Effects of nutritional supplements on muscle mass and activities of daily living in elderly rehabilitation patients with decreased muscle mass: A randomized controlled trial
- 587 Downloads
To investigate the effects of nutritional intervention with resistance training on skeletal muscle mass in elderly patients with disabilities in a convalescent rehabilitation setting.
A randomized controlled trial. (UMIN Clinical Trials Registry ID: UMIN000006238).
A rehabilitation hospital.
39 elderly patients with decreased skeletal muscle mass in an inpatient convalescence rehabilitation unit.
A combination of resistance training plus nutritional supplementation (R/N group) or resistance training alone (R group). The training and supplementation were conducted essentially from the patient’s admission to discharge (2–6 months).
The patients were evaluated at the time of admission and at the end of the intervention for skeletal muscle mass (calf circumference [CC] as a primary outcome, and arm circumference [AC]), hand grip strength (HG), Mini-Nutritional Assessment-Short Form (MNA®-SF) score, serum albumin level (Alb), body mass index (BMI), and activities of daily living (ADL) as represented by the Barthel Index (BI) score.
Significant treatment effects were seen for CC, AC, BI, Alb in the R/N group compared to the R group. A mean treatment effect of 3.2 (95%CI: 2.0–4.4) was seen in CC, 1.4 (95%CI: 0.8–2.1) was seen in AC, 11.2 (95%CI: 0.5–21.8) was seen in BI, 0.3 (95%CI: 0.1–0.5) was seen in Alb.
The results of this study suggest that nutritional intervention added to resistance training during convalescent rehabilitation may improve skeletal muscle mass and activities of daily living.
Key wordsSarcopenia rehabilitation malnutrition elderly
Unable to display preview. Download preview PDF.
- 1.Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, Tsai AC, Vellas B, Sieber CC. Mini Nutritional Assessment International Group: Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58:1734–1738CrossRefPubMedGoogle Scholar
- 2.Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime-Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 2011;12:249–256PubMedGoogle Scholar
- 7.Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M. European working group on sarcopenia in older people: Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010;39:412–423PubMedCentralCrossRefPubMedGoogle Scholar
- 8.Morley JE, Argiles JM, Evans WJ, Bhasin S, Cella D, Deutz NE, Doehner W, Fearon KC, Ferrucci L, Hellerstein MK, Kalantar-Zadeh K, Lochs H, MacDonald N, Mulligan K, Muscaritoli M, Ponikowski P, Posthauer ME, Rossi-Fanelli F, Schambelan M, Schols AM, Schuster MW, Anker SD. Society for Sarcopenia, Cachexia, and Wasting Disease. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc 2010;11:391–396PubMedCentralCrossRefPubMedGoogle Scholar
- 9.Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative(EWGSOP and IWGS). Age Ageing 2014;43:748–759PubMedCentralPubMedGoogle Scholar
- 10.Martone AM, Lattanzio F, Abbatecola AM, La-Carpia D, Tosato M, Marzetti E, Calvani R, Onder G, Landi F. Treating sarcopenia in older and oldest old. Curr Pharm Des. 2015;30. [Epub ahead of print]Google Scholar
- 11.Beavers KM, Gordon MM, Easter L, Beavers DP, Hairston KG, Nicklas BJ, Vitolins MZ. Effect of protein source during weight loss on body composition, cardiometabolic risk and physical performance in abdominally obese, older sdults: a pilot feeding study. J Nutr Health Aging 2015;19:87–95. doi: 10.1007/s12603-015-0438-7 CrossRefPubMedGoogle Scholar
- 13.Yamada M, Arai H, Yoshimura K, Kajiwara Y, Sonoda T, Nishiguchi S, Aoyama T. Nutritional supplementation during resistance training improved skeletal muscle mass in community-dwelling frail older adults. J Frailty Aging 20141: 64–70Google Scholar
- 14.Bonnefoy M, Cornu C, Normand S, Boutitie F, Bugnard F, Rahmani A, Lacour JR, Laville M. The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study. Br J Nutr 2003;89:731–739CrossRefPubMedGoogle Scholar
- 16.Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2009;15:003288Google Scholar
- 30.Cabinet Office, Government of Japan. The aging society: current situation and implementation measures FY. Annual report on the aging society. http://www8.cao.go.jp/kourei/english/annualreport/index-wh.html, 2013. Accessed 24 December 2014Google Scholar
- 31.Tokunaga M, Watanabe S, Nakanishi R, Yamanaga H, Sannomiya K, Hirata Y. Comparison between convalescent rehabilitation hospitals participating in the stroke liaison critical pathway with respect to the gain of Nichijo-seikatsu-kino-hyokahyo score. Jpn J Compr Rehabil Sci 2012;3: 11–17 (article in Japanese)Google Scholar
- 33.O’Sullivan S, Schmitz T. Physical rehabilitation 5th edition. F.A. Davis Company, USA, 2006Google Scholar
- 34.Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC. MNA-International Group. Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782–788CrossRefPubMedGoogle Scholar
- 44.Carlsson M, Littbrand H, Gustafson Y, Lundin-Olsson L, Lindelöf N, Rosendahl E, Håglin L. Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial. J Nutr Health Aging. 2011;15:554–560.CrossRefPubMedGoogle Scholar
- 46.Kim HK, Suzuki T, Saito K, Yoshida H, Kobayashi H, Kato H, Katayama M. Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc. 2012;60:16–23CrossRefPubMedGoogle Scholar
- 47.Kim H, Suzuki T, Saito K, Kojima N, Hosoi E, Yoshida H. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: A 4-year follow-up study. Geriatr Gerontol Int, 2015. doi: 10.1111/ggi.12448 Google Scholar
- 49.Frank AW, Farthing JP, Chilibeck PD, Arnold CM, Olszynski WP, Kontulainen SA. Community-dwelling female fallers have lower muscle density in their lower legs than non-fallers: Evidence from the Saskatoon Canadian multicentre osteoporosis study (CaMos) cohort. J Nutr Health Aging. 2015;19:113–120. doi: 10.1007/s12603-014-0476-6 CrossRefPubMedGoogle Scholar