Training modalities for elder sarcopenic obesity: a systematic review and network meta-analysis

Abstract

IntroductionSarcopenic obesity (SO) is a condition characterized by the coexistence of age-related obesity and sarcopenia. This systematic review and network meta-analysis (NMA) aimed to compare the effects of different training modalities, such as aerobic training (AT), resistance training (RT), combined resistance with AT (CT), and multicomponent training (MCT) on body composition, muscle strength, and physical performance in elderly patients with SO.MethodsWe electronically searched randomized controlled trials, published from inception to March 2024 in PubMed, Embase, Cochrane Library, Web of Science and Scopus. Effect estimates were presented as mean differences (MD) or Standard Mean Difference (SMD) with 95% confidence interval (CI). The comprehensive effects of all treatments were ranked by the surface under the cumulative ranking (SUCRA) probabilities.Results14 trials enrolling 955 participants were included. The body fat percentage (BFP) in MCT (MD= −6.37, 95% CI: −8.67, −4.07), CT (MD = −2.08, 95% CI: −4.00, −0.16), and RT (MD = −1.85, 95% CI: −3.25, −0.44) was significantly lower than in the normal control group, with MCT showing superior effects compared to CT and RT. Furthermore, only MCT significantly improved fat-free mass (FFM; MD = 5.21, 95% CI:1.51, 8.91), as well as in body mass index (BMI; MD = 0.74, 95% CI:0.08, 1.40). In addition, handgrip strength (HGS) significantly improved under both MCT (SMD = 0.87, 95% CI: 0.19, 1.5) and RT(SMD = 0.84, 95% CI: 0.43, 1.25). The performance on the 30s chair stand test also yielded better outcomes for MCT (MD = 3.10, 95% CI: 1.33, 4 0.86), CT(MD = 2 0.50, 95% CI: 0.18, 5.18), and RT(MD = 3.91, 95% CI: 2.30, 5.52) when compared to the control group. Lastly, gait speed was enhanced by both MCT (MD = 0.35, 95% CI: 0.30, 0.41) and CT(MD = 0.14, 95% CI: 0.06, 0.21). The ranking results indicated that MCT was superior to other training modalities in enhancing body composition and gait speed. In contrast, RT appears to be more advantageous in the 30-second chair standing test and in improving HGS.ConclusionMCT outperformed other training modalities in improving body composition and gait speed. RT was more beneficial for the 30-second chair standing test and enhancing HGS. These findings provide valuable insights for clinicians and researchers to customize exercise prescriptions for older patients with SO.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42024544962.

Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial

“…PT, by involving intense and repeated contractions of large muscle groups, may amplify this myokine response, contributing to the observed reductions in body fat and improvements in body composition [ 37 , 38 ]. Notably, MT also led to significant improvements in these variables, suggesting that combined aerobic, resistance, and balance training may be a viable option for improving body composition and functionality in individuals who may not tolerate or have access to more intensive protocols such as PT [ 12 ]. This supports the relevance of MT in less physically prepared individuals or those with comorbidities.…”

“…These findings are partially consistent with those reported by Hui Qiu et al who conducted a network meta-analysis comparing various exercise modalities in older adults with SO. Their results indicated that MT produced statistically significant improvements in body composition and GS, while RT was most effective for improving HG and the 30 s chair stand test [ 12 ]. However, their analysis did not include long-term studies evaluating PT as an isolated modality.…”

“…However, recent studies have shown that power training (PT) could have an even greater impact on improving muscle power and functional performance in this population [ 11 ]. So far, RT and multicomponent training (MT) have been shown to be more valid strategies to improve physical function and body composition in older adults with SO, as evidenced by several meta-analyses [ 12 , 13 , 14 ]. However, many of these investigations present methodological limitations, such as short intervention durations (usually 12 weeks) and designs with high risk of bias, underscoring the need for more rigorous studies with prolonged interventions as mentioned in the meta-analyses.…”