As one of the ways to prevent sarcopenia, exercising generally refers to physical activity performed during leisure time, and is characterised as planned, structured, and repetitive physical activity for the purpose of improving physical fitness or functioning health. Exercises can increase the mechanical forces by strength training or resistance training, and increase muscle mass and strength in even senior citizens. Resistance training (RT) in regular manner can stimulate muscle hypertrophy and increase strength among normal or even frail senior citizens. In addition, regular RT can promote muscle protein synthesis to outweigh protein breakdown, prevent sarcopenia, and eventually to strengthen body balance to lower the chance of falling, as well as to reduce the consequential injuries of falling.

What is resistance training?

In order to understand the benefits of resistance training (RT), we should know what actually RT is, which is also called weight training or strength training for easier understanding. When we mention RT, you may have the impression of Olympic weight-lifting, and you may even shake your head in negation, concerned about the unsuitability of RT for senior citizens. You may have unpleasant experiences associated with exercise, fear of falling when exercising, or you may lack the knowledge on the benefits of exercise. That pretty much explains why senior citizens generally don't feel motivated towards exercising or RT.

It is important to understand that RT is not confined to the sense of Olympic weight-lifting. It can be described as any muscle group mustered together against an external resistance, such as an elastic band, wall pulley, bricks, bottles of water, your own body weight or dumbbell in the gym that causes a load for the muscle to contract. It helps in building up the strength, endurance and muscle size. Thus, RT basically can be performed even at home with basic equipment.

Benefits of resistance training

Many studies have reported on the efficacy of regular RT in the increase of strength, muscle mass, improved function and decreased falls. RT has also been shown to be a significant intervention in the prevention and treatment of sarcopenia. Nelson et al. showed that high-intensity strength training exercises are effective and feasible means to improve muscle mass, strength and balance in postmenopausal women. McCartney et al., meanwhile, reported continued improvement in dynamic strength and endurance in 142 elderly persons 60 to 80 years old. Yarasheski et al. reported that in a group of men and women of 76 to 92 years old, RT over a three-month-period resulted in an increase in mixed protein synthesis. In addition, RT can increase the sensitivity neuromuscular system, hormone concentration and protein synthesis rate. Besides, acute and short-term RT can increase the number of muscle progenitors or ancestor cells in the trained muscle group, resulting in faster muscle regeneration.

Basically, the effect of regular exercise is not only effective in improving general and muscular health, but it may also induce adaptations at the cellular and molecular levels that directly impede the various causes of ageing. Improvements in muscle protein synthesis and muscle bulk are observed after RT. Regular RT in senior citizens significantly increases the fast twitch fibre cross sectional area, leading to increased force-generating power. Thus, in real life, muscle strength training can effectively improve simple daily activities such as walking, climbing up stairs or standing up from chair more quickly, and just as well is it in the prevention of fall and fracture.

Dr Liu Kin-wah
Specialist in Geriatric Medicine

Reference:
Nelson et al. Effects of high intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. JAMA 1994 Dec 28:272(24): 1909-14

McCartney N et al. A longitudinal trial of weight training in the elderly: continued improvements in year 2. J Gerontol A Bio Sci Med Sci, 51(6): B425-33

Yarasheski et al. Resistance exercise training increases mixed muscle protein synthesis rate in frail women and men > and = 76 yr old. Am. J. Physio. 277:E118-E125. PMID: 10409135