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Prehabilitation needs to be lengthy - study

Monday December 21st 2020

Older adults should complete a lengthy programme of exercise before undergoing elective surgery to help counteract muscle-wasting effects caused by bed rest, says a UK study published today (21 December 2020).

Research by a team at the University of Birmingham’s School of Sport, Exercise and Rehabilitation Sciences, with colleagues from the Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research, showed that short-term ‘prehabilitation’ strength exercises do not prevent muscle loss.

They recommend extended programmes of strengthening as an alternative.

The study involved a group of older adults, who were asked to complete four sessions of weightlifting exercise over one week, with participants exercising one leg only. The other leg was not exercised.

After completing the course, the participants had five days of bed rest and researchers found that muscle loss was about the same in both legs.

Writing in the Journal of Cachexia, Sarcopenia and Muscle, they say their analysis showed that while short-term exercise prehabilitation improves the body’s muscle-building processes, thigh muscle-wasting was about 3-4% in both legs, which is what older adults would typically lose over three to five years of ageing.

Corresponding author Dr Leigh Breen said: “Although short-term prehabilitation offers a cost-effective and easy-to-implement strategy, it does not prevent muscle wasting among older adults undergoing bed-rest. This muscle loss may be extremely hard to recover from and can lead to long-term health and disease complications.”

Instead, they recommend an exercise programmes that includes aerobic exercise alongside strength training to protect cardiovascular health, and a protein-rich diet to increase muscle mass levels to cancel out the muscle loss that is experienced during bed rest

They also say that older hospitalised patients should aim to get mobile again as quickly as possible, where it is appropriate and safe to do so, while post-surgery exercise and dietary strategies are also be important.

Lead author Dr Benoit Smeuninx, now at Monash University in Australia, added: “Our study reinforces the need for more research into the benefits of longer-term training programmes prior to surgery. In the same way as an athlete would train before a race or a competition, exercise training before hospitalisation is likely to be highly beneficial to older adults undergoing elective surgeries.”

Breen L et al . The effect of short-term exercise prehabilitation on skeletal muscle protein synthesis and atrophy during bed rest in older men. Journal of Cachexia, Sarcopenia and Muscle 21 December 2020.

Tags: Elderly Health | Rheumatology | UK News

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