短期多成分运动对有急性肌肉疏松症风险的住院老年人肌肉功能和结构的影响

IF 8.9 1区 医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2024-10-13 DOI:10.1002/jcsm.13602
Mikel L Sáez de Asteasu,Nicolás Martínez-Velilla,Fabricio Zambom-Ferraresi,Yesenia García-Alonso,Arkaitz Galbete,Robinson Ramírez-Vélez,Eduardo L Cadore,Mikel Izquierdo
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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.\r\n\r\nRESULTS\r\nAmong 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. 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引用次数: 0

摘要

背景住院会加重老年人的肌肉疏松症和身体功能障碍。量身定制的住院锻炼能否预防急性肌肉疏松症尚属未知。本研究旨在探讨多成分运动计划对住院老年人肌肉和身体功能的影响。我们假设,与单纯的常规住院治疗相比,参加简短的定制运动疗程(即 3-5 天)将减轻肌肉功能和结构的变化。方法这项随机临床试验于 2018 年 5 月至 2021 年 4 月在西班牙纳瓦拉大学医院进行,结果评估为盲法。参与者为急诊老年病科收治的 130 名 75 岁及以上患者。患者被随机分配到一个定制的3至5天锻炼计划(n = 64)或通常的医院护理(对照组,n = 66),其中包括必要的物理治疗。主要终点是入院至出院期间,各组间短期体能测试(SPPB)评分和通常步速的变化差异。次要终点包括股直肌回声强度、横截面积、厚度以及皮下和肌肉内脂肪的超声波变化。结果130名随机患者(平均 [SD] 年龄,87.7 [4.6]岁;57 [44%] 名女性)中,与对照组相比,运动组患者的平均 SPPB 得分提高了 0.98 分(95% CI,0.28-1.69 分),步速提高了 0.09 米/秒(95% CI,0.03-0.15 米/秒)(均 p <0.01)。在任何超声肌肉结果中均未观察到组间差异。结论在易受伤害的老年患者中,与单纯的常规医院护理相比,3 到 5 天的量身定制的多成分运动可提供功能性益处,但不会改变肌肉或脂肪结构。简短运动有助于预防住院期间急性肌肉疏松症:NCT04600453。
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Short-Term Multicomponent Exercise Impact on Muscle Function and Structure in Hospitalized Older at Risk of Acute Sarcopenia.
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04600453.
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来源期刊
Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine
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12.40%
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期刊介绍: The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
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