EXERCISE-BASED STRATEGIES FOR THE MANAGEMENT AND PREVENTION OF SARCOPENIA IN OLDER ADULTS: A REVIEW

Ibrahim Karaca

Abstract


Sarcopenia, characterized by the decline in muscle mass and function that occurs with aging, is a significant clinical condition that threatens independent living in older adults. It leads to reduced physical capacity, greater risk of falls, and deterioration in quality of life, creating a considerable burden on healthcare systems. The purpose of this review is to examine comprehensively the role of current exercise modalities in the management of sarcopenia, in light of its pathophysiology and epidemiological characteristics. Progressive resistance training, power-oriented exercises, low load blood flow restriction training, combined programs, and multicomponent approaches are evaluated in terms of their physiological effects and implementation parameters. The findings indicate that exercise is a central intervention for addressing sarcopenia, particularly when it is applied as a multidisciplinary, individualized, and sustainable strategy.

Keywords


sarcopenia; resistance training; exercise therapy; aging

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References


American College of Sports Medicine. (2021). ACSM's guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer.

Baptista, F. M., Andias, R., Rocha, N. P., & Silva, A. G. (2024). A practice guide for physical therapists prescribing physical exercise for older adults. Journal of Aging and Physical Activity, 32(6), 771–783. https://doi.org/10.1123/japa.2023-0283

Beaudart, C., Sanchez-Rodriguez, D., Locquet, M., Reginster, J. Y., & Bruyère, O. (2022). Diagnostic tools for sarcopenia: An update and review of their validity. Ageing Research Reviews, 74, 101530. https://doi.org/10.1016/j.arr.2021.101530

Carcelén Fraile, M. C., et al. (2023). Resistance training combined with aerobic training has better effects than resistance only in older male adults with sarcopenia: Systematic review. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2022.1037464

Centner, C., Wiegel, P., Gollhofer, A., & König, D. (2021). Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: A systematic review and meta-analysis. Sports Medicine, 51(3), 525–537. https://doi.org/10.1007/s40279-020-01390-6

Chen, H. T., Chen, Y. J., Chung, Y. C., et al. (2023). Effects of power training on neuromuscular performance and functional capacity in older adults: A randomized controlled trial. Journal of Strength and Conditioning Research, 37(4), 752–760. https://doi.org/10.1519/JSC.0000000000004307

Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., ... & Cooper, C. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16–31. https://doi.org/10.1093/ageing/afy169

Damluji, A. A., et al. (2023). Low muscle mass should be determined based on the risk of muscle weakness: Association between sarcopenia and cardiovascular diseases. Circulation. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064071

de Melo, T. A., Silva Guimarães, F. S., & Lapa e Silva, J. R. (2023). The five times sit to stand test: Safety, validity and reliability with critical care survivors at ICU discharge. Archives of Physiotherapy, 13, Article 2. https://doi.org/10.1186/s40945-022-00156-z

Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Arai, H., Kritchevsky, S. B., Guralnik, J., ... & Woo, J. (2023). International clinical practice guidelines for sarcopenia (ICFSR): Screening, diagnosis and management. Journal of Nutrition, Health and Aging, 27, 1–20. https://doi.org/10.1007/s12603-022-1812-7

Fragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., & Ryan, E. D. (2019). Resistance training for older adults: Position statement from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research, 33(8), 2019–2052. https://doi.org/10.1519/JSC.0000000000003230

Geraedts, H. A., Dijkstra, B., & Meulenbelt, M. (2023). Power training in sarcopenia: Systematic review of effectiveness in older adults. BMC Geriatrics, 23(1), 145. https://doi.org/10.1186/s12877-023-03794-6

He, S., Meng, D., Wei, M., Guo, H., Yang, G., & Wang, Z. (2024). Proposal and validation of a new approach in tele rehabilitation with 3D human posture estimation: A randomized controlled trial in older individuals with sarcopenia. BMC Geriatrics, 24, Article 586.

Hurst, C., Weston, K. L., McLaren, S. J., Weston, M., & Page, R. M. (2022). The effects of combined resistance and aerobic exercise training on functional performance and quality of life in older adults: A systematic review and meta-analysis. Ageing Research Reviews, 74, 101543. https://doi.org/10.1016/j.arr.2021.101543

Izquierdo, M., Rodríguez-Mañas, L., Sinclair, A. J., & Morley, J. E. (2021). What is new in exercise regimes for frail older people: How does the Erasmus Vivifrail project fit? Journal of the American Medical Directors Association, 22(3), 388–394. https://doi.org/10.1016/j.jamda.2020.12.022

Izquierdo-Gómez, R., Esteban-Cornejo, I., Gómez-Martínez, S., Padilla-Moledo, C., & Veiga, O. L. (2021). Effects of concurrent training on physical fitness and adiposity in adolescents: A systematic review and meta-analysis. Sports Medicine, 51(5), 1051–1070. https://doi.org/10.1007/s40279-020-01414-1

Korean Working Group on Sarcopenia. (2023). 2023 update of the Korean clinical practice guideline for sarcopenia: Exercise intervention and molecular adaptations. Journal of Cachexia, Sarcopenia and Muscle, 14(2), 240–256. https://doi.org/10.1002/jcsm.13206

Landi, F., Calvani, R., Tosato, M., Martone, A. M., Ortolani, E., Savera, G., ... & Marzetti, E. (2023). Resistance exercise and protein intake to combat sarcopenia: A combined strategy. Aging Clinical and Experimental Research, 35, 1–9. https://doi.org/10.1007/s40520-022-02117-w

Lee, J., et al. (2024). Efficacy of a combined exercise and nutrition intervention study for outpatients with possible sarcopenia in community-based primary care clinics (ENdSarC). BMC Geriatrics, 24. https://doi.org/10.1186/s12877-024-05434-y

Li, N., et al. (2024). Feasibility, usability and acceptability of a lifestyle integrated functional exercise (LiFE) program supported by an mHealth platform in pre-frail older adults. BMC Geriatrics, 24, Article 555. https://doi.org/10.1186/s12877-024-05523-y

Lin, W. S., et al. (2024). Predicting sarcopenia in community-dwelling older adults: Functional fitness components and risk factors. BMC Geriatrics, 24, Article 535. https://doi.org/10.1186/s12877-024-05528-7

Liu, M. (2024). Graded progressive home-based resistance combined with aerobic exercise in community-dwelling older adults with sarcopenia: A randomized controlled trial. Patient Preference and Adherence, Article 45968. https://pubmed.ncbi.nlm.nih.gov/39355281/

Loenneke, J. P., Buckner, S. L., Abe, T., & Thiebaud, R. S. (2022). Blood flow restriction training: A novel way to enhance muscle size and strength. Strength & Conditioning Journal, 44(1), 14–23. https://doi.org/10.1519/SSC.0000000000000600

Makizako, H., Nakai, Y., Tomioka, K., Taniguchi, Y., Sato, N., Wada, A., ... & Takenaka, T. (2020). Effects of a multicomponent exercise program in physical function and muscle mass in sarcopenic/pre-sarcopenic adults. Journal of Clinical Medicine, 9(5), 1386. https://doi.org/10.3390/jcm9051386

Martínez-Amat, A., Aibar-Almazán, A., Cruz-Díaz, D., de la Torre-Cruz, M., & Hita-Contreras, F. (2023). Multicomponent exercise programs for older adults: A meta-analysis of randomized controlled trials. Journal of Aging and Physical Activity, 31(2), 217–228. https://doi.org/10.1123/japa.2022-0111

Park, S.-H., & Lee, H.-W. (2023). Effectiveness of combined exercise and nutrition interventions in preventing and improving sarcopenia in frail or healthy older adults: A systematic review. Research in Gerontological Nursing, 1–9. https://doi.org/10.3928/19404921-20230817-03

Park, W. T., Shon, O. J., & Kim, G. B. (2023). Multidisciplinary approach to sarcopenia: A narrative review. Journal of Yeungnam Medical Science, 40(4), 352–363. https://doi.org/10.12701/jyms.2023.00726

Ogawa, M., et al. (2024). Age-associated muscle atrophy mechanisms and exercise-induced remodeling: Focus on satellite cells and mitochondria. Aging and Disease, 15(1), 1–13. https://doi.org/10.14336/AD.2023.0901

Papadopoulou, S. K., Tsintzas, D., & Papandreou, D. (2020). Effects of sarcopenia on quality of life and daily living. Aging Clinical and Experimental Research, 32(3), 477–484. https://doi.org/10.1007/s40520-019-01380-z

Ramírez-Vélez, R., et al. (2023). Power versus traditional resistance training for improving physical function and quality of life in older adults: A systematic review and meta-analysis. Experimental Gerontology, 174, 112143. https://doi.org/10.1016/j.exger.2023.112143

Sánchez-Sánchez, J. L., Udina, C., Medina-Rincón, A., Esbrí-Victor, M., Bartolomé-Martín, I., Moral-Cuesta, D., ... & Casas-Herrero, Á. (2023). Correction: Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: Study protocol for a randomized multicenter control trial. BMC Geriatrics, 23, 31. https://doi.org/10.1186/s12877-022-03624-0

Sepúlveda-Loyola, W., Silva-Diaz, Y. A., Teixeira, D. D. C., Solis, C. S., Caputo, D. D. C. D. S., Barrios, O. E. A., & Álvarez-Bustos, A. (2025). New exercise programs for older adults in the community: Evidence and applicability in the Latin American context. Geriatrics, Gerontology and Aging, 19, 1–3. https://doi.org/10.53886/gga.e2025

Sung, J. H., et al. (2022). The association of aerobic, resistance, and combined exercise with preserved handgrip strength in older adults. BMC Geriatrics, 22, Article 929. https://doi.org/10.1186/s12877-022-03483-7

Tieland, M., Trouwborst, I., & Clark, B. C. (2018). Skeletal muscle performance and ageing. Journal of Cachexia, Sarcopenia and Muscle, 9(1), 3–19. https://doi.org/10.1002/jcsm.12238

Toro Román, V., et al. (2024). Functionality, muscular strength and cardiorespiratory fitness in older adults: Performance indicators. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-024-02694-7

Valenzuela, P. L., Morales, J. S., Pareja-Galeano, H., Lucia, A., & Castillo-Garzon, M. J. (2021). Effects of physical exercise on sarcopenia in the elderly: A systematic review and meta-analysis. Scandinavian Journal of Medicine & Science in Sports, 31(5), 942–956. https://doi.org/10.1111/sms.13925

Wilkinson, D. J., Piasecki, M., & Atherton, P. J. (2021). The age-related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing Research Reviews, 67, 101273. https://doi.org/10.1016/j.arr.2021.101273

Wu, N., Li, M., & Chen, X. (2025). Adherence to exercise intervention for community-dwelling older adults with sarcopenia: A systematic review and meta-analysis. Age and Ageing, 54(4). https://doi.org/10.1093/ageing/afae070

Zhang, L., Song, X., Wang, H., et al. (2024). Effects of blood flow restriction combined with aerobic stepping exercise in sarcopenia: A study protocol for a randomized clinical trial. International Journal of General Medicine, 17, 85–94. https://doi.org/10.2147/IJGM.S490060

Zhang, X., Wang, C., Dou, Q., Zhang, W., Yang, Y., & Xie, Y. (2022). Prevalence of sarcopenia and its associated factors in older Chinese adults: A systematic review and meta-analysis. BMJ Open, 12(3), e051724.




DOI: http://dx.doi.org/10.46827/ejprs.v5i1.228

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