Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? Early nutritional support and physiotherapy improved long-term self-sufficiency in acutely ill older patients. Nutritional Supplementation of Very Old People at Hospital Discharge Increases Muscle Strength: A Randomised Controlled Trial Muscle mass, strength and functional outcomes in critically ill patients after cardiothoracic surgery: does neuromuscular electrical stimulation help? The Catastim 2 randomized controlled trial Effects of an Exercise Intervention in Frail Older Patients with Chronic Obstructive Pulmonary Disease Hospitalized due to an Exacerbation: A Randomized Controlled Trial Impact of resistance training in chronic obstructive pulmonary disease patients during periods of acute exacerbation. Neuromuscular Electrical Stimulation for Intensive Care Unit–Acquired Weakness: Protocol and Methodological Implications for a Randomized, Sham-Controlled, Phase II Trial Physical Complications in Acute Lung Injury Survivors: A Two-Year Longitudinal Prospective Study Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review Results of a Multimodal Program During Hospitalization in Obese COPD Exacerbated Patients Effect of neuromuscular stimulation and individualized rehabilitation on muscle strength in Intensive Care Unit survivors: A randomized trial The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial. Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study. The value of strength training for older adults. Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training.
OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity OBJECTIVES To examine the association between strength , function , lean mass , muscle density , and risk of hospitalization . DESIGN Prospect i ve cohort study . SETTING Two U.S. clinical centers . PARTICIPANTS Adults aged 70 to 80 ( N=3,011 ) from the Health , Aging and Body Composition Study . MEASUREMENTS Measurements were of  grip strength , knee extension strength , lean mass , walking speed , and chair st and pace . Thigh computed tomography scans assessed muscle area and density ( a proxy for muscle fat infiltration ) . Hospitalizations were confirmed by local review of medical records . Negative binomial regression models estimated incident rate ratios ( IRRs ) of hospitalization for race- and sex-specific quartiles of each muscle and function parameter separately . Multivariate models adjusted for age , body mass index , health status , and coexisting medical conditions . RESULTS During an average 4.7 years of follow-up , 1,678 ( 55.7 % ) participants experienced one or more hospitalizations . Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized ( multivariate IRR=1.47 , 95 % confidence interval (CI)=1.24 - 1.73 ) than those in the highest quartile . Similarly , participants with the weakest grip strength were at greater risk of hospitalization ( multivariate IRR=1.52 , 95 % CI=1.30 - 1.78 , Q1 vs. Q4 ) . Comparable results were seen for knee strength , walking pace , and chair st and s pace . Lean mass and muscle area were not associated with risk of hospitalization . CONCLUSION Weak strength , poor function , and low muscle density , but not muscle size or lean mass , were associated with greater risk of hospitalization . Interventions to reduce the disease burden associated with sarcopenia should focus on increasing muscle strength and improving physical function rather than simply increasing lean mass OBJECTIVE An acute disease is regularly associated with inflammation , decreased food intake , and low physical activity ; the consequence is loss of muscle mass . However , the restoration of muscle tissue is problematic , especially in older patients . Loss of muscle mass leads to further decrease of physical activity which leads , together with recurring disease , to the progressive muscle mass loss accompanied by loss of self-sufficiency . Early nutrition support and physical activity could reverse this situation . Therefore , the aim of this study was to determine whether an active approach based on early nutritional therapy and exercise would influence the development of sarcopenia and impaired self-sufficiency during acute illness . METHODS Two hundred patients > 78 y were admitted to a hospital internal medicine department and participated in a prospect i ve , r and omized controlled study . The patients were r and omized to a control group receiving st and ard treatment ( n = 100 ) or to an intervention group ( n = 100 ) . The intervention consisted of nutritional supplements ( 600 kcal , 20 g/d protein ) added to a st and ard diet and a simultaneous intensive rehabilitation program . The tolerance of supplements and their influence on spontaneous food intake , self-sufficiency , muscle strength , and body composition were evaluated during the study period . The patients were then regularly monitored for 1 y post-discharge . RESULTS The provision of nutritional supplements together with early rehabilitation led to increased total energy and protein intake while the intake of st and ard hospital food was not reduced . The loss of lean body mass and a decrease in self-sufficiency were apparent at discharge from the hospital and 3 mo thereafter in the control group . Nutritional supplementation and the rehabilitation program in the study group prevented these alterations . A positive effect of nutritional intervention and exercise during the hospital stay was apparent at 6 mo post-discharge . CONCLUSIONS The early nutritional intervention together with early rehabilitation preserves muscle mass and independence in ill older patients hospitalized because of acute disease Background : Undernutrition is common in older people admitted to hospital , but little is known about how nutritional state changes after discharge . Objective : This r and omised controlled trial was design ed to examine the effect of oral nutritional supplementation of undernourished very old people prepared to take supplements after hospital discharge following acute illness . Methods : Participants aged ≧75 years with a BMI ≤24 kg/m2 and triceps skin fold thickness or mid-arm muscle circumference below the 10th centile and /or weight loss ≧5 % during an acute hospital stay were allocated at r and om to either oral nutritional supplementation for 8 weeks from hospital discharge or to usual care . Primary outcome was change in weight , secondary outcomes were h and grip strength and anthropometry . Results : Of 198 patients eligible to participate , 136 patients ( mean age 85 years ) were r and omised and 76/136 ( 56 % ) completed the study . Twenty percent ( 13/66 ) of the intervention group withdrew after only 2 weeks , citing intolerance of the supplements . Using intention-to-treat analysis , body weight increased by a mean of 1.6 and 2.2 % in the control and intervention groups , respectively , but this between-group difference was not significant ( p = 0.188 ) . However , h and grip strength increased more ( p = 0.055 ) in the intervention group ( 13.9 % ) than in the control group ( 7.2 % ) . Conclusions : Oral nutritional supplementation was associated with a greater increase in h and grip strength than in non-supplemented controls and this observation merits further study Background The effects of neuromuscular electrical stimulation ( NMES ) in critically ill patients after cardiothoracic surgery are unknown . The objectives were to investigate whether NMES prevents loss of muscle layer thickness ( MLT ) and strength and to observe the time variation of MLT and strength from preoperative day to hospital discharge . Methods In this r and omized controlled trial , 54 critically ill patients were r and omized into four strata based on the SAPS II score . Patients were blinded to the intervention . In the intervention group , quadriceps muscles were electrically stimulated bilaterally from the first postoperative day until ICU discharge for a maximum of 14 days . In the control group , the electrodes were applied , but no electricity was delivered . The primary outcomes were MLT measured by ultrasonography and muscle strength evaluated with the Medical Research Council ( MRC ) scale . The secondary functional outcomes were average mobility level , FIM score , Timed Up and Go Test and SF-12 health survey . Additional variables of interest were grip strength and the relation between fluid balance and MLT . Linear mixed models were used to assess the effect of NMES on MLT , MRC score and grip strength . Results NMES had no significant effect on MLT . Patients in the NMES group regained muscle strength 4.5 times faster than patients in the control group . During the first three postoperative days , there was a positive correlation between change in MLT and cumulative fluid balance ( r = 0.43 , P = 0.01 ) . At hospital discharge , all patients regained preoperative levels of muscle strength , but not of MLT . Patients did not regain their preoperative levels of average mobility ( P = 0.04 ) and FIM score ( P = 0.02 ) at hospital discharge , independent of group allocation . Conclusions NMES had no effect on MLT , but was associated with a higher rate in regaining muscle strength during the ICU stay . Regression of intramuscular edema during the ICU stay interfered with measurement of changes in MLT . At hospital discharge patients had regained preoperative levels of muscle strength , but still showed residual functional disability and decreased MLT compared to pre-ICU levels in both groups . Trial registration Clinical trials.gov identifier NCT02391103 . Registered on 7 March 2015 ABSTRACT The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease ( COPD ) during hospitalization due to an acute exacerbation . This study was a r and omized , single-blind clinical trial . Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD ( AE COPD ) were included in this study . All patients received st and ard medical and pharmacological care . Patients assigned to the intervention group also received an exercise intervention . The main outcome measures were balance , muscle strength , and exercise capacity . Significant between-group differences were found in muscle strength ( p = 0.028 ) and balance ( p = 0.013 ) after the intervention . All the variables improved significantly ( p < 0.05 ) in the exercise intervention group . In the intervention group , the mean difference in muscle strength between baseline and discharge was 10.47 N. Balance also improved , showing a mean difference of 7.56 seconds on the right leg and 6.57 seconds on the left leg . Exercise capacity improved as well , with a difference of 4.97 st and s between baseline and discharge . All the variables showed impairment in the control group . In conclusion , an exercise intervention using a pedal exerciser during the hospital stay of frail elderly patients with an AE COPD improves muscle strength , balance , and exercise capacity OBJECTIVE To evaluate the effects of whole-body resistance training on exercise capacity , health-related quality of life ( HRQOL ) , and muscle strength in patients hospitalized for exacerbation of chronic obstructive pulmonary disease . DESIGN R and omized controlled trial . SETTING University hospital . PARTICIPANTS Patients ( N=46 ) were r and omized to either a control group ( CG ) or training group ( TG ) , and 29 patients completed the study . INTERVENTION Training consisted of weight-lifting exercises for 6 muscle groups in the upper and lower limbs ( 2 sets of 8 repetitions each ) , and the initial load was set at 80 % of the 1-repetition maximum load . MAIN OUTCOME MEASURES Patients were evaluated on the second day of hospitalization , at hospital discharge , and 30 days postdischarge . Patients were evaluated on the basis of the 6-minute walking distance ( 6MWD ) , HRQOL , muscle strength , systemic inflammatory markers , and level of physical activity in daily life ( PADL ) . RESULTS The CG showed a reduction in the strength of lower-limb muscles ( P<.05 ) but not in the 6MWD ( P>.05 ) . In contrast , patients from the TG improved strength in the lower-limb muscles and 6MWD during and 30 days after hospitalization ( P<.05 ) . The TG also improved the impact domain in HRQOL after hospitalization . No improvement in PADL was observed in the TG . Finally , a reduction in the blood levels of inflammatory markers was observed only in the TG after hospitalization . CONCLUSIONS Our results suggest that resistance training during hospitalization improves the 6MWD , HRQOL , and lower-limb muscle strength , without altering the levels of systemic inflammation . However , future research should explore this intervention in larger r and omized trials Background As the population ages and critical care advances , a growing number of survivors of critical illness will be at risk for intensive care unit (ICU)–acquired weakness . Bed rest , which is common in the ICU , causes adverse effects , including muscle weakness . Consequently , patients need ICU-based interventions focused on the muscular system . Although emerging evidence supports the benefits of early rehabilitation during mechanical ventilation , additional therapies may be beneficial . Neuromuscular electrical stimulation ( NMES ) , which can provide some muscular activity even very early during critical illness , is a promising modality for patients in the ICU . Objective The objectives of this article are to discuss the implication s of bed rest for patients with critical illness , summarize recent studies of early rehabilitation and NMES in the ICU , and describe a protocol for a r and omized , phase II pilot study of NMES in patients receiving mechanical ventilation . Design The study was a r and omized , sham-controlled , concealed , phase II pilot study with caregivers and outcome assessors blinded to the treatment allocation . Setting The study setting will be a medical ICU . Participants The study participants will be patients who are receiving mechanical ventilation for 1 day or more , who are expected to stay in the ICU for an additional 2 days or more , and who meet no exclusion criteria . Intervention The intervention will be NMES ( versus a sham [ control ] intervention ) applied to the quadriceps , tibialis anterior , and gastrocnemius muscles for 60 minutes per day . Measurements Lower-extremity muscle strength at hospital discharge will be the primary outcome measure . Limitations Muscle strength is a surrogate measure , not a patient-centered outcome . The assessment s will not include laboratory , genetic , or histological measures aim ed at a mechanistic underst and ing of NMES . The optimal duration or dose of NMES is unclear . Conclusions If NMES is beneficial , the results of the study will help advance research aim ed at reducing the burden of muscular weakness and physical disability in survivors of critical illness Objective : Survivors of severe critical illness frequently develop substantial and persistent physical complications , including muscle weakness , impaired physical function , and decreased health-related quality of life . Our objective was to determine the longitudinal epidemiology of muscle weakness , physical function , and health-related quality of life and their associations with critical illness and ICU exposures . Design : A multisite prospect i ve study with longitudinal follow-up at 3 , 6 , 12 , and 24 months after acute lung injury . Setting : Thirteen ICUs from four academic teaching hospitals . Patients : Two hundred twenty-two survivors of acute lung injury . Interventions : None . Measurements and Main Results : At each time point , patients underwent st and ardized clinical evaluations of extremity , h and grip , and respiratory muscle strength ; anthropometrics ( height , weight , mid-arm circumference , and triceps skin fold thickness ) ; 6-minute walk distance , and the Medical Outcomes Short-Form 36 health-related quality of life survey . During their hospitalization , survivors also had detailed daily evaluation of critical illness and related treatment variables . Over one third of survivors had objective evidence of muscle weakness at hospital discharge , with most improving within 12 months . This weakness was associated with substantial impairments in physical function and health-related quality of life that persisted at 24 months . The duration of bed rest during critical illness was consistently associated with weakness throughout 24-month follow-up . The cumulative dose of systematic corticosteroids and use of neuromuscular blockers in the ICU were not associated with weakness . Conclusions : Muscle weakness is common after acute lung injury , usually recovering within 12 months . This weakness is associated with substantial impairments in physical function and health-related quality of life that continue beyond 24 months . These results provide valuable prognostic information regarding physical recovery after acute lung injury . Evidence -based methods to reduce the duration of bed rest during critical illness may be important for improving these long-term impairments Background and aims : An acute illness may place older frail people at increased risk of losing independence in functional abilities . Physical exercise may reduce the risk by improving muscle strength and balance . However , the effects of physical training on functional abilities have not been studied among frail , very old people recovering from an acute illness . The aim of this study was to determine the effects of a group-based exercise program on their ability to carry out self-care ( ADL ) and instrumental activities ( IADL ) relevant to daily life after discharge from hospital . Methods : This r and omized controlled trial examined 68 community-dwelling women aged 75 years or older ( mean age 83.0 , SD 3.9 ) who were hospitalized due to an acute illness , and were mobility-impaired at admission . Participants were recruited from the geriatric ward of a primary -care health-center hospital , and were r and omized into group-based strength training ( n=34 ) and control ( n=34 ) groups . The 10-week group-based intervention included strength training and functional exercises . The control group received instructions for a home exercise training program , including functional exercises but no further encouragement to exercise . The level of independence in ADL and IADL was evaluated , using a 13-item scale with stepwise grading from fully independent to fully dependent . Measurements took place immediately before and after the intervention , and three and nine months later . Results : The intervention did not have any significant main effect ( p=0.407 ) , nor was there any significant interaction between follow-up time and intervention ( p=0.854 ) . Conclusions : The multi-component outpatient strength training program did not improve autonomy in expert-evaluated ADL/IADL functions Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed . However , it is unknown whether these are effective in this particular population . This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization . Methods The systematic search included PubMed , EMBASE , Cinahl , the Trials data base of The Cochrane Library and SPORTd iscus from inception to 22 November 2017 . Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on  physical performance or physical activity  was evaluated during hospitalization . Results Fifteen r and omized controlled trials met the inclusion criteria . Overall , the effect of physical interventions on physical performance was inconsistent . Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not . Physical activity as outcome measure was not addressed . Reporting of intensity of the interventions and adherence were frequently lacking . Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain . Further research on the efficacy of the intervention is needed , comparing types of intervention with detailed reporting of frequency , intensity and duration The objective of this study was to analyze the results of a multimodal therapeutic program during hospitalization in obese AE COPD patients . This was a r and omized , single-blind clinical trial conducted at two university hospitals in Granada , Spain . Forty-nine patients hospitalized due to AE COPD were r and omly allocated to a control group ( CG ) , in which patients received st and ard care , or to an intervention group ( IG ) , in which patients were included in a multimodal therapeutic program , added to the st and ard care . The main outcome measures were pulmonary , physical ( strength and exercise capacity ) and perceived ( dyspnea , quality of life and psychological distress ) variables . Within-group significant improvements ( p < 0.05 ) were found in physical and perceived variables in the IG after the treatment . In the CG , a significant decrease was found in lower limb strength and a significant improvement in dyspnea and in three subscales of the EuroQol-5D question naire . The between-groups analysis showed significant differences after the treatment on lower limb strength and exercise capacity values ( p < 0.05 ) , in three of the EuroQol-5D subscales , and in the total score and the depression subscale of the Hospital Anxiety and Depression Scale . A multimodal therapeutic program has a beneficial effect on physical functioning and perceived variables in hospitalized obese patients with AE COPD Purpose Intensive Care Unit ( ICU ) survivors experience muscle weakness leading to restrictions in functional ability . Neuromuscular electrical stimulation ( NMES ) has been an alternative to exercise in critically ill patients . The aim of our study was to investigate its effects along with individualized rehabilitation on muscle strength of ICU survivors . Material and methods Following ICU discharge , 128 patients ( age : 53 ± 16 years ) were r and omly assigned to daily NMES sessions and individualized rehabilitation ( NMES group ) or to control group . Muscle strength was assessed by the Medical Research Council ( MRC ) score and h and grip at hospital discharge . Secondary outcomes were functional ability and hospital length of stay . Results MRC , h and grip , functional status and hospital length of stay did not differ at hospital discharge between groups ( p > 0.05 ) . & Dgr;MRC% one and two weeks after ICU discharge tended to be higher in NMES group , while it was significant higher in NMES group of patients with ICU‐acquired weakness at two weeks ( p = 0.05 ) . Conclusions NMES and personalized physiotherapy in ICU survivors did not result in greater improvement of muscle strength and functional status at hospital discharge . However , in patients with ICU‐aw NMES may be effective . The potential benefits of rehabilitation strategies should be explored in larger number of patients in future studies . Clinical trial registration : www . Clinical trials.gov : NCT01717833 HighlightsR and omized trial implementing Neuromuscular Electrical Stimulation ( NMES ) and rehabilitation program in ICU survivors . The program was performed from ICU discharge to hospital discharge . Outcome measures included assessment of muscle strength , functional ability and hospital length of stay . MRC , h and grip strength , functional status and length of stay did not differ at hospital . MRC improved significantly in patients with ICU‐acquired weakness after 2 weeks of NMES.Intervention may be beneficial in ICU survivors with ICU‐acquired weakness BACKGROUND & AIM Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient . The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than st and ard care . Secondary outcomes were changes in muscle strength , functional ability and body weight . METHODS 29 acutely admitted old ( > 65 years ) patients were r and omly assigned to the intervention ( n = 14 ) or to st and ard care ( n = 15 ) . The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement ( 18.8 g protein ) and resistance training 3 times per week the 12 weeks following discharge .  Muscle mass was assessed by Dual-energy X-ray Absorptiometry . Muscle strength was assessed by H and Grip Strength and Chair St and Test . Functional ability was assessed by the de Morton Mobility Index , the Functional Recovery Score and the New Mobility Score . Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis . RESULTS The intention-to-treat analysis showed no significant effect of the intervention on lean mass ( unadjusted : β-coefficient = -1.28 P = 0.32 , adjusted for gender : β-coefficient = -0.02 P = 0.99 , adjusted for baseline lean mass : β-coefficient = -0.31 P = 0.80 ) . The de Morton Mobility Index significantly increased in the Control Group ( β-coefficient = -11.43 CI : 0.72 - 22.13 , P = 0.04 ) . No other differences were found . CONCLUSION No significant effect on muscle mass was observed in this group of acutely ill old medical patients . High compliance was achieved with the dietary intervention , but resistance training was challenging . Clinical trials identifier NCT02077491 Reduction in muscle mass and physical function depends on a variety of interacting factors : age , physical activity level , nutritional state and the type and impact of disease . The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength , balance , mobility , ambulation and activities of daily living ( ADL ) in institutionalized elderly people aged 65 and over with multiple diagnoses . Baseline assessment s consisted of strength , balance , mobility/ambulation , and ADL .  Twenty-one subjects were included in the intervention program . A control group ( 21 subjects ) was first matched in pairs according to gender , age , ADL and mobility , and then by balance , ambulation and strength . The intervention program was individualized and included strength , mobility , balance and endurance training . Follow-up measures were conducted directly after the intervention and 10 weeks later . After drop-out , 20 subjects in the intervention group and 15 subjects in the control group remained for analyses . Balance and mobility improved significantly in the intervention group while declining in the control group . This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses Health in older adults can best be measured in terms of functional status . Skeletal muscle strength has been reported to be a determinant of functional status in older individuals . Two major contributors to the decline in muscle function as a person ages are disuse and physical inactivity . Declining muscle function through a loss of muscular strength may decrease functional independence and mobility and increase the risk for falls and injuries , physical frailty , and disability .  Older individuals lacking an appropriate amount of muscular strength may not be able to perform various activities of daily living , which are important indicators of independence This study poses two questions : 1 ) is there an abnormality in isokinetic skeletal muscle strength and endurance in mild chronic obstructive pulmonary disease ( COPD ) ? and 2 ) what is the effect of a r and omized , controlled , 12 week hospital outpatient weight training programme in terms of skeletal muscle function and exercise tolerance ? Upper and lower limb isokinetic maximum and sustained muscle function were compared in 43 COPD patients ( age 49+/-11 yrs ) , mean forced expiratory volume in one second ( FEV1 ) 77+/-23 % pred and 52 healthy , sedentary subjects ( age 51 ( 10 ) yrs ) , mean FEV1 109+/-16 % pred . The 43 COPD patients were r and omly allocated into training ( n=26 ) and control ( n=17 ) groups . Isokinetic and isotonic muscle function , whole body endurance , maximal exercise capacity and lung function were measured . The COPD patients had reduced isokinetic muscle function ( with the exception of sustained upper limb strength ) as compared with healthy sedentary subjects . Muscle function improved after weight training in the COPD patients . Whole body endurance during treadmill walking also improved with no change in maximal oxygen consumption . A deficit in skeletal muscle function can be identified in patients with mild chronic obstructive pulmonary disease which can not be explained by factors such as hypoxaemia and malnutrition . Intervention with weight training is effective in countering this deficit which the authors conclude is probably due to muscle deconditioning
In conclusion , decrease in muscle strength and muscle mass in older patients is dependent on the type of admission .
HIGHLIGHTSPhysical inactivity during hospitalization is associated with detrimental outcome .Muscle strength and muscle mass decreased in electively admitted older patients .Muscle strength and muscle mass did not change in acutely admitted older patients
ABSTRACT Hospitalization may induce a decrease of muscle strength and muscle mass in older patients due to physical inactivity , malnutrition and diseases , negatively affecting health outcome .
We aim ed to examine the literature on change in muscle strength and muscle mass in older patients during hospitalization .