The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis.

BACKGROUND: Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults. METHODS: We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes. RESULTS: Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups. CONCLUSIONS: This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.

Feasibility of a problem-solving exercise program based on short physical performance battery for older patients with chronic respiratory diseases: A multicenter, pilot clinical trial.

BACKGROUND: This study aimed to assess the feasibility and safety of a problem-solving exercise program based on the items in the short physical performance battery (SPPB) for older patients with chronic respiratory diseases (CRDs) to inform future randomized controlled trials. METHODS: This was a multicenter, prospective, non-randomized feasibility study. Participants with CRD received an enhancement program based on the SPPB decline items (balance, walk, and/or chair stand) for 4 weeks. The feasibility, safety, and efficacy of the problem-solving exercise program in improving the SPPB score, physical function, and step count (measured using a pedometer) were assessed. RESULTS: Overall, 36 patients were enrolled in this study, and adherence to the exercise program was high (100%). No exercise program-related adverse events were observed. The implementation of the exercise program ranged from 70 to 100%. The mean daily step count increased from 2152 ± 1498 steps during the first week to 2899 ± 1865 steps in the last week (p<0.01). Additionally, the SPPB total score increased from 8.9 ± 1.8 points to 10.7 ± 1.3 points at the end of the program (p<0.001). CONCLUSIONS: The problem-solving exercise program based on SPPB is feasible and safe for older patients with CRDs. However, the effectiveness of this exercise program should be validated in large-scale, randomized-controlled trials in the future. TRIAL REGISTRATION: University Hospital Medical Information Network Center (UMIN-CTR) UMIN: approval number: UMIN000048761.

Virtual Assessment of Functional Mobility in Lower Extremity Prosthesis Clients: An Exploratory Study.

Objective: To investigate the relationship between patient perception of lower extremity function and a home-based virtual clinician assessment of mobility in lower limb prosthesis clients. Design: Descriptive observational study using a clinician-administered functional mobility survey and timed Up and Go test to assess lower extremity function under supervision. Setting: Health Insurance Portability and Accountability Act-compliant online virtual platform. Participants: Twelve lower limb loss clients currently using prostheses, aged ≥19 years, not pregnant, and with no stroke, seizure disorder, or cancer. Interventions: Not applicable. Main Outcome Measures: Main outcomes were mobility survey scores and mean timed Up and Go duration. Results: Most participants reported significant ease of completing basic indoor ambulation and toileting tasks (66%-75%) and significant difficulty in running or prolonged ambulation activities (83%) requiring use of lower limb prosthesis. Timed Up and Go test was faster (11.0±2.9 s) than the reference range for transtibial prosthesis users and negatively associated with self-reported lower extremity functional status (r=-.70, P=.02). Conclusions: Self-reported movement with lower limb prostheses at home and evaluation of mobility via a virtual platform is a feasible assessment modality that may reduce the frequency of therapy visits, defray some rehabilitation costs, and minimize the travel burden to distant prosthetic clinics.

Association of Calf Circumference, Hand Grip Strength, and Physical Performance with Serious Adverse Events in Patients with Sub-Acute Stroke Hospitalized for Rehabilitation: An Observational Study.

OBJECTIVE: To determine whether calf circumference (CC), hand grip strength (HGS), and physical performance are linked to the incidence of serious adverse events (SAEs) in patients with sub-acute stroke. DESIGN: Retrospective cohort study. SETTING: Single rehabilitation hospital. PARTICIPANTS: Stroke patients admitted for rehabilitation hospital. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: The incidence of SAEs, such as death, cardiovascular events including recurrent stroke, and conditions requiring transfer to another hospital for specialized care or immediate treatment for an acute illness during hospitalization. RESULTS: A total of 341 patients (median age: 74 years) participated in this study, with 232 patients (68%) exhibiting low physical performance. In the adjusted model, low physical performance was significantly associated with SAEs (HR = 3.01, 95% CI = 1.04-8.68, p = 0.042). However, low CC (HR = 1.60, 95% CI = 0.76-3.38, p = 0.219) and low HGS (HR = 0.98, 95% CI = 0.39-2.42, p = 0.960) did not show an independent association. CONCLUSION: Low physical performance was independently associated with the occurrence of SAEs during hospitalization for rehabilitation in patients with sub-acute stroke.

Nutritional Status and Inflammation as Mediators of Physical Performance and Delirium in Elderly Community-Acquired Pneumonia Patients: A Retrospective Cohort Study.

Purpose: This study proposes a multiple mediation model to evaluate the association among diminished physical performance, malnutrition, inflammation, and delirium in seniors with community-acquired pneumonia. Patients and Methods: This retrospective cohort study included elderly patients hospitalized for community-acquired pneumonia at the Geriatrics Department of the Second People's Hospital of Lianyungang from January 1, 2020, to January 1, 2024. Logistic regression analysis was conducted to examine the associations among physical performance, nutritional status, C-reactive protein (CRP) levels, and delirium. Mediation models assessed the effects of nutritional status and CRP on the relationship between physical performance and delirium, with subgroup analyses based on diabetes status. Results: A total of 379 patients were included, with a mean age of 80.0±7.4 years, and 51.7% were male. The incidence of delirium during hospitalization was 28.5% (n=108). Subgroup analyses revealed significant correlations between physical performance, nutritional status, and CRP (P<0.001), regardless of diabetes status. After adjusting for confounding variables, CRP was positively associated with delirium, while MNA-SF and SPPB scores showed negative correlations with delirium risk (OR=0.852, 95% CI: 0.730-0.995; OR=0.580, 95% CI: 0.464-0.727, P<0.05). Mediation analyses indicated that MNA-SF scores and CRP significantly mediated the association between SPPB and delirium. Specifically, pathways "SPPB→ MNA-SF→ delirium", "SPPB→ CRP→ delirium", and "SPPB→ MNA-SF→ CRP→ delirium" demonstrated significant mediating effects in patients without diabetes, while only the pathway "SPPB→ MNA-SF→ CRP→ delirium" was significant in those with diabetes. Conclusion: Older patients with community-acquired pneumonia and poor physical performance are more susceptible to delirium, with nutritional status and inflammation as key mediators.

From wearables to performance: how acceptance of IoT devices influences physical education results in college students.

With the advent of IoT technology in education, understanding its impact on physical education is crucial. This study investigates how the acceptance of wearable IoT devices influences the physical education results of college freshmen. It posits that user acceptance plays a mediating role in the effectiveness of these devices in enhancing physical performance metrics. The study enrolled 150 first-year students from Guangzhou University of Finance, divided equally into an experimental group and a control group. Participants in the experimental group were provided with 'Xiaomi 8' smart bracelets to be worn during physical education classes. The study spanned six weeks, focusing on assessing various physical performance metrics and the acceptance of the wearable technology. The data analysis involved comparing the physical performance of both groups and conducting regression analyses to evaluate the mediation effect of acceptance. Results indicated significant improvements in physical performance metrics in the experimental group, as evidenced by the Standardized Mean Differences (SMD). Notably, enhancements were observed in short-distance speed and aerobic endurance. The direct impact of wearable IoT devices on physical performance accounted for 66.4% variance, which increased to 84.1% upon incorporating acceptance as a mediator. These findings suggest that the effectiveness of wearable technology in physical education is significantly influenced by students' acceptance. The study concludes that wearable IoT devices can effectively enhance physical education outcomes among college students, with user acceptance playing a crucial mediating role. This underscores the importance of considering user acceptance in the integration of technology in educational settings. The findings provide valuable insights for educators and technologists in designing and implementing technology-integrated curricula.

Association between dynapenic obesity phenotypes and physical performance in middle-age and older women living in community.

Background: Dynapenic obesity (DO) is the coexistence of excess adipose tissue/body weight and low muscle strength. This condition is associated with an increased risk of suffering from various chronic diseases and physical deterioration in older people. Aim: To analyze the association between DO phenotypes and physical performance in middle-aged women living in the community. Methods: This cross-sectional study was conducted on middle-aged and older women (≥50 years) residing in Guayaquil, Ecuador. Dynapenia was diagnosticated by a handgrip strength (HGS) < 16 kg; obesity was determined based on body mass index (BMI) ≥ 30 kg/m2. Participants were categorized into four groups based on their dynapenia and obesity status: non-dynapenic/non-obesity (ND/NO), obesity/non-dynapenic (O/ND), dynapenic/non-obesity (D/NO) and dynapenic/obesity (D/O). Physical performance was assessed by the Short Physical Performance Battery (SPPB). Results: A total of 171 women were assessed. The median (IQR) age of the sample was 72.0 (17.0) years. Obesity and dynapenia were 35% (n = 60) and 57.8% (n = 99) of the participants, respectively. The prevalence of ND/NO was 25.1% (n = 43), O/ND 17% (n = 29), D/NO 39.8% (n = 68) and DO 18.1% (n = 31). The mean SPPB total score was 6.5 ± 3.2. Participants of D/NO and DO groups presented significantly lower mean SPPB scores (p < 0.001) compared to those of NO/ND and O/ND groups. Conclusion: Women with DO and D/NO exhibited significantly lower SPPB scores, indicating poorer physical performance. These findings emphasize the importance of incorporating a comprehensive assessment of muscle strength and obesity in middle-aged and older women.

Caffeine Placebo Effect in Sport and Exercise: A Systematic Review.

The objective of this review article is to systematically identify the caffeine placebo effect in sport and exercise activities. We selected randomized controlled trial studies to better understand the impact of caffeine and its placebo effect on sports performance. We extracted a set of articles that refer strictly to the topics of caffeine and its placebo effect in sport and exercise, considering the databases integrated to the Core Collection Web of Science and Scopus, as well as the registration of the documents in PubMed®, a system with a selection process aligned with the guidelines for the PRISMA methodology, establishing the eligibility criteria of the articles with the PICOS tool, to which a systematic review is applied. Finally, the results show that caffeine improves anaerobic capacity and endurance, while placebo perceived as caffeine can also increase performance by reducing pain and improving concentration. This finding underscores the influence of expectations and placebo on physical performance, suggesting that managing these expectations may be an effective strategy for improving athletic performance.

Intrasession Caffeine Intake and Cycling Performance After Accumulated Work: A Field-Based Study.

BACKGROUND: Preexercise caffeine intake has proven to exert ergogenic effects on cycling performance. However, whether these benefits are also observed under fatigue conditions remains largely unexplored. We aimed to assess the effect of caffeine ingested during prolonged cycling on subsequent time-trial performance in trained cyclists. METHODS: The study followed a triple-blinded, randomized, placebo-controlled cross-over design. Eleven well-trained junior cyclists (17 ± 1 years) performed a field-based 8-min time trial under "fresh" conditions (i.e., after their usual warm-up) or after two work-matched steady-state cycling sessions (total energy expenditure∼20 kJ/kg and ∼100 min duration). During the latter sessions, participants consumed caffeine (3 mg/kg) or a placebo ∼60 min before the time trial. We assessed power output, heart rate, and rating of perceived exertion during the time trial and mood state (Brunel Mood Scale) before and after each session. RESULTS: No significant condition effect was found for the mean power output attained during the time trial (365 ± 25, 369 ± 31, and 364 32 W for "fresh," caffeine, and placebo condition, respectively; p = .669). Similar results were found for the mean heart rate (p = .100) and rating of perceived exertion (p = 1.000) during the time trial and for the different mood domains (all p > .1). CONCLUSIONS: Caffeine intake during prolonged exercise seems to exert no ergogenic effects on subsequent time-trial performance in junior cyclists. Future studies should determine whether significant effects can be found with larger caffeine doses or after greater fatigue levels.

Effectiveness of whey protein supplementation on muscle strength and physical performance of older adults: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: The efficacy of whey protein supplement (WPS) in improving muscle strength, physical performance, and body composition in older adults has been widely promoted. However, the results of randomized clinical trials in this regard have been inconsistent. We aimed to determine the impact of WPS, compared to a placebo, during or without training on muscle strength, physical function, and body composition in older adults. METHODS: Randomized controlled trials were thoroughly searched using PubMed, EMBASE, the Cochrane Library Database, and Scopus databases up to June 2024. The analysis focused on key parameters such as handgrip strength (HS), leg press, knee extension, gait speed (GS), 6-min walking test (6MWT), Timed-up and go test (TUG), lean body mass (LBM), fat mass (FM), and appendicular skeletal muscle mass (ASM). A pooled effect size was calculated using a random-effects model based on standardized mean differences (SMD). RESULTS: Thirty studies involving 2105 participants aged 60 and older met the inclusion criteria. The meta-analysis of 26 RCTs showed no significant positive effect of WPS on HS (n = 11, SMD: 0.18; 95% CI: -0.13, 0.49; I2 = 69%), 6MWT (n = 5, SMD: -0.08; 95%CI: -0.31, 0.16; I2 = 0%), GS test (n = 4, SMD: -0.08; 95%CI: -0.43, 0.28; I2 = 36%), TUG test (n = 9, SMD: 0.0, 95% CI -0.15, 0.14; I2 = 0%), LBM (n = 11, SMD: 0.02; 95%CI: -0.13, 0.17; I2 = 0%), FM (n = 15, SMD: -0.04; 95%CI: -0.18, 0.10; I2 = 0%). However, ASM significantly improved after WPS consumption but with high heterogeneity (n = 2, SMD: 0.39; 95%CI: 0.28, 0.51; I2 = 69%). In interventions incorporating RE, statistically significant positive effects of WPS on lower body strength were observed (n = 11, SMD: 0.25; 95%CI: 0.05, 0.45; I2 = 0%). CONCLUSION: The present meta-analysis indicates that WPS, when combined with resistance training (RT), can enhance lower body strength but does not seem to have a significant beneficial effect on handgrip strength, physical performance, or body composition. Further large-scale studies are necessary to confirm these findings and elucidate the potential benefits of WPS in this population.

Mobility abilities mediate the association of a more active lifestyle with mobility disability in older adults.

BACKGROUND: Few studies have analyzed sensor-derived metrics of mobility abilities and total daily physical activity (TDPA). We tested whether sensor-derived mobility metrics and TDPA indices are independently associated with mobility disabilities. METHODS: This cohort study derived mobility abilities from a belt-worn sensor that recorded annual supervised gait testing. TDPA indices were obtained from a wrist-worn activity monitor. Mobility disability was determined by self-report and inability to perform an 8-feet walk task. Baseline associations of mobility metrics and TDPA (separately and together) were examined with logistic regressions and incident associations (average 7 years follow-up) with Cox models. Mediation analysis quantified the extent mobility metrics mediate the association of TDPA with mobility disability. RESULTS: 724 ambulatory older adults (mean age 82 years, 77.4% female) were studied. In separate models, mobility abilities (e.g. step time variability, turning angular velocity) and TDPA were related to mobility disabilities. Examined together in a single model, mobility abilities remained associated with mobility disabilities, while TDPA was attenuated. This attenuation of TDPA could be explained by mediation analysis that showed about 50% of TDPA associations with mobility disabilities is mediated via mobility abilities (prevalent mobility disability 54%, incident mobility disability 40%, incident loss of ambulation 50%; all p's<0.001). CONCLUSIONS: Sensor-derived mobility metrics assess more diverse facets of mobility. These metrics mediate approximately half of the association of higher levels of daily physical activity with reduced mobility disability in older adults. Findings may inform the design of targeted interventions to reduce mobility disability in late life.

VO2MAX, 6-minute walk, and muscle strength each correlate with frailty in US veterans.

Introduction: Frailty often manifests as an increased vulnerability to adverse outcomes, and detecting frailty is useful for informed healthcare decisions. Veterans are at higher risk for developing frailty and at younger ages. The goal of this study was to investigate approaches in Veterans that can better inform the physiologic underpinnings of frailty, including maximal oxygen uptake (VO2max), 6-min walk, muscle strength, and inflammatory biomarkers. Methods: Participants (N = 42) were recruited from the Buffalo VA Medical Center. Inclusion criteria: ages 60-85, male or female, any race, and not having significant comorbidities or cognitive impairment. Outcome measures included: the Fried frailty phenotype, the short physical performance battery (SPPB), quality of life (QOL) using the Q-LES-Q-SF, and the following physiologic assessments: VO2max assessment on an upright stationary bicycle, 6-min walk, and arm and leg strength. Additionally, inflammatory biomarkers (C-reactive protein, IL-6, IL-10, interferon-γ, and TNF-α) were measured using ELLA single and multiplex ELISA. Results: Participants: 70.3 ± 7.4 years of age: 34 males and 8 females, BMI = 30.7 ± 5.4 kg/m2, 26 white and 16 African American. A total of 18 (42.8%) were non-frail, 20 (47.6%) were pre-frail, and 4 (9.5%) were frail. VO2max negatively correlated with Fried frailty scores (r = -0.40, p = 0.03, N = 30), and positively correlated with SPPB scores (r = 0.50, p = 0.005), and QOL (r = 0.40, p = 0.03). The 6-min walk test also significantly correlated with VO2max (r = 0.57, p = 0.001, N = 42) and SPPB (r = 0.55, p = 0.0006), but did not quite reach a significant association with frailty (r = -0.28, p = 0.07). Arm strength negatively correlated with frailty (r = -0.47, p = 0.02, N = 26), but not other parameters. Inflammatory profiles did not differ between non-frail and pre-frail/frail participants. Conclusion: Objectively measured cardiorespiratory fitness was associated with important functional outcomes including physical performance, QOL, and frailty in this group of older Veterans. Furthermore, the 6-min walk test correlated with VO2max and SPPB, but more validation is necessary to confirm sensitivity for frailty. Arm strength may also be an important indicator of frailty, however the relationship to other indicators of physical performance is unclear.

Seasonal Comparison of Pre-Adolescent Soccer Players' Physical Performance Using an Objective Physical Test Battery.

BACKGROUND/OBJECTIVE: Soccer is a multifactorial sport, requiring physical, psychological, technical, and tactical skills to succeed. Monitoring and comparing physical characteristics over time is essential to assess players' development, customize training, and prevent injury. The use of wearable sensors is essential to provide accurate and objective physical data. METHODS: In this longitudinal study, 128 male adolescent soccer players (from Under 12 to Under 19) were evaluated at two time points (pre- and post-season). Participants completed the Euleria Lab test battery, including stability, countermovement and consecutive jumps, agility, and quick feet tests. A single Inertial Measurement Unit sensor provided quantitative data on fifteen performance metrics. Percentage changes were compared to the Smallest Worthwhile Changes to assess significant changes over time. RESULTS: The results showed significant improvements in most variables, including a 19.7% increase in quick feet, 10.9% in stability, and 9.6% in countermovement jumps. In principal component analysis, we identified four principal components-strength-power, balance, speed-agility, and stiffness-that explained over 80% of the variance. CONCLUSIONS: These findings align with previous studies assessing seasonal changes in adolescent soccer players, showing that the proposed test battery seems to be adequate to highlight physical performance changes and provide coaches with meaningful data to customize training and reduce injury rates.

Intestinal Microbiota Interventions to Enhance Athletic Performance-A Review.

Recent years have witnessed an uptick in research highlighting the gut microbiota's role as a primary determinant of athletes' health, which has piqued interest in the hypothesis that it correlates with athletes' physical performance. Athletes' physical performances could be impacted by the metabolic activity of the assortment of microbes found in their gut. Intestinal microbiota impacts multiple facets of an athlete's physiology, including immune response, gut membrane integrity, macro- and micronutrient absorption, muscle endurance, and the gut-brain axis. Several physiological variables govern the gut microbiota; hence, an intricately tailored and complex framework must be implemented to comprehend the performance-microbiota interaction. Emerging evidence underscores the intricate relationship between the gut microbiome and physical fitness, revealing that athletes who engage in regular physical activity exhibit a richer diversity of gut microbes, particularly within the Firmicutes phylum, e.g., Ruminococcaceae genera, compared to their sedentary counterparts. In elite sport, it is challenging to implement an unconventional strategy whilst simultaneously aiding an athlete to accomplish feasible, balanced development. This review compiles the research on the effects of gut microbiota modulation on performance in sports and illustrates how different supplementation strategies for gut microbiota have the ability to improve athletic performance by enhancing physical capacities. In addition to promoting athletes' overall health, this study evaluates the existing literature in an effort to shed light on how interventions involving the gut microbiota can dramatically improve performance on the field. The findings should inform both theoretical and practical developments in the fields of sports nutrition and training.

Beyond the Buzz: Do Energy Drinks Offer More Than Caffeine for Mental and Physical Tasks?

Energy drinks are marketed for enhancing mental and physical performance, often containing ingredients beyond caffeine. This study investigated whether an energy drink (ED), Gorilla Mind, exerted greater effects on sustained attention, mood, handgrip strength, and push-up performance than a caffeine-matched control drink (CAF) in exercise-trained individuals (n = 21, age: 22 ± 5.9 years). In a randomized, counterbalanced, crossover design, participants first completed tests assessing mood (Profile of Mood States; POMS), sustained attention (Psychomotor Vigilance Test; PVT), handgrip strength (HG), and 1-minute maximum push-up performance (PU). They then consumed either an ED or CAF drink (200mg caffeine) in a randomized order. After 45 minutes, the tests were repeated. Following a 1-week washout period, participants returned to consume the other drink and completed the same protocol. While the ED group improved reaction time (PVT), the Delta score between ED and CAF was not statistically significant (p = 0.3391). No significant differences were found between ED and CAF groups for other measures (POMS: p = 0.152, HG: p = 0.499, PU: p = 0.209). These findings suggest that the additional ingredients in the ED may not offer substantial benefits beyond caffeine for these measures in active individuals. It is important to note that the caffeine dose was, on average, less than 3.0 mg/kg body mass, which may have influenced the outcomes.

Effect of Comprehensive Balance Modulating Strategies on Physical Performance Among the Elderly in Care Home Settings in Southern India.

Purpose Globally, the proportion of the elderly population is rising. Age-related physical performance impairments are more common and affect quality of life. This study aimed to investigate the impact of a new exercise regimen called Comprehensive Balance-Modulating Strategies (CBMS) on the physical performance of older adults living in care home settings. Methods Forty-eight functionally independent elderly individuals were randomized into two groups: group A received the CBMS programme for eight weeks, and group B received routine medical care. The Short Physical Performance Battery (SPPB) and the Four Square Step Test (FSST) were outcome measures. Outcomes were measured at baseline, immediately after the intervention, and eight weeks after the intervention. Results The mean and standard deviation of subjects' ages in both groups were 72.46 (8.28) and 68.12 (6.95), respectively. The CBMS programme significantly improved physical performance among the intervention group (p = <0.0001). Conclusion The present study found that CBMS was effective in improving physical performance among institutionalized elderly. Large-scale clinical trials and research exploring the effect of CBMS among community-dwelling elderly individuals are recommended.

Effect of Bimagrumab on body composition: a systematic review and meta-analysis.

BACKGROUND: Sarcopenia, a condition marked by progressive muscle mass and function decline, presents significant challenges in aging populations and those with chronic illnesses. Current standard treatments such as dietary interventions and exercise programs are often unsustainable. There is increasing interest in pharmacological interventions like bimagrumab, a monoclonal antibody that promotes muscle hypertrophy by inhibiting muscle atrophy ligands. Bimagrumab has shown effectiveness in various conditions, including sarcopenia. AIM: The primary objective of this meta-analysis is to evaluate the impact of bimagrumab treatment on both physical performance and body composition among patients diagnosed with sarcopenia. MATERIALS AND METHODS: This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed, Ovid/Medline, Web of Science, and the Cochrane Library databases up to June 2024 using appropriate Medical Subject Headings (MeSH) terms and keywords related to bimagrumab and sarcopenia. Eligible studies were randomized controlled trials (RCTs) that assessed the effects of bimagrumab on physical performance (e.g., muscle strength, gait speed, six-minute walk distance) and body composition (e.g., muscle volume, fat-free body mass, fat body mass) in patients with sarcopenia. Data extraction was independently performed by two reviewers using a standardized form, with discrepancies resolved through discussion or consultation with a third reviewer. RESULTS: From an initial search yielding 46 records, we screened titles, abstracts, and full texts to include seven RCTs in our meta-analysis. Bimagrumab treatment significantly increased thigh muscle volume (mean difference [MD] 5.29%, 95% confidence interval [CI] 4.08% to 6.50%, P < 0.001; moderate heterogeneity χ2 = 6.41, I2 = 38%, P = 0.17) and fat-free body mass (MD 1.90 kg, 95% CI 1.57 kg to 2.23 kg, P < 0.001; moderate heterogeneity χ2 = 8.60, I2 = 30%, P = 0.20), while decreasing fat body mass compared to placebo (MD - 4.55 kg, 95% CI - 5.08 kg to - 4.01 kg, P < 0.001; substantial heterogeneity χ2 = 27.44, I2 = 89%, P < 0.001). However, no significant improvement was observed in muscle strength or physical performance measures such as gait speed and six-minute walk distance with bimagrumab treatment, except among participants with slower baseline walking speeds or distances. DISCUSSION AND CONCLUSION: This meta-analysis provides valuable insights into the effects of bimagrumab on sarcopenic patients, highlighting its significant improvements in body composition parameters but limited impact on functional outcomes. The observed heterogeneity in outcomes across studies underscores the need for cautious interpretation, considering variations in study populations, treatment durations, and outcome assessments. While bimagrumab shows promise as a safe pharmacological intervention for enhancing muscle mass and reducing fat mass in sarcopenia, its minimal effects on muscle strength and broader physical performance suggest potential limitations in translating body composition improvements into functional gains. Further research is needed to clarify its long-term efficacy, optimal dosing regimens, and potential benefits for specific subgroups of sarcopenic patients.

Sex differences in the adaptations in maximal strength and anaerobic power to upper body plyometric training.

This study aimed to compare the effects of a 6-week upper body plyometric training (UBPT) on maximal strength and anaerobic power performance of male and female subjects. Forty collegiate physically active male and female subjects participated in the study and were assigned to either UBPT group (M-UBPT, n = 10, F-UBPT, n = 10) or control group (M-CON, n = 10; F-CON, n = 10). The training groups performed 6 weeks of progressive overload UBPT three times per week using six exercises and were evaluated for upper-body anaerobic power and maximal strength, 3-kg medicine ball throw (MBT), push-up endurance, and reaction time at pre- and post-intervention. After the training intervention, the M-CON and F-CON groups did not show significant (p > 0.05) changes in the variables, while both the M-UBPT and F-UBPT groups demonstrated significant (p = 0.001) medium to very large improvements in their performance as follows: maximal strength (effect size [ES] = 0.55, 0.92), MBT (ES = 1.96, 0.89) peak power output (ES = 2.31, 1.52), mean power output (ES = 2.19, 1.11), push-up endurance (ES = 1.26, 0.70), and reaction time (ES = - 2.16, - 1.56), respectively. Nevertheless, the male group experienced more significant improvements in the MBT (p = 0.001), peak (p = 0.001) and mean power output (p = 0.01), as well as reaction time (p = 0.01) compared to the female group when utilizing UBPT. In conclusion, it is imperative to take sex into account as a crucial factor when incorporating UBPT, particularly if the objective is to enhance anaerobic power output, muscular power, and reaction time.

In elderly individuals, the effectiveness of sensorimotor training on postural control and muscular strength is comparable to resistance-endurance training.

While classical resistance exercise is an effective way to improve strength and control postural sway, it may not be suitable for some elderly individuals with specific health disorders (e.g., aneurysms). Therefore, there is a need to explore alternative modalities. The study aimed to evaluate the effects of sensorimotor training on muscle strength and postural control in the female elderly population and subsequently compare these effects with a traditional combined resistance-endurance training program. A total of 34 healthy, active elderly women aged from 65 to 75 years, (average age 72.7 ± 4.4 years, height 161.6 ± 5.1 cm, and weight 66.9 ± 8.4 kg) were randomly assigned to three groups undergoing different 10-week interventions: the resistance-endurance training (RET, n = 11), the sensorimotor training (SMT, n = 12) and the control group (COG, n = 11). Prior to and after the interventions all participants underwent tests of maximal voluntary contraction of the dominant and non-dominant leg; postural sway tests with open and closed eyes; novel visual feedback balance test; 10-meter maximal walking speed (10 mMWS) and stair climb test. A T-test and repeated measures ANOVA were used, followed by the Bonferroni post hoc test, to compare the pre and post-measurements and assess differences in gains between groups. Results showed a significant main effect of time on strength (p < 0.001). In addition, significant differences in time × group interaction on strength (p < 0.01), postural control (p < 01), and ascendant and descended vertical speed (p < 0.001) were observed. Besides, the RET group improved significantly the maximal voluntary contraction of both dominant (16.3%, p ≤ 0.01) and non-dominant leg (10.9%, p ≤ 0.05). SMT group improved maximal voluntary contraction of both dominant (16.6%, p ≤ 0.001) and non-dominant leg (12.7%, p ≤ 0.01). In addition, they also improved mean velocity of the centre of pressure (COP) in postural sway test with eyes open (24.2%, p ≤ 0.05) as well as eyes closed (29.2%, p ≤ 0.05), mean distance of COP in novel visual feedback balance test (37.5%, p ≤ 0.001), ascendant and descended vertical velocity (13.6%, p ≤ 0.001 and 17.8%, p ≤ 0.001, respectively). Results show not only resistance training but sensorimotor intervention boosts strength too. This intervention also enhances postural control and functional abilities for both ascending and descending movements.