Non-Pharmacological Interventions in Osteosarcopenia: A Systematic Review.
Study Goal
The researchers aimed to examine the efficacy of non-pharmacological interventions, including calcium supplementation, on musculoskeletal measures in osteosarcopenic adults.
Results Summary
The study did not assess the effects of calcium supplementation, as no eligible RCTs examined its impact against a control/placebo in this population.
Population
Older osteosarcopenic adults (≥65 years)
Effective Dosage
Not available
Duration
Not available
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
progressive resistance training (RT) | increase | muscle mass | older osteosarcopenic adults (≥65 years) | - | increases | #1 |
progressive resistance training (RT) | increase | muscle strength | older osteosarcopenic adults (≥65 years) | - | increases | #2 |
progressive resistance training (RT) | increase | muscle quality | older osteosarcopenic adults (≥65 years) | - | increases | #3 |
progressive resistance training (RT) | increase | strength and quality | older osteosarcopenic adults (≥65 years) | 12 weeks | changes in | #4 |
progressive resistance training (RT) | increase | muscle mass | older osteosarcopenic adults (≥65 years) | 28 weeks | changes in | #5 |
progressive resistance training (RT) | increase | lumbar spine BMD | older osteosarcopenic adults (≥65 years) | 12 months | increases | #6 |
progressive resistance training (RT) | no change | total hip BMD | older osteosarcopenic adults (≥65 years) | 18 months | maintains | #7 |
progressive resistance training (RT) | no change | markers of bone turnover | older osteosarcopenic adults (≥65 years) | - | has no effect on | #8 |
progressive resistance training (RT) | no change | physical performance | older osteosarcopenic adults (≥65 years) | - | has no effect on | #9 |
progressive resistance training (RT) | no change | major adverse effects | older osteosarcopenic adults (≥65 years) | - | is safe | #10 |
BACKGROUND: Osteosarcopenia is a geriatric syndrome defined by the concomitant presence of osteopenia/osteoporosis (loss of bone mineral density (BMD)) and sarcopenia (loss of muscle mass and/or function), which increases the risk of falls, fractures, and premature mortality. OBJECTIVE: To examine the efficacy of non-pharmacological (exercise and/or nutritional) interventions on musculoskeletal measures and outcomes in osteosarcopenic adults by reviewing findings from randomized controlled trials (RCTs). METHODS: This review was registered at PROSPERO (registration number: CRD42020179292) and conducted in accordance with the PRISMA guidelines. Electronic databases were searched for RCTs assessing the effect of at least one non-pharmacological intervention (any form of exercise and/or supplementation with protein, vitamin D, calcium or creatine) on any musculoskeletal measure/outcome of interest (BMD, bone strength/turnover, muscle mass and strength, physical performance, falls/fractures) in adults with osteosarcopenia as defined by any proposed criteria. RESULTS: Two RCTs (of n=106 older osteosarcopenic adults (≥65 years)) assessing the effects of progressive resistance training (RT) (via resistance bands or machines; 2-3 times/week; ~60 minutes in duration) were eligible for inclusion. The two RCTs demonstrated moderate quality evidence that RT increases muscle mass, strength, and quality, with changes in strength and quality occurring before muscle mass (12 vs 28 weeks). There was low quality evidence that RT increases lumbar spine BMD and maintains total hip BMD when performed for 12 and 18 months, respectively, and moderate quality evidence that RT has no effect on markers of bone turnover or physical performance. No major adverse effects were recorded in either of the RCTs. There were no eligible RCTs examining the impact of nutritional interventions. CONCLUSION: Chronic RT is safe and effective at potentiating gains in muscle mass, strength, and quality, and increasing or maintaining BMD in older osteosarcopenic adults. No RCT has examined the effects of protein, vitamin D, calcium, or creatine against a control/placebo in this high-risk population.