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Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions

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Abstract

Background

The physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life.

Objectives

The objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature.

Methods

Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function.

Results

Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions.

Conclusions

Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks.

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Authors and Affiliations

  1. Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK

    Christopher Byrne, David J. Keene & Sarah E. Lamb

  2. Ecole Normale Supérieure de Rennes, Bruz, France

    Charles Faure

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  1. Christopher Byrne
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Correspondence to Christopher Byrne.

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This review was supported by the National Institute for Health Research (NIHR) Oxford Musculoskeletal Biomedical Research Unit. The views expressed are those of the authors and are not necessarily those of the National Health Service, the NIHR or the Department of Health.

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Christopher Byrne, Charles Faure, David Keene and Sarah Lamb declare that they have no conflicts of interest relevant to the content of this review.

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Byrne, C., Faure, C., Keene, D.J. et al. Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions. Sports Med 46, 1311–1332 (2016). https://doi.org/10.1007/s40279-016-0489-x

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