, p > 0.05) and 0.34 (95% CI 0.11-0.57; p = 0.003; I2 = 54%, p 0.01), respectively; Results of meta-analyses also showed significant effects on hand grasp (SMD 0.25, 95% CI 0.08-0.41; p = 0.004; I2 = 45%, p 0.05) and leg strength (SMD 0.35, 95% CI 0.26-0.45; p 0.00001; I2 = 20%, p > 0.05) favoring PS plus exercise intervention. In function outcomes, PS plus exercise intervention exhibited greater effects on gait speed with a significant SMD of 0.32 (95% CI 0.17-0.47; p 0.0001; I2 = 57%, p 0.001) compared to PS alone or exercise alone. Subgroup analyses based on exercise intervention type showed no difference between RET and MET subgroups in effects on all outcomes.
Conclusion(s): Additional PS in combination with RET, as well as MET, is effective for eliciting gains in lean body mass, appendicular lean mass, muscle strength, and physical mobility, in older adults with sarcopenia or frailty.
Implications: Clinicians should incorporate strategies for improving physical activity into their management of patients who are at risk of low muscle mass to maximize health status, especially for elder individuals with sarcopenia or frailty.
Keywords: sarcopenia, protein supplement, exercise training
Funding acknowledgements: This study received no fund or grant.
Purpose: The purpose of this study was to identify the effect of PS in combination with exercise intervention on body composition and physical function for older adults with sarcopenia or frailty.
Methods: A comprehensive search of online databases including Medline, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), and the search engine of Google Scholar was performed to identify randomized controlled trials (RCT) that reported the efficacy of PS combined with RET or MET on lean mass gain, strength gain, and physical mobility in elder people with sarcopenia or frailty. The included RCTs were analyzed through meta-analysis and risk of bias assessment.
Results: Thirty seven RCTs were included in the analysis with a mean (range/total) PEDro score of 7.6 (5-9/10). Participants with additional PS had significantly greater gain in whole body and appendicular lean mass with a standard mean difference (SMD) of 0.40 [95% confidence interval (CI) 0.29-0.52; p 0.00001; heterogeneity (I2) = 28%, p > 0.05) and 0.34 (95% CI 0.11-0.57; p = 0.003; I2 = 54%, p 0.01), respectively; Results of meta-analyses also showed significant effects on hand grasp (SMD 0.25, 95% CI 0.08-0.41; p = 0.004; I2 = 45%, p 0.05) and leg strength (SMD 0.35, 95% CI 0.26-0.45; p 0.00001; I2 = 20%, p > 0.05) favoring PS plus exercise intervention. In function outcomes, PS plus exercise intervention exhibited greater effects on gait speed with a significant SMD of 0.32 (95% CI 0.17-0.47; p 0.0001; I2 = 57%, p 0.001) compared to PS alone or exercise alone. Subgroup analyses based on exercise intervention type showed no difference between RET and MET subgroups in effects on all outcomes.
Conclusion(s): Additional PS in combination with RET, as well as MET, is effective for eliciting gains in lean body mass, appendicular lean mass, muscle strength, and physical mobility, in older adults with sarcopenia or frailty.
Implications: Clinicians should incorporate strategies for improving physical activity into their management of patients who are at risk of low muscle mass to maximize health status, especially for elder individuals with sarcopenia or frailty.
Keywords: sarcopenia, protein supplement, exercise training
Funding acknowledgements: This study received no fund or grant.
Topic: Older people; Musculoskeletal; Disability & rehabilitation
Ethics approval required: No
Institution: Taipei Medical University
Ethics committee: The Joint Institutional Review Board of Taipei Medical University
Reason not required: This study was an systemic review and meta-analysis. All included trials have been published and all of the data were extracted from the published literatures.
All authors, affiliations and abstracts have been published as submitted.
