ECSS Paris 2023: OP-MH14
INTRODUCTION: Strength training yields superior muscle strength and physical function in force-demanding tasks compared to recreational physical activity and sedentary behaviour. How these benefits evolve with age, particularly approaching life’s oldest years is unclear. This study is a follow-up to (Unhjem et al., 2019), and follows a cohort of lifelong strength trained, recreationally active and sedentary older adults over 10 years. METHODS: Maximal strength (1RM), early (0-100 ms) and late (100-200 ms) rate of force development (RFD), and functional performance following a decade among strength-trained master athletes (MA; n=6, 81±3yrs), recreationally active (AO; n=6, 82±7yrs), and sedentary older adults (SO; n=5, 82±4yrs). RESULTS: At follow-up, 1RM (kg) was higher in MA (143±48) and AO (115±43) than SO (90±42) (p<0.05). Concomitantly, MA (2892±727) displayed greater early RFD (N·s⁻¹) than AO (1390±281; p<.05), late RFD was greater in MA (2838±591) than AO (1477±232) and SO (1611±192; both p<.05). Chair-rise time (s) was shorter in MA (7.5±1.0) than SO (11.6±1.9), stair-climbing power (W) was greater in MA (360±129) than AO (262±87) (p<0.05). Walking speed (m·s⁻¹) was higher in MA (1.37±0.29) than SO (1.01±0.19) (p<0.05). From baseline, 1RM declined in MA (–23%) and AO (–15%, p<.05). Early RFD declined across all groups (MA: –55%, AO: –59%, SO: –50%; p<.05), as well as late RFD (MA: -49%, AO: -53%, SO: -43%; p<.05). Chair-rise time increased in MA (+26%) and SO (+29%, both p<.05). Stair-climbing power declined in MA (–49%), AO (–54%), and SO (–55%), and walking speed declined in MA (–9%), AO (–20%), and SO (–21%, all p<0.05). CONCLUSION: Strength training advantages in muscle strength and function were maintained in MA into very old age. Although AO displayed higher maximal strength than SO, this did not translate to attenuation of age-related loss of functional performance, highlighting strength training’s importance to healthy aging.
Read CV Ronan ShermanECSS Paris 2023: OP-MH14
INTRODUCTION: Low handgrip strength (HGS), defined as possible sarcopenia by the Asian Working Group for Sarcopenia (AWGS) 2025, is a robust predictor of premature mortality. While physical activity may mitigate this risk, existing evidence often relies on total physical activity without isolating the domain, and the minimum effective dose of leisure-time physical activity (LTPA) required to offset the risk associated with possible sarcopenia remains unclear. This study aimed to examine the independent and joint association of LTPA and possible sarcopenia with all-cause mortality among Koreans aged >= 50. METHODS: This prospective cohort study included 12,741 participants (mean age 61.9 years; 51.4% female) from the Korea National Health and Nutrition Examination Survey 2014-2018. Possible sarcopenia was defined by the AWGS 2025 sex- and age-specific cutoffs. LTPA was assessed via self-reported questionnaires and calculated as metabolic equivalent of task (MET) values per week. LTPA was categorised as inactive (0), insufficient (1-599), and sufficient (>=600) for the independent analysis to evaluate the benefits of sub-optimal activity. For the joint analysis, it was dichotomised as inactive (0) vs active (>0) to examine the benefits of feasible behavioural targets. Cox proportional hazards models estimated hazard ratios (HR) for all-cause mortality risk, and non-linear dose-response relationships were assessed via restricted cubic splines (RCS). Sensitivity analysis excluding deaths within the first year of follow-up was performed to minimise reverse causality. All models were adjusted for sociodemographic factors, chronic conditions, health behaviours, and nutritional status. RESULTS: The mean follow-up period was 6.2 years (925 death). RCS analysis revealed inverse non-linear associations of HGS and LTPA with mortality, having steep risk decline upon engaging in any LTPA, with plateauing at low activity levels. Independent of LTPA, the normal group was associated with lower mortality (HR 0.64; 95% CI 0.53-0.76) than the possible sarcopenia. For LTPA, the insufficient LTPA (HR 0.50; 95% CI 0.33-0.76) showed a risk reduction comparable to the sufficient LTPA (HR 0.61; 95% CI 0.43-0.87) compared to inactivity. In the joint analysis, the possible sarcopenia and active group (HR 0.55; 95% CI 0.34-0.89) exhibited HR similar to the normal and inactive group (HR 0.63; 95% CI 0.53-0.76). The lowest risk was observed in the normal and active group (HR 0.36; 95% CI 0.25-0.52), remaining robust in the sensitivity analysis. CONCLUSION: Engagement in LTPA, even at levels below standard recommendations, effectively offsets the mortality risk associated with possible sarcopenia. This study indicates that initiating minimal LTPA allows possible sarcopenic individuals to achieve survival probabilities comparable to their inactive healthy peers. Therefore, public health strategies should highlight minimal LTPA as a viable and potent intervention target for sarcopenia management under the AWGS 2025 framework.
Read CV Junhyung ParkECSS Paris 2023: OP-MH14
INTRODUCTION: Beyond spinal pathology, the role of systemic muscle health in the persistence of chronic low back pain has gained significant attention [1]. This study aimed to examine (1) the cross-sectional association between sarcopenia severity and pain, and (2) the bidirectional prospective relationship between these constructs over a 2-year period in individuals with chronic primary low back pain (CPLBP). METHODS: A total of 171 individuals with CPLBP, recruited from a hospital setting in southern Spain at baseline (median age 51 [interquartile range 41, 58] years; 61.4% women), were followed over 2 years (n=59, median age 56 [IQR 48, 61] years; 54.2% women). A composite sarcopenia severity index was calculated by standardizing and aggregating measures of muscle mass (Skeletal Muscle Mass adjusted by Body Mass Index [SMM/BMI], measured via multi-frequency bioelectrical impedance analysis [InBody R20]) and strength performance (handgrip strength, chair-stand, Sørensen, and prone-bridging tests). To ensure that higher scores represented sarcopenia severity, z-scores for muscle mass and strength were inverted. Pain was evaluated using a multidimensional pain index, derived from standardized scores of: (1) pain intensity (0–10 Visual Analogue Scale [VAS]), (2) the bodily pain subscale of the self-reported Short Form-36 (SF-36) questionnaire, and (3) lumbar pressure pain thresholds (PPTs). Components where higher values reflect better health (SF-36 and PPTs) were inverted so that higher index scores represent greater multidimensional pain. Linear regression models were adjusted for age, sex, analgesic use (yes/no), and catastrophizing; longitudinal models were further adjusted for baseline values. No significant interaction between sex and the main predictors was found (all p > 0.39); therefore, all analyses were conducted using the total sample. RESULTS: Cross-sectional analysis revealed that a higher sarcopenia severity was significantly associated with greater multidimensional pain at baseline (β=0.258; p=0.016). Prospectively, baseline sarcopenia severity was a significant predictor of multidimensional pain at 2-year follow-up (β=0.596; p=0.004). Conversely, the inverse prospective model showed that baseline multidimensional pain did not predict changes in the sarcopenia severity over time (p=0.809), with sarcopenia severity showing high stability (Adj. R²=0.85). CONCLUSION: These findings suggest a unidirectional longitudinal relationship where sarcopenia severity predicts future multidimensional pain in CPLBP patients, rather than pain driving muscle deterioration. Clinical interventions focusing on maintaining muscle mass and strength may be crucial not only for physical function but also as a potential strategy to mitigate long-term multidimensional pain in this population. [1]. Zhang Z, Guan Y, Xie S. Experimental Gerontology 2025; 210:112872. [2]. Segura-Jiménez V, et al. Sports Health 2025; 17(2):342–350. FUNDING: Instituto de Salud Carlos III (CP20/00178 and PI22/01791).
Read CV Víctor Segura-JiménezECSS Paris 2023: OP-MH14