Revalidatie van spieratrofie & spierzwakte Ivan Bautmans Frailty in Ageing research group

Sarcopenia Rosenberg J Nutr 1997 Age-related loss of muscle mass Roubenoff R. J Gerontol yrs75 yrs Muscle weakness; Physical fatigue; Loss of flexibility

Bauer & Sieber Exp Gerontol 2008; 43: Neuroendocrine dysregulation

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 yrs, elective abdominal surgery

Saini ea. Ageing Research Reviews 2009;8:251–267 Inflammation Exercise ↑ ↑

Adapted from Williams ea Circulation % Max resistance

N=31, Age=60-80 yrs Bautmans ea. Gerontology 2005; 51:

Peterson ea. Ageing Research Reviews 2010;9:226–237 15kg60kg

N=56, aged 68±5yrs Van Roie ea. Exp Gerontol 2013; 48: HIGH = 2x 10–15 80% 1RM LOW = 1× 80–100 20% 1RM LOW+ = 1× 60 20% 1RM + 1× 10–20 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 6RM) + aerobic exercise 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-inflammatoryAnti-inflammatory = reduction of chronic low-grade inflammatory profile

N=31, Age=60-80 yrs Bautmans ea. Gerontology 2005; 51: Acute exercise-induced response

Chronic effects N=31, age=60-80 yrs Bautmans ea. Gerontology 2005; 51:

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

Thank you.