SC-22 A 48-week randomized controlled study of a home-based, app-monitored physical exercise intervention for older people with sarcopenia (grow your muscle – GYM study): preliminary results on muscle function and body composition at week-12

Background

Sarcopenia is a pathophysiological process of aging, caused by reduction of muscle strength, mass and function and it is associated with an increased risk of falls, fractures, physical disability and death. To date no controlled studies have assessed the efficacy of physical activity for treatment of sarcopenia. We present here the preliminary results at baseline (BL) and after 12 weeks (W12) of the Grow Your Muscle (GYM) randomized-controlled study, consisting of a 48-week home-based, app-monitored body-weight resistance training program that aims to improve muscle function and mass in sedentary elderly persons with sarcopenia.

Materials and Methods

The study is enrolling 98 persons with HIV (PWH) >50-year-old and 98 persons of general population (GPP) >60-year-old with sarcopenia, as defined by low appendicular skeletal muscle mass index (ASMMI) by bioimpedentiometry (BIA) and/or low muscle strength by handgrip. Participants are randomized 1:1, separately in PWH or GPP group, to: 1) Exercise group (EG), performing a home-based, app-monitored resistance-training program of 4 session/week consisting of 5-min warm-up, 20-min body-weight exercise, 5-min cool-down with increasing number of repetitions and sets every 6 weeks; 2) Control group (CG), without exercise prescription. At BL, W12 and W48, participants are tested for muscle function (handgrip, chair-stand-test, right and left maximal isometric strength of knee extensors, Mini-BESTest, and 6-minutes walking test), body composition (fat mass, fat free mass and ASMMI) by BIA, blood lipids, and self-perceived health status assessment (SF-12). Results are presented as median and 25th-75th interquartile (IQR) range; changes between BL and W12 have been assessed by Wilcoxon matched pairs signed rank test.

Results

A total of 156/196 participants have so far been enrolled: 91/98 PWH (45 randomized to EG and 46 to CG) and 66/98 GPP (32 to EG and 34 to CG). Sixty-six PWH and 32 GPP have completed W12, and overall, 24 participants have dropped-out (16 PWH (17%) and 8 GPP (12%); 11 EG and 13 CG]. Among 91 PWH [49 males (74%), median age 62 (IQR 57–66)], significant improvements were observed in EG, but not in CG for measures of muscle function and body mass distribution, whereas the 6-minutes walking test performance improved in both EG and CG. Among the 66 GPP [17 males (26%), median age 73 (IQR 68–76); 16 EG and 16 CG], a significant improvement was observed only in muscle function tests in EG, but not in CG, and in left maximal strength of knee extensors in both EG and CG. No statistically significant changes were observed in the other analyzed variables. Table 1 shows the results of functional tests and body composition in PWH and GPP.

Conclusions

This home-based, app-monitored body-weight resistance program significantly improved measures of muscle strength and body composition in sedentary PWH>50 years and GPP>60 years with sarcopenia after the first 12 weeks of training.