Exercise Interventions for the Management of Sarcopenia: Possibilities and Challenges

Abstract Skeletal muscles undergo macroscopic changes, including atrophy and myosteatosis, alongside microscopic changes in their phenotype due to ageing. Sarcopenia is a muscle disease that affects older people and is characterised by the progressive loss of skeletal muscle, resulting in reduced muscle function and a decrease in quality of life. A lack of early diagnosis increases the risk of immobility and disability; highlighting the need for effective early indicators and interventions to prevent disease progression and improve muscle health. Following the onset of sarcopenia current treatment relies upon a progressive resistance training (RT) programme to promote muscle hypertrophy and improve physical performance by the upregulation of protein synthesis and the increase in type II muscle fibre size. However, RT is not appropriate for all patients, and is infrequently integrated into medicine or social care for older people. Alternative interventions to RT include multi-modal training, low-intensity blood-flow restriction training, and whole-body vibration training. Understanding the macroscopic and microscopic changes in the skeletal muscle in response to different interventions is essential to recognising their validity and further utility as a preventative intervention. Unfortunately, these changes are yet to be elucidated within the literature. Once effective exercise interventions have been established, barriers to exercise need to be identified and resolved. This will ensure that effective interventions are easily accessible for those who are diagnosed or at risk of developing sarcopenia.