不同运动强度对老年肌少症的干预研究进展

doi:10.3969/j.issn.1003-9198.2026.02.018

摘要/Abstract

摘要： 老年肌少症是一种和年龄相关的综合征,常引发病人跌倒、骨折、衰弱、认知障碍等不良预后,已成为公共卫生体系的重要挑战。运动干预被认为是预防和治疗肌少症的有效手段,但关于运动干预的强度选择仍然存在争议。本综述从肌少症的定义、发病机制及影响因素,抗阻运动和有氧运动的分类与特点,运动强度的概念、分级及其对肌肉的影响等方面进行阐述,对老年肌少症病人不同强度运动干预的研究进展进行总结。发现低强度运动安全耐受性高,中等强度运动是常用干预手段,高强度运动在改善肌肉功能上更优但风险较高。未来研究应着眼于不同运动方式、强度、频率、持续时间等对老年肌少症病人的治疗效果,为制定个性化长期运动方案奠定基础,并为老年肌少症病人运动处方的制定提供更多思路。

关键词: 肌少症, 骨骼肌, 运动干预

Abstract: Sarcopenia is an age-related syndrome in the elderly, which often induces fall, fracture, weakness, cognitive impairment and other adverse prognosis, and has become an important challenge for the public health system. Exercise intervention is considered to be an effective means to prevent and treat sarcopenia, but there is still a debate about the intensity of exercise intervention. This paper summarizes the research progress of different intensity exercise interventions in elderly patients with sarcopenia, including the definition, pathogenesis and influencing factors of sarcopenia, the classification and characteristics of resistance exercise and aerobic exercise, the concept and grading of exercise intensity and its impact on muscle, and identifies that low intensity exercise has a high safety tolerance, moderate intensity exercise is a commonly used intervention method, and high intensity exercise is better in improving muscle function but has higher risk. Future research should focus on the effect of different exercise modes, intensities, frequencies, and durations on the treatment of elderly patients with sarcopenia, lay the foundation for the formulation of personalized long-term exercise programs, and provide more ideas for the formulation of exercise prescriptions for elderly patients with sarcopenia.

Key words: sarcopenia, skeletal muscle, exercise intervention

中图分类号:

R 746
R 592

李鹏利, 袁艺玮, 张方曙, 许静雯. 不同运动强度对老年肌少症的干预研究进展[J]. 实用老年医学, 2026, 40(2): 196-200.

LI Pengli, YUAN Yiwei, ZHANG Fangshu, XU Jingwen. Advances in exercise interventions with different intensities for sarcopenia in the elderly[J]. Practical Geriatrics, 2026, 40(2): 196-200.

参考文献

[1] CAO M Y, LIAN J S, LIN X S, et al. Prevalence of sarcopenia under different diagnostic criteria and the changs in muscle mass, muscle strength, and physical function with age in Chinese old adults [J]. BMC Geriatrics, 2022, 22(1): 889.
[2] DEFREITAS M M, DE OLIVEIRA V L P, GRASSI T, et al. Difference in sarcopenia prevalence and associated factors according to 2010 and 2018 European consensus (EWGSOP) in elderly patients with type 2 diabetes mellitus[J]. Exp Gerontol, 2020, 132: 110835.
[3] CHEN L K, LIU L K, WOO J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia[J]. J Am Med Dir Assoc, 2014, 15(2): 95-101.
[4] KORTEBEIN P, FERRANDO A, LOMBEIDA J, et al. Effect of 10 days of bed rest on skeletal muscle in healthy older adults[J]. JAMA, 2007, 297(16):1772-1774.
[5] LONNIE M, HOOKER E, BRUNSTROM J M, et al. Protein for life: review of optimal protein intake, sustainable dietary sources and the effect on appetite in ageing adults[J]. Nutrients, 2018, 10(3): 360.
[6] LIU Z, YE X, LI N, et al. Roles of natural products on myokine expression and secretion in skeletal muscle atrophy[J]. Gen Comp Endocrinol, 2024, 355: 114550.
[7] CHOI K M. Sarcopenia and sarcopenic obesity[J]. Korean J Intern Med, 2016, 31(6): 1054-1060.
[8] PATE R R, PRATT M, BLAIR S N, et al.Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine [J]. JAMA, 1995, 273:402-407.
[9] CRUZ-JENTOFT A J, LANDI F, SCHNEIDER S M, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)[J]. Age Ageing, 2014, 43(6): 748-759.
[10] LIU C J, LATHAM N K. Progressive resistance strength training for improving physical function in older adults[J]. Cochrane Database Syst Rev, 2009, 2009(3): CD002759.
[11] 王月兵, 刘庆春, 李军, 等. 抗阻力运动和肌酸在肌肉衰减综合征中的研究进展[J]. 军事医学, 2017, 41(8): 703-706.
[12] BOWEN T S, SCHULER G, ADAMS V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training[J]. J Cachexia Sarcopenia Muscle, 2015, 6(3): 197-207.
[13] 王光辉, 蔡文玮, 沈晓君, 等. 弹力带抗阻运动训练12周对社区老年肌少症患者肌力的影响[J]. 中国临床保健杂志, 2021, 24(6): 800-804.
[14] 金银哲. 抗阻运动对2型糖尿病大鼠模型血脂代谢和胰岛素抵抗的影响[J]. 基因组学与应用生物学, 2020, 39(9): 4235-4242.
[15] CHEN B Y, CHEN Y Z, SHIN S H, et al. Effect of a moderate-intensity comprehensive exercise program on body composition, muscle strength, and physical performance in elderly females with sarcopenia[J]. Heliyon, 2023, 9(8): e18951.
[16] 钟静, 王秀华. 老年人肌少症非药物干预的研究进展[J]. 中国护理管理, 2019, 19(8): 1256-1262.
[17] MENDE E, MOEINNIA N, SCHALLER N, et al. Progressive machine-based resistance training for prevention and treatment of sarcopenia in the oldest old: a systematic review and meta-analysis[J]. Exp Gerontol, 2022, 163: 111767.
[18] LUNDBERG T R, FERNANDEZ-GONZALO R, TESCH P A, et al. Aerobic exercise augments muscle transcriptome profile of resistance exercise[J]. Am J Physiol Regul Integr Comp Physiol, 2016, 310(11): R1279-R1287.
[19] 麦雪萍, 王磊. BORG主观体力感等级量表的生理效度研究: 一项元分析[J]. 广州体育学院学报, 2012, 32(3): 78-83.
[20] Veterans Health Administration, Department of Defense.VA/DoD clinical practice guideline for the management of stroke rehabilitation in the primary care setting[M].Washington DC: Department of Veteran Affairs, 2003:27-28.
[21] ESTEVE SIMO V, JUNQUÉ JIMÉNEZ A, MORENO GUZMÁN F, et al. Benefits of a low intensity exercise programme during haemodialysis sessions in elderly patients [J]. Nefrologia, 2015, 35(4):385-394.
[22] 夏汶, 郑洁皎, 张杰, 等. 低强度运动控制训练对老年共病患者下肢肌肉衰减的影响[J]. 老年医学与保健, 2022, 28(5): 1114-1118.
[23] 孔健达, 解瑛傲, 陈世娟, 等. 血流限制训练干预老年肌少症: 生物学机制和应用方案建议[J]. 中国组织工程研究, 2024, 28(23): 3743-3750.
[24] FABERO-GARRIDO R, GRAGERA-VELA M, DEL CORRAL T, et al. Effects of low-load blood flow restriction resistance training on muscle strength and hypertrophy compared with traditional resistance training in healthy adults older than 60 years: systematic review and meta-analysis[J]. J Clin Med, 2022, 11(24): 7389.
[25] YAN Z, LIRA V A, GREENE N P. Exercise training-induced regulation of mitochondrial quality[J]. Exerc Sport Sci Rev, 2012, 40(3): 159-164.
[26] CEBRIÀ I IRANZO M À, BALASCH-BERNAT M, TORTOSA-CHULIÁ M Á, et al. Effects of resistance training of peripheral muscles versus respiratory muscles in older adults with sarcopenia who are institutionalized: a randomized controlled trial[J]. J Aging Phys Act, 2018, 26(4): 637-646.
[27] VIKBERG S, SÖRLÉN N, BRANDÉN L, et al. Effects of resistance training on functional strength and muscle mass in 70-year-old individuals with pre-sarcopenia: a randomized controlled trial[J]. J Am Med Dir Assoc, 2019, 20(1): 28-34.
[28] CHEN H T, CHUNG Y C, CHEN Y J, et al. Effects of different types of exercise on body composition, muscle strength, and IGF-1 in the elderly with sarcopenic obesity[J]. J Am Geriatr Soc, 2017, 65(4): 827-832.
[29] 张音, 许轶明, 沈宏华, 等. 12周有氧训练联合弹力带抗阻训练对老年肌少症体成分、肌力、躯体功能和肺功能的影响[J]. 老年医学与保健, 2024, 30(2): 529-542.
[30] PAHOR M, GURALNIK J M, AMBROSIUS W T, et al. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial[J]. JAMA, 2014, 311(23): 2387-2396.
[31] FRAGALAM S, CADORE E L, DORGO S, et al. Resistance training for older adults: position statement from the national strength and conditioning association[J]. J Strength Cond Res, 2019, 33(8): 2019-2052.
[32] 董蕾, 张钰, 刘遂心. 健康青年男性进行高强度间歇训练的心血管反应[J]. 中华高血压杂志, 2018, 26(7): 634-638.
[33] 梁丰, 霍文璟, 欧阳刚, 等. 不同运动方式训练对慢性肾脏病患者运动功能的影响[J]. 中国康复理论与实践, 2018, 24(2): 208-213.
[34] KIRKMAN D L, MULLINS P, JUNGLEE N A, et al. Anabolic exercise in haemodialysis patients: a randomised controlled pilot study [J]. J Cachexia Sarcopenia Muscle, 2014, 5(3): 199-207.
[35] STOEVER K, HEBER A, EICHBERG S, et al. Influences of resistance training on physical function in older, obese men and women with sarcopenia[J]. J Geriatr Phys Ther, 2018, 41(1): 20-27.
[36] COLBERG S R, SIGAL R J, YARDLEY J E, et al. Physical activity/exercise and diabetes: aposition statement of the American Diabetes Association[J]. Diabetes Care, 2016, 39(11): 2065-2079.
[37] GOMES J H, MENDES R R, FRANCA C S, et al. Acute leucocyte, muscle damage, and stress marker responses to high-intensity functional training[J]. PLoS One, 2020, 15(12): e0243276.
[38] AAMOT I L, FORBORD S H, GUSTAD K, et al. Home-based versus hospital-based high-intensity interval training in cardiac rehabilitation: a randomized study[J]. Eur J Prev Cardiol, 2014, 21(9): 1070-1078.
[39] 赵之光, 陈浩, 张倩, 等. 运动相关心血管事件风险的评估与监测中国专家共识[J]. 中国循环杂志, 2022, 37(7): 659-668.