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Revalidatie van spieratrofie & spierzwakte
Ivan Bautmans
Frailty in Ageing research groupwww.vub.ac.be/FRIA
Sarcopenia Rosenberg J Nutr 1997
Age-related loss of muscle mass
Roubenoff R. J Gerontol 2003
25 yrs 75 yrs
Muscle weakness; Physical fatigue; Loss of flexibility
Bauer & Sieber Exp Gerontol 2008; 43: 674-678
Neuroendocrinedysregulation
Acute inflammation
• Rapid worsening of sarcopenia• Hospitalized geriatric patients with
acute infections / after elective surgery– Worse muscle performance ~ Inflammation– Reduced recovery of muscle endurance
Bautmans ea. AgeingClin&ExpRes 2005; Mets ea. AmJGeriatrPharmacother 2004; Bautmans ea. JGerontol 2005; Bautmans ea. BMC Geriatrics 2007; Bautmans ea. JAmGeriatrSoc 2008; Bautmans ea. JGerontol 2010; Bautmans ea. JNutrHealth&Ageing 2011; Beyer ea. ExpGerontol 2011; Bautmans ea. Gait & Posture 2011; Beyer ea. BMC Musculoskeletal 2011
Bautmans ea. J Gerontology 2010
Inflammatory response following surgery
N=66, age 24-91 yrs, elective abdominal surgery
Saini ea. Ageing Research Reviews 2009;8:251–267
InflammationExercise ↑ ↑
Adapted from Williams ea Circulation 2007
70-80% Max resistance
N=31, Age=60-80 yrs
Bautmans ea. Gerontology 2005; 51: 253-65
Peterson ea. Ageing Research Reviews 2010;9:226–237
15kg 60kg
N=56, aged 68±5yrs
Van Roie ea. Exp Gerontol 2013; 48: 1351-61
HIGH = 2x 10–15 rep @ 80% 1RM
LOW = 1× 80–100 rep @ 20% 1RM
LOW+ = 1× 60 rep @ 20% 1RM + 1× 10–20 rep @ 40% 1RM
• Inefficient Akt/mTOR signaling pathway• Preference for endurance exercise?• Inflammation-reducing effect of exercise.
• N=106, age 53–83 yrs, randomly assigned to– 1yr 3x/wk strength training (60-80% 1RM)
+ impact exercise (jumping)– 1yr 3x/wk stretching
• Training:– ↑muscle strength– functional benefit observed in both groups
• N=20, 75± 7 yrs• Fatigue & weakness• 12wk training,
±20min 3x/wk• Results:
– No pain– ↑knee strength– ↓TUG
• N=57, age 70±7 yrs, randomly assigned to
– 12 wks 2x/wk resistance (2-4 stets @ 6RM)
+ aerobic exercise (20min @ 80% HRmax)
– 12 wks usual care
• Exercise:
– ↑lean mass, ↑ muscle strength, ↑ walk speed, ↑QoL,
– ↓fatigue, ↓CRP
Beyer ea Current Opinion in Clinical Nutrition and Metabolic Care 2012; 15: 12-22
Pedersen & Febbraio Physiol Rev 2008; 88: 1379–1406
“myokine” pathway
Pro-inflammatory Anti-inflammatory Anti-inflammatory
= reduction of chronic low-grade inflammatory profile
N=31, Age=60-80 yrs
Bautmans ea. Gerontology 2005; 51: 253-65
Acute exercise-induced response
Chronic effectsN=31, age=60-80 yrs
Bautmans ea. Gerontology 2005; 51: 253-65
8wk training 3x/wk
RT & RTTB ↑intra-muscular IL-6 levels!
Strength training in older cancer patients
• Literature is rather scarce• Positive effects can be obtained!
– Muscle performance– inflammation
• Dose-response relationships remain unclear
• Potential interfering factors– Inflammation / cachexia– Chemo/radio therapy or ‘survivor’– Hormonal treatment
http://www.vub.ac.be/FRIA/SPRINT.html
Thank you. [email protected]