Efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass: a prospective longitudinal clinical trial.

Low muscle mass is a common condition among older adults that adversely affects strength, physical performance and quality of life. This study aimed to investigate the efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass, which was defined as appendicular skeletal mass (ASM) measured by bioimpedance analysis lower than 5.7 kg/m2 in females, and lower than 7.0 kg/m2 in males. This home-based resistance exercise program targets 10 muscles with a frequency of 3-5 days/week for 24 weeks. ASM, grip strength, gait speed and functional reach were measured at baseline, 3 and 6 months. The same four outcomes were then remeasured at 9 months to assess long-term effects. A total of 112 participants (average age: 70 years) were recruited. The mean difference between baseline and 6 months was statistically significant for all outcomes, including ASM [0.12 kg/m2: 95% confidence interval (CI), 0.05-0.18; P = 0.001], gait speed (0.19 meter/s: 95% CI, 0.14-0.25; P < 0.001), grip strength (2.06 kg: 95% CI, 1.32-2.80; P < 0.001), and functional reach distance (4.18 cm: 95% CI, 3.18-5.18; P < 0.001). Change over time for all main outcomes from baseline to 9 months also showed statistically significant improvement. The most commonly reported adverse events were muscle pain, joint pain and fatigue. The majority of participants (90-93%) had good exercise compliance, even at the end of the study. In conclusion, this 24-week simple home-based resistance exercise program significantly improved all main outcomes with low adverse events, and most participants continued the program after the end of the intervention.

Is four-week underwater treadmill exercise regimen compared to home exercise efficacious for pain relief and functional improvement in obese patients with knee osteoarthritis? A randomized controlled trial.

OBJECTIVE:: To investigate the efficacy of a four-week underwater treadmill exercise regimen compared to a home exercise regimen relative to pain relief and functional improvement in obese patients with knee osteoarthritis. DESIGN:: Single-blind randomized controlled trial. SETTING:: Outpatient. PARTICIPANTS:: Eighty primary knee osteoarthritis with pain ⩾5/10 and body mass index ⩾25 kg/m2. INTERVENTIONS:: Daily quadriceps exercise at home for 30 minutes (control group) or underwater treadmill exercise (study group) for 30 minutes/day, three times/week for four weeks. MAIN OUTCOMES:: Pain score, six-minute walking distance, quadriceps strength, and body weight were evaluated at baseline and after four weeks. Adverse events, global assessment, and satisfaction index were assessed at the end of study. RESULTS:: All outcomes in both groups were significantly improved at the end of the study, except for body weight. The mean difference (95% confidence interval (CI)) in outcomes between groups were -0.53 (-1.31, 0.26) for pain; 10.81 (-11.9, 33.53) meters for 6-minute walking distance; 0.67 (-0.10, 1.44) kilograms for quadriceps strength; and 0.01 (-0.66, 0.68) kilograms for body weight. No significant differences were observed between groups, for the per protocol analysis or the intention-to-treat analysis. Participants in the study group evaluated significantly better global improvement and higher patient satisfaction than those in control group (13 (39.4%) vs. 4 (10.8%); P = 0.014 and 23 (69.7%) vs. 16 (43.2%); P = 0.021, respectively). CONCLUSION:: Exercise using an underwater treadmill was found to be as efficacious as home exercise for relieving pain and improving function in obese people with mild to moderate knee osteoarthritis.