SLOVENIAN APPROACH FOR COMBATING SARKOPENIA IN A POPULATION BASED PROGRAMS AT THE PRIMARY HEALTH CARE LEVEL

T. Knific¹, M. Čeplak¹, A. Backović Juričan¹

Background: Age-related muscle atrophy and loss of functional strength lead to many health problems in old age (e.g. independence, falls, fractures, death). Up to 15% of people over the age of 65, and as many as 50% of people over the age of 80, have sarcopenia. Regular physical activity (PA) and progressive exercise for muscle strength are proven to prevent sarcopenia and improve muscle status (MS). For the long-term effect of reducing the share of sarcopenia among population, a workshop "I move" (WIM) within the preventive program "Together for health" was implemented in Slovenia. WIM lasts 14 weeks and in addition to basic elements of physical literacy includes also 2-4 weeks’ exercise program (EP) for muscle strength. It is aimed for adults who have risk factors or chronic diseases.

Purpose: The purpose of this work is to show the difference between physical fitness testing results of adults (especially the components of muscle strength, power and endurance) before and after the end of the EP within the WIM.

Methods: The WIM was conducted by 75 physiotherapists in 31 Health education centers and 28 Health promotion centers countrywide. Physiotherapists tested the workshop participants with two groups of tests: an AFT-ALPHA-FIT tests (Slovenian version for younger adults) and a SFT - Senior fitness test (Slovenian version for older adults). MS was assessed in AFT group with hand-grip strength test, back extension test, dynamic sit-ups, modified push-up and jump-and-reach test, and in SFT group with 30-second chair stand test and 30-second arm curl test. Baseline testing was performed in the 2-3rd week of the intervention and final in the 12-13th week. Prior to testing, the participants were medically examined and they completed a questionnaire on health status and PA. The results were statistically processed with the SPSS program with the student's t-test.

Results: 3099 adults attended the WIM in 2019. 2888 of them (85% F, 15% M) passed the fitness test in the first and/or second time point. The average age of the participants was 60 years. The AFT group results were: hand-grip strength test (n=714, MD=1,12, 95 % CI 0,77-1,46), back extension test (n=531; MD=15,45; 95 % CI 11,70-19,20), dynamic sit-ups (n=521; MD=2,99; 95 % CI 2,39-3,56), modified push-up (n=488; MD=1,52; 95 % CI 1,24-1,80), jump-and-reach test (n=529; MD=1,91; 95 % CI 1,53-2,29). The SFT group results were: 30-second chair stand test (n=768; MD=2,49; 95 % CI 2,28-2,71) and 30-second arm curl test (n=706; MD=2,49; 95 % CI 2,25-2,73).

Conclusion(s): In all seven MS tests, there were statistical differences between the averages before and after the end of the EP. The biggest challenge is how to maintain the positive change in MS of participants after the workshop.

Implications: It is imperative to provide the general public and above all the elderly with quality and financially sustainable EP that are not dependent of the health fund alone and take place in local communities. These can have a long-term impact on a participant’s lifestyle, thus preventing sarcopenia and disability in old age.

Funding, acknowledgements: Special thanks to National Institute of Public Health, the Health Insurance Institute of Slovenia and involved physiotherapists from the practice.

Keywords: sarkopenia prevention, muscle status, primary health care physiotherapists

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Institution: National Institute of Public Health in Slovenia

Committee: National Medical Ethics Committee

Reason: Authors work for the National Institute of Public Health and are obligated to evaluate interventions of primary health care PTs.