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Year 2006, Volume 18 / Issue 1

DOI: 10.1615/CritRevPhysRehabilMed.v18.i1

Pages: 98

DOI: 10.1615/CritRevPhysRehabilMed.v18.i1.30

Article price - $60.00

Aging Muscle

Walter R. Frontera
Department of Physical Medicine and Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA

During the last 100 years, the number and percentage of people in older age groups has increased dramatically in the United States and many other countries around the world. Aging is associated with a decline in functional capacity and an increase in the incidence of disability. One of the main causes of functional loss and disability in the elderly is the loss of muscle mass (sarcopenia) and the development of skeletal muscle weakness. Recent research shows that not only the quantity but also the quality of muscle tissue, at the whole-muscle and single-fiber levels, is compromised. This may be due to abnormalities in the myosin molecule structure and function. Important determinants of skeletal muscle weakness and atrophy include, but are not limited to, genetic abnormalities, a reduction in protein synthesis, post-translational protein damage, changes in the hormonal milieu, impairment of satellite cell function, and chronic inflammation. The most effective and safe intervention for the rehabilitation of sarcopenia is strength training. Although the optimal prescription is not known, strength training induces positive and significant adaptations in muscle size and function. Stimulation of protein synthesis is an important metabolic event during exercise training. Although nutritional (protein) supplementation may enhance the benefits of strength training, hormonal therapy has not been shown to be effective. In addition to multiple physiological benefits, strength training also results in other important health-related benefits. Practitioners should include strength training in geriatric rehabilitation programs.

pages 63-94

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