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Older people about to undergo elective surgery should begin a sustained program of targeted exercise first to counter the muscle wasting effects of bed rest, new research suggests.
A study published by researchers at the School of Sport, Exercise and Rehabilitation Sciences at the University of Birmingham found that short-term “pre-rehabilitation” strength exercises, undertaken before surgery , are insufficient to prevent muscle loss.
In the study, researchers asked a group of older adults to perform four strength-training sessions over a week. Participants did the exercises using only one leg, while the other leg did not do any exercise.
After completing pre-adaptation, participants underwent five days of bed rest – a typical length of hospital stay for an older patient. Although the researchers expected to find that the leg that underwent the exercise would experience less muscle loss than the other leg, in fact, they found that the muscle loss was about the same in both legs.
The team’s detailed analysis showed that although pre-rehabilitation through short-term exercise improves muscle building processes in the body, thigh muscle wasting was around 3-4% in both legs. , roughly the equivalent of what older adults would typically lose in 3-5. years of aging.
The researchers recommend that one approach to protecting older muscles from wasting during hospitalization is to perform longer-term pre-rehabilitation exercises beforehand.
Dr Leigh Breen, corresponding author of the study, says: “Although short-term pre-rehabilitation offers a cost-effective and easy-to-implement strategy, it does not prevent muscle wasting in older people in times of crisis. bed rest. This muscle loss can be extremely difficult to recover and can lead to long-term health and illness complications. “
The team recommends that pre-rehabilitation exercise programs also incorporate aerobic exercise alongside strength training to protect cardiovascular health, and a high-protein diet to increase muscle mass levels in a way. to effectively reverse the muscle loss experienced during bed rest
They also recommend that, where appropriate and safely, elderly hospitalized patients strive to get back on their feet and move around as quickly as possible. Postoperative exercises and diet strategies will also be important to ensure a return to health and reduce the risk of future health complications.
Our study reinforces the need for further research on the benefits of longer-term pre-surgery training programs. In the same way that an athlete would train before a race or competition, physical training before hospitalization is likely to be of great benefit to seniors undergoing elective surgeries. “
Dr Benoit Smeuninx, lead study author, Monash University in Australia
The work was carried out in collaboration with colleagues at the Medical Research Council Versus Arthritis Center for Musculoskeletal Aging Research, which is a partnership between the University of Birmingham and the University of Nottingham. The work was funded by the Biotechnology and Biological Sciences Research Council.
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