Home-based intervention to reduce sarcopenia

It is already well established in age-related sarcopenia (a muscle wasting syndrome) that resistance exercise can prevent and even reverse sarcopenia and such exercise programmes are also recommended to patients with sarcopenia related to chronic inflammatory diseases.

However, it was not known if such exercises could be carried out by the patient at home, thus reducing pressure on physiotherapy services, and whether patients would continue to perform the exercises at a sufficient level and frequency to impact on their muscle wasting and loss of function (strength).

Dr Matt Armstrong (consultant liver surgeon) and Ms Felicity Williams (physiotherapist and PhD student) of the Birmingham BRC Sarcopenia theme recently led the testing of a feasibility study of a home-based resistance exercise programme (HBEP) in patients with chronic liver disease awaiting a liver transplant.

Their study showed that the programme, involving 18 patients, achieved good adherence as 82% and 90% of participants adhered to the average daily step targets and the twice-weekly functional resistance-exercises, respectively. The programme also led to improved physical function in the patients with the Short physical performance battery (a functional measure) increasing after 6-weeks from a median score 9.5 to 11.5 (median difference +2.0; p=0.016).

There were also improvements in patients quality of life measures (QoL) by 12 weeks; health-related quality of life (HR-QoL) significantly improved (median change +17.5; p=0.039) and the EQ-5D-5L questionnaire highlighted that the proportion of patients reporting ‘no’ problems with mobility and pain/discomfort increased by 44% and 56% after 12-weeks HBEP, respectively.

This study has led to a successful application to the NIHR’s Efficacy and Mechanism Evaluation Programme for a larger trial of the exercise programme to help to ensure its broader efficacy and adoption nationally (EXALT study).

The BRC theme will also use this programme as a basis for lifestyle interventions to reduce sarcopenia in RA and IBD patients. Furthermore the programme will be discussed with our regional BRC partners at our regular Sarcopenia meetings to gain further rapid adoption of the scheme across the Midlands region.