Muscle loss in elderly patients - prevention effects of a multimodal therapy program for low back pain

  • Aki PietschEmail author
  • Heide Kuhlow
  • Eric Hartinger
  • Helge Riepenhof
Original Article



Muscle loss with an increasing loss of muscle mass, muscle strength and muscle function is a disease in elderly individuals. Along with the severity of muscle loss, an increased frailty is evident. The consequences of an increased frailty are age-related reduced resilience and reduced strength conditions, and following this substantial loss of quality of life. The onset and progression of aging processes can be positively influenced by physical training, which helps to prevent the decline in neuromuscular capacity. There is consensus that hypertrophy training focusing on the training of situation specific movement tasks of the individual muscle groups is recommended.


In this study we demonstrated that multimodal therapy is an efficient alternative intervention to strengthen the back muscles and by this to increase muscle growth in the areas of extension and flexion as well as lateralization and rotation on both sides.

Material and methods

52 patients aged between 50 and 65 with a main diagnosis of back disease were examined prospective. They completed a 3-week inpatient multimodal therapy program. Effects of the program were assessed by applying two isometric strength measurements of the back muscles. Baseline measurement (T0) was done on the first day of the program and post measurement (T1) on the last day of therapy. The results were described by means of SPSS as mean (M) and standard deviation (SD). The normal distribution was verified (Kolmogorov-Smirnov test).


Data indicates that there are significant improvements in extension force, right lateral and right rotation force. Strength gains in flexion, left lateral and left rotation could also be demonstrated, but compared to the other three directions with reduced strength.

Discussion and conclusion

It could be shown that even a multimodal therapy program leads to an increase in strength. Since pure hypertrophy training is a great challenge, especially for the elderly, the multimodal therapy concepts promising approach to facilitate the often difficult start to the treatment of muscle loss. The significant higher power increase concerning extension, rotation and lateralization on the right side compared to the left side is remarkable. Here further research is needed to obtain explanations. A significant weakness of the study is the lack of a control group. Further research with more sophisticated study designs (e.g. RCT) is necessary in order to learn more about this alternative intervention to treat muscle loss.


Muscle loss Prevention Multimodal therapy Muscle growth 


Compliance with ethical standards

The approval of the responsible ethics committee was given. All therapeutic content and testing were ethically harmless measures that are internationally certified and are part of the standard care package for back pain patients. All patients were informed about the clinical measures and the evaluation of the data and agreed in writing to the utilization of their anonymous data. The evaluation was carried out in accordance with the 2013 Helsinki Declaration in its current version of 2013 (World Medical Association, 2013).

Conflict of interest

All authors state that there are no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Aki Pietsch
    • 1
    Email author
  • Heide Kuhlow
    • 1
  • Eric Hartinger
    • 2
  • Helge Riepenhof
    • 1
  1. 1.Sportprävention, Sportrehabilitation, BG Klinikum HamburgHamburgGermany
  2. 2.Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, Bezirksverwaltung HamburgHamburgGermany

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