Effect of Resistance and Balance Training on Muscle function and Balance in Older People with Sarcopenia : A Randomized Controlled Trial

Sarcopenia is a progressive loss of skeletal muscle mass strength and function that increases with age and is linked to falls frailty disability poor quality of life and mortality Muscle mass may decline up to 40 percent between ages 20 and 70 and at a rate of about 14 to 25 percent per year after 60 Aging leads to reduction of type 2 fibers fat infiltration and impaired satellite cell function along with systemic changes such as endocrine decline neuromuscular dysfunction insulin resistance mitochondrial dysfunction oxidative stress and denervation Risk factors include age gender and low physical activity Resistance training is the most effective strategy to slow muscle decline and physical activity in general is protective Progressive resistance training improves strength mass and functional ability Balance training enhances stability coordination proprioception and fall prevention while also activating core and lower limb muscles Together resistance and balance training provide greater benefits than either alone by improving strength mobility neuromuscular control and independence thereby enhancing quality of life There is a strong need for structured research as most current interventions focus only on nutrition and general activity and there are very few studies focusing on resistance and balance training Combined resistance and balance programs may provide superior outcomes This study aims to evaluate the effectiveness of a structured resistance and balance training program in enhancing muscle strength, functional mobility, balance, and overall quality of life in older adults with sarcopenia The objectives are to assess improvements in muscle strength calf circumference balance functional independence and fear of falls and to compare resistance training alone with combined training in older adults with sarcopenia

MATHEDOLOGY AND MATERIAL The study will be carried out in the Community Physiotherapy Department Dr APJ Abdul Kalam College of Physiotherapy over a duration of one year Data will be collected primarily by the principal investigator and will be quantitative in nature The study will follow a randomized control trial design and will be experimental in type A simple random sampling method will be used with a sample size of fifty The study population will include patients reporting to the Department of Community Physiotherapy Dr APJ Abdul Kalam College of Physiotherapy Pravara Medical Trust Loni Ahilyanagar The tools used for assessment will include the SARC CalF Questionnaire Berg Balance Scale and Barthel Index The materials required for the study will consist of informed consent forms stationery inch tape theraband or resistance band theradisk or wobble board cones chair stepper and stopwatch

OUTCOME MEASURES: Primary Outcome Measures :-

1. SARC-CalF Questionnaire

2. Berg Balance Scale

3. TUG

Secondary Outcome Measure :-

1. Barthel Index

INTERVENTION

CONVENTIONAL GROUP

The control group participates in a balance exercise program During every session, attendees will undergo a 5-minute warm-up session followed by 20 minutes of balance training. Subsequently, they will receive a 5-minute break, after which there will be 20 minutes of resistance training, culminating in a cool-down exercise.

WARM UP STRETCHING, WALKING 10 MINUTES

BALANCE EXERCISE 20-25 MINUTES 10 Reps x 2 Sets

1. Heel and Toe Raise

2. varied directional Quick steeping

3. reach outs

4. single leg standing

5. heel to toe walking

6. complex cross over Steeping

7. weight shifts

8. tandem standing

9. tandem walking

10. wobble board

COOL DWON STATIC STRETCHING RELAXATION 10 MINUTES

EXPERIMENTAL GROUP

The intervention group participated in a varied exercise program that included both balance and resistance training. During every session, the participants underwent a brief 5-minute warm-up, followed by 20 minutes of specific balance training. Subsequently, they received a five-minute break before engaging in another 20 minutes of resistance training. Every session concluded with a 5-minute cool-down that included stretching

WARM UP STRETCHING  WALKING 10 MINUTES

BALANCE EXERCISE  20-25 MINUTES 10 Reps x 2 Sets

1. Heel and Toe Raise

2. varied directional Quick steeping

3. reach outs

4. single leg standing

5. heel to toe walking

6. complex cross over Steeping

7. weight shifts

8. tandem standing

9. tandem walking

10. wobble board

RESISTANCE EXERCISE  20-25 MINUTES

According to FIIT Principle F : 4 Days/Week

I : low to moderate Intensity

T : 10 Reps x 2 Sets

T: Theraband / Resistance band And bodyweight – based

1. Hip flexion and Extension (theraband)

2. Hip abduction And adduction (theraband)

3. Prone Knee Extension (theraband)

4. Biceps curls

5. Shoulder press

6. Leg Press

7. Chest press

8. Squats

COOL DWON STATIC STRETCHING RELAXATION 10 MINUTES