Weight training for the elderly is useful for preventing sarcopenia. Weight training, or more precisely referred to as weight training, is a movement or physical activity that causes muscles to contract against external resistance in the hope of increasing strength, hypertrophy, or endurance. The external resistance or load in question can be dumbbells, exercise tubing, weights from body weight, water bottles, or any object that can stimulate muscle contraction.
Initially, the term sarcopenia was used to describe age-related muscle mass decline. Later, sarcopenia was further defined to describe decreased muscle mass, muscle weakness, and loss of physical function. This definition can also describe the severity of sarcopenia.
In the elderly, sarcopenia can reduce quality of life, increase the risk of disability, health care costs, and even increase the risk of death. Therefore, good prevention and treatment strategies are needed.
What are preventative measures for sarcopenia?
Sarcopenia prevention efforts must be carried out from a young age, because lifestyle determines a person's risk of experiencing sarcopenia in old age. The most important lifestyles that play a role in preventing sarcopenia include:
- Food selection: eating habits with balanced nutrition will help prevent sarcopenia because they allow for sufficient protein intake. Some recommended food products to be combined for daily consumption are grains, nuts, milk, fish, and eggs
- Physical activity: it is recommended to do physical activity for at least 150 minutes/week to prevent sarcopenia
- Sitting time: sitting time that is considered to increase the risk of sarcopenia is more than 7 hours/day
- Sleep duration: it is recommended to sleep with good quality with a duration of 7-8 hours/day
How does physical inactivity cause sarcopenia?
Physical activity is the main key in preventing sarcopenia at all ages. For the elderly themselves, very strong and growing scientific evidence shows that progressive weight training can prevent sarcopenia. Weight training has a real physiological effect on the nervous and musculoskeletal systems that affect muscle strength.
Various studies have shown evidence of the effect of weight training on muscle strength in the elderly. One study showed a 49% increase in muscle strength in older adults after 6 weeks of progressive resistance training.
Another study showed a 64% increase in muscle fascicle length after resistance training in older adults. Additionally, there is evidence that resistance training for 24 weeks in older adults with limited mobility, when combined with simple protein supplementation, can increase thigh muscle cross-sectional area by 4.6%.
A meta-analysis of 25 clinical trials with a total of 2267 participants showed that resistance training in older adults is effective in increasing handgrip and lower extremity strength, dexterity, gait speed, postural stability, functional performance, fat mass, and muscle mass.
What are the exercise prescription guidelines for older adults?
When prescribing resistance training in older adults to prevent sarcopenia, it is important to be aware of several important variables that contribute to its success. Variables to consider when prescribing resistance training include frequency, duration, type of exercise, sets, intensity, repetitions, and progression.
It is important to remember that older adults often have pre-existing health issues, such as orthopedic limitations and cardiovascular disease, that require special consideration. The Exercise And Screening for You (EASY) is a screening tool that helps provide guidance on appropriate exercise programs for older adults.
Another consideration when prescribing resistance training for older adults, especially those who are just starting out, is the importance of instruction and supervision by an exercise professional such as a physical therapist or exercise physiologist.
1. Frequency of Weight Training
Frequency of weight training is the number of training sessions per week. The recommended frequency is 2 to 4 days per week with a rest day in between each session. An example is doing weight training sessions on Monday, Wednesday, and Saturday.
The most common approach for older adults who are just starting a weight training program is to do a 'total body' workout where all major muscle groups are trained in each session. As the level of training can be increased, weight training can be changed to 2 days/week of muscle group training and the remaining days of 'total body' training with a rest day in between each session.
2. Duration of Weight Training
Duration describes the length of each training session. The total duration of weight training varies widely and there is no specific benchmark because there are many contributing factors, such as rest time between sets.
In general, weight training should be able to be completed in 30 minutes to 1 hour (the more intense and high-level the exercise, the longer it will take). With regard to rest intervals between sets, the American College of Sports Medicine currently recommends a rest interval of 1–2 minutes for training programs designed to stimulate muscle hypertrophy.
However, some researchers suggest that the optimal rest interval between sets is approximately 30–60 seconds, as this will produce the greatest increase in anabolic hormones, particularly growth hormone.
3. Types of Weight Training Exercises
Exercise types are generally categorized as multi-joint or uni-joint. Multi-joint exercises are those in which more than one joint is involved, such as the chest press and leg press. Uni-joint exercises are those in which only one joint is involved, such as the bicep curl and leg extension. For older adults, the recommended type of exercise is multi-joint, in order to gain the benefits of increased physical function.
Weight training using machines (such as the leg press) is preferred for older adults who are just beginning to exercise over free weight training (such as lifting dumbbells) for safety reasons. Because weight training with machines restricts joint range of motion and does not require special skills to operate, there is a lower risk of injury from incorrect technique during the exercise.
The specific exercises that can be performed vary greatly depending on the patient's needs and the availability of equipment, but the principle of weight training with 'total body' exercises should include exercises that involve all "major muscle groups". These muscle groups are generally defined as the chest, back, arms, shoulders, upper legs (quadriceps, hamstrings, and gluteals), and lower legs (calves).
4. Weight Training Sets
A set is the number of repetitions of a cycle of repetitions of a particular muscle group exercise. A practical example, if a muscle exercise such as a biceps curl consists of 2 sets and 8 repetitions, it means that one cycle of repetitions consists of 8 of the same biceps curl movements and the cycle is repeated 2 times which represents a set, where usually there should be a rest interval between sets.
For the introduction period of training, it is recommended that each movement only consist of 1 set. The introduction of training is carried out for 1-2 weeks until physical adaptation occurs, then the new set is increased progressively. Each time there is an increase in sets in the training session, the training volume will automatically increase.
5. Weightlifting Intensity
Intensity is the relative amount of weight lifted, usually as a percentage of repetition maximum (RM). 1-RM or 1 repetition maximum is the maximum amount of weight that the body can only lift once and cannot be repeated without a rest break.
High-intensity weightlifting (80% repetition maximum) can be done by the elderly, but it should be remembered that achieving high intensity requires progressive training. So you still have to start from a light one first and then gradually increase the intensity.
6. Weightlifting Repetitions
Repetitions are the number of times a person performs a complete movement of a given exercise in 1 cycle without a rest interval. The number of repetitions a person can do is usually inversely proportional to the intensity of the exercise, the higher the intensity, the lower the number of repetitions that can be done.
7. Weightlifting Progression
The concept of "progression" refers to the gradual increase in the load given to the body during exercise. The principle of progression in weightlifting is that the human body will only respond if it is continuously asked to exert greater strength to meet higher physiological demands. Therefore, to obtain increased muscle mass, strength, and function, it is very important to consistently provide variation and progression in weightlifting.
Conclusion
Sarcopenia is an age-related disease characterized by progressive and complete loss of muscle mass and strength with impacts in the form of physical disability, poor quality of life, and increased risk of death. Efforts to prevent sarcopenia must be carried out as early as possible by changing lifestyle, including increasing physical activity. The recommended and effective physical activity for preventing sarcopenia in the elderly is weightlifting.
Prescription of weight training must meet specific variables to obtain the benefits of increasing muscle mass, strength, and function. The variables that must be considered when prescribing weight training are frequency, duration, type of exercise, sets, intensity, repetitions, and exercise progression...
