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Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes. Currently, resistance exercise (RE) is recommended as the first-line treatment for counteracting the deleterious consequences of sarcopenia in older adults. However, whilst there is considerable evidence demonstrating that RE is an effective intervention for improving muscle strength and function in healthy older adults, much less is known about its benefits in older people living with sarcopenia. Furthermore, evidence for its optimal prescription and delivery is very limited and any potential benefits of RE are unlikely to be realised in the absence of an appropriate exercise dose. We provide a summary of the underlying principles of effective RE prescription (specificity, overload and progression) and discuss the main variables (training frequency, exercise selection, exercise intensity, exercise volume and rest periods) that can be manipulated when designing RE programmes. Following this, we propose that an RE programme that consists of two exercise sessions per week and involves a combination of upper- and lower-body exercises performed with a relatively high degree of effort for 1–3 sets of 6–12 repetitions is appropriate as a treatment for sarcopenia. The principles of RE prescription outlined here and the proposed RE programme presented in this paper provide a useful resource for clinicians and exercise practitioners treating older adults with sarcopenia and will also be of value to researchers for standardising approaches to RE interventions in future sarcopenia studies. [ABSTRACT FROM AUTHOR]

Background: The benefits of regular exercise and physical activity are well known. Those living in long-term care are often frail, but have the potential to benefit from physical activity; yet are less likely to be offered exercise. Promoting exercise within residential and nursing homes may reduce health risks associated with inactivity in this population. The aim of this cohort study is to identify predictors of attendance at physiotherapy led exercise groups offered to older adults residing in long-term care in the United Kingdom. Methods: One thousand and twenty three older adults residing in residential and nursing homes, were recruited to the Older People's Exercise in Residential and nursing Accommodation (OPERA) cluster randomised controlled trial. Secondary analysis of 428 adults (aged 75 to 107) randomised to twice-weekly physiotherapy-led group exercise sessions for 12 months was undertaken. Using attendance data, linear regression analysis was utilised to separately identify individual and home-level factors predictive of attendance at exercise in the residential and nursing homes. Results: Of 428 older adults, 326 lived in residential homes and 102 in nursing homes. Mean age of the sample was 88.0 years and the majority of residents were female (324/428, 76%). Pre-intervention assessment suggested that most residents had moderate cognitive impairment; median (range) Mini Mental State Examination scores in residential homes were 19 (0-30) and 14 (0-29) in nursing homes. Median Geriatric Depression Scale (GDS-15) scores were 3 (0-13) and 5 (0-13) respectively, indicating low levels of depressive symptoms. Over a 12-month period, 3191 exercise groups were delivered. Mean number of groups in the residential homes was 82 and 78 in the nursing homes. Number of attendances at group exercise was 11,534/21,292 (54.2%) and 3295/6436 (51.2%) respectively. Linear regression analysis revealed that depression, social engagement, and socio-economic characteristics were significantly associated with participant attendance at exercise groups in the residential homes, but none of these factors predicted attendance at group exercise in nursing homes. Conclusions: Older people living in long-term care are receptive to participating in exercise programmes, but there are individual and home-level reasons for attendance and non-attendance. [ABSTRACT FROM AUTHOR]