One definition of sarcopenia by Santilli et al1, states: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is strictly correlated with physical disability, poor quality of life and death. Risk factors for sarcopenia include age, gender and level of physical activity.
To diagnosis sarcopenia three of the following need to be present:
- HR >84 bpm at rest
- Orthostasis: a decrease in systolic 20 bpm or diastolic 10 bpm within three minutes of standing compared to sitting or supine
- Muscle weakness: a general 3/5, no specific muscle group
- Impaired mobility: need assistive device, need assist with bed mobility, difficulty with transfers
- Heart rate increases 10-20 bpm with verbal exam
As PTs we should be drooling at this. All of these are WELL within our scope to treat and VERY treatable! Treatment of deconditioning typically targets activity HR 20 beats greater than resting (light load). And remember to educate your patients to be patient as recondition takes two times longer than deconditioning.
Ikezoe2 found that older adults need knee extension force of 45 percent of their body weight and sit to stand of 5.6 times in 30 seconds to retain their ability to walk independently.
There is a wealth of research to support the benefits of low intensity strength programs that improve knee extension strength and functional mobility in frail older adults. Westoff3 demonstrated significant strength increases using these parameters: one to three sets of four to eight reps, with one minute rest, using TheraBand and using criteria that when they can perform three sets with good form to increase load.
Sarcopenia cost over 18 billion dollars in healthcare costs per year. We as PTs have the power to impact that and significantly improve the quality of life of our older adults! What a great job we have!!
Kele Murdin, PT
Geriatric Certified Specialist
Geriatric Training Certification
Certified Exercise Expert for Aging Adults
1) Santilli V, Bernetti A, Mangone M, and Paolone M. Clinical Definition of Sarcopenia. Clin Cases Miner Bone Metabv. 11(3); Sept-Dec 2015. Published online 2014 Dec 10.
2) Ikezoe, et. al, Muscle Strength and Muscle Endurance Required for Independent Walking in the Elderly. Journal of Physical Therapy Science. 9(1):19-22. January 1997. DOR 10.1589/jpts9.19
3) Westhoff M, Stemmerik L, Boshuizen H. Effects of a Low-Intensity Strength-Training Program on Knee-Extensor Strength and Functional Ability of Frail Older People. Journal of aging and physical activity. 8(4):325-342. October 200. DOI: 10.1123/japa.8.4.325