Graded Progressive Home-Based Resistance Combined with Aerobic Exercise in Community-Dwelling Older Adults with Sarcopenia: A Randomized Controlled Trial

Minjing Liu,1,2,&ast; Jiaojiao Li,2,&ast; Jing Xu,2 Ya Chen,2 Chiafu Chien,3 Hui Zhang,4 Qing Zhang,5 Li Wang2 1Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2School of Nursing, Suzhou Medical College of Soochow University, Suzhou, People’s Republic of China; 3Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 4School of Nursing, Suzhou Vocational Health College, Suzhou, People’s Republic of China; 5Physical Education and Sports School, Soochow University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li Wang, School of Nursing, Suzhou Medical College, Soochow University, No. 1 Shi zi Street, Suzhou, Jiangsu, 215006, People’s Republic of China, Email [email protected] Qing Zhang, Physical Education and Sports School, Soochow University, Suzhou, People’s Republic of China, Email [email protected]: This randomized parallel controlled trial aimed to determine the effectiveness of graded progressive home-based resistance combined with aerobic exercise in improving physical fitness in community-dwelling older adults with sarcopenia.Patients and Methods: Community-dwelling older adults (≥ 60 years) with sarcopenia were randomly assigned to the intervention group (IG), receiving 12 weeks of graded progressive home-based resistance and aerobic exercise training, and the control group (CG), maintaining lifestyle unchanged. The primary outcomes were knee extensor muscle strength and the six-minute walk distance (6MWD). Intention-to-treat analysis was applied to the data from all participants in the CG and IG. Post-intervention differences between the intervention and control groups were determined using a generalized estimated equation model with pre-values adjusted.Results: Data from all the participants in the IG (n=41) and CG (n=45) were analyzed. After the intervention, knee extensor muscle strength (95% CI: 0.140– 3.460, P=0.036), 6MWD (95% CI: 35.350– 80.010, P< 0.001), flexor muscle strength and the results of 30s bicep curls, 30s chair stand, the chair sit and reach test and back stretch test in the IG were larger and value of the timed up-and-go test was smaller than those in the CG (P< 0.05). The body composition, quality of life and their changes showed no group differences. The attendance rates were 82.9% and 85.4% for resistance and aerobic exercise, respectively.Conclusion: The 12-week graded progressive home-based resistance and aerobic exercise intervention improved muscle strength, balance, flexibility, and cardiorespiratory fitness in community-dwelling older adults with sarcopenia, whereas body composition and quality of life remained unchanged. The research was approved by the Ethics Committee of Soochow University (ECSU-2019000161) and registered at the Chinese Clinical Trial Registry (ChiCTR1900027960, http://www.chictr.org.cn/showproj.aspx?proj=45968).Keywords: physical function, muscle strength, multicomponent exercise, walking, skeletal muscle disease