PhD-student
Jeppe Grabov Phillip
Geriatric Research Unit, Odense University Hospital, Odense, Denmark / Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| Projekt styring | ||
| Projekt status | Open | |
| Data indsamlingsdatoer | ||
| Start | 05.01.2023 | |
| Slut | 26.02.2026 | |
Impact of Acute Hospitalisation and Resistance Training on Muscle Architecture and Physical Performance in Older Adults
Short summary
Sarcopenia, marked by loss of muscle mass, strength, and performance, leads to functional decline in older adults. Hospitalization worsens this decline, affecting not just muscle mass but also muscle architecture, a key factor in strength and performance. This study aims to investigate changes in muscle architecture and physical performance during and after hospitalization, and the impact of lower limb resistance training. Results could enhance understanding of sarcopenia and help prevent funct
Rationale
As we get older, a number of structural changes takes place in human skeletal muscle tissue that can lead to sarcopenia. The currently most used operational definition of Sarcopenia from the European Working Group on Sarcopenia in Older People (EWGSOP) is low muscle strength, low muscle mass, and low physical performance. Sarcopenia is becoming one of the biggest health care challenges together with increasing life expectancy. Prevalence differs widely depending on the population, methodologies and definition used. A study has reported a prevalence as high as 33% in older adults (<70 years) living in nursing homes. Sarcopenia is related to increased risk of falls, decreased ability to perform activities of daily living (ADL), increased risk of hospitalisation, and increased mortality. The primary cause of sarcopenia is age related, while secondary causes are disease, nutrition or inactivity. Periods of immobilisation or physical inactivity such as during hospitalisation lead to further loss of muscle mass and muscle strength and thus increases the risk of developing sarcopenia (Cruz-Jentoft). During hospitalisation older adults spend only 1 hour standing/or walking per day and more than half of older adults who are admitted to the hospital have not regained habitual physical performance 1 year after admission. Early mobilization and resistance training during hospitalisation is beneficial for older adults in order to prevent functional loss, reduce length of hospital stay. Despite this, early mobilization and resistance training of older adults during hospitalisation is often overlooked as an intervention. Barriers are high work pressure, the availability of staff and access to appropriate training equipment. Robots have the potential to increase the amount of resistance training, and the field of robotics in rehabilitation is constantly expanding with new devices and technologies being developed every year. One such example is the innovative training robot ROBERT®. ROBERT was developed in Denmark and offers the possibility of strength training while the patient is lying in bed, which makes it possible exercise even the most frail and bedridden patients who otherwise would not have received any resistance training. The robot can also support the individualized training program all by itself, so that the staff can carry out other relevant tasks, such as documentation close to the patient etc. while the patient exercises. In many countries, including Denmark, rehabilitation after hospitalization has moved away from hospitals and into municipalities after discharge. We therefore miss a golden opportunity to intervene early and prevent muscle weakness and functional decline as a result of hospitalisation. State of the art The most frequently mentioned characteristic of sarcopenia is the gradual loss of muscle mass. However, emerging evidence clearly shows that the loss of muscle mass is not the sole contributor to the loss of muscle strength and physical performance associated with sarcopenia, as there is no linear relation with either muscle strength or muscle function. Changes in pennation angle, fiber fascicle length and muscle thickness - also referred to as muscle architecture - has been found with sarcopenia. Muscle architecture is one of the most important determinants in muscle strength, and thus plays an important role in muscle function. Muscle architecture can be assessed by ultrasound which is a valid, reliable, low-cost and easy assessable tool to use in clinical practice. Furthermore, sarcopenia is associated with decreased physical performance. Physical performance has been defined as an objective measurement of whole-body function in relation to movement. Low physical performance in older adults is related to adverse events such as falls, hospitalisation, mortality and need for health care services. As for assessment of physical performance a gait speed test is suitable since the ability to walk is an important, common, and functional ADL task. Over the years several studies have found that resistance training is a powerful tool to improve muscle function in old adults. Moreover, previous studies have proved that resistance training can positively affect muscle architecture and improve physical performance in community-dwelling old adults. However, to our knowledge no studies have investigated the impact of acute hospitalization on muscle architecture and physical performance, and subsequently evaluated the effect of resistance training during admission.
Description of the cohort
Hospitalized patients aged 65 or older in the Geriatric Department G, Odense University Hospital (OUH).
Data and biological material
Sociodemographic data: age, sex, body mass index, functional level, comorbidities, medication, reason for admission, physical tests (30-second Sit-to-Stand test and gait speed test), Questionnaires (Quality of life, Depression, Fear of falling, Cognitive function), Sarcopenia, Ultrasound measurement of thigh muscles, C-reative protein, Length of hospital stay, Number of falls, Readmissions, Discharge destination, Mortality.
Collaborating researchers and departments
Geriatric Department, OUH Odense University, Svendborg