Yaşlı Bireylerde Dinapeni için Direnç Antrenmanı Uygulamaları: Bir Sistematik Derleme

Öz

Kas kütlesinden bağımsız olarak yaşlanmaya bağlı kas kuvveti kaybı şeklinde tanımlanan dynapenia, ileri yaştaki bireylerde fonksiyonel gerileme, engellilik ve yaşam kalitesinde azalma açısından önemli bir belirleyicidir. Yaşlanma sürecinde kas kuvvetinin korunması amacıyla direnç egzersizleri yaygın biçimde önerilmekle birlikte, direnç temelli egzersiz müdahalelerinin dynapenia üzerindeki özgül etkileri henüz sistematik olarak yeterince değerlendirilmemiştir. Bu sistematik derlemenin amacı, dynapenisi olan yaşlı bireylerde uygulanan direnç egzersizi müdahalelerinin kas kuvveti ve fonksiyonel çıktılar üzerindeki etkilerini incelemektir. İlgili literatür, PubMed, Scopus ve Web of Science veri tabanlarında taranmıştır. Dahil edilen çalışmalar, direnç egzersizi müdahalelerinin dynapenisi olan yaşlı bireylerde kas kuvvetinde anlamlı artışlar sağladığını göstermiştir. Antrenman protokollerinin süre, şiddet ve sıklık açısından farklılık gösterdiği belirlenmiş olmakla birlikte, orta ve yüksek şiddette uygulanan direnç egzersizlerinin kuvvet kaybını azaltmada özellikle etkili olduğu görülmüştür. Direnç egzersizi, dynapenisi olan yaşlı bireylerde kas kuvveti ve fonksiyonel performansın geliştirilmesinde etkili bir non-farmakolojik müdahale olarak değerlendirilmektedir. İyi planlanmış direnç egzersizi programlarının, yaşa bağlı kas kuvveti kaybının önlenmesi ve yönetiminde temel bir bileşen olarak ele alınması önerilmektedir.

Anahtar Kelimeler

• Dinapeni
• Egzersiz
• Direnç Antrenmanı
• Yaşlı Bireyler.

Destekleyen Kurum

Akdeniz Üniversitesi

Resistance Training Interventions for Dynapenia in Older Adults: A Systematic Review

Öz

Dynapenia, defined as the age-related loss of muscle strength independent of muscle mass, is a major contributor to functional decline, disability, and reduced quality of life in older adults. Resistance training has been widely recommended to preserve muscle strength during aging; however, the specific effects of resistance-based exercise interventions on dynapenia remain to be systematically evaluated. This systematic review aimed to examine the effects of resistance training interventions on muscle strength and functional outcomes in older adults with dynapenia. Relavant literature was searched in PubMed, Scopus and Web of Science. The included studies demonstrated that resistance training interventions led to significant improvements in muscle strength in older adults with dynapenia. Training protocols varied in duration, intensity, and frequency; however, moderate- to high-intensity resistance training appeared to be particularly effective in attenuating strength decline. Resistance training is an effective non-pharmacological intervention for improving muscle strength and functional performance in older adults with dynapenia. Well-designed resistance exercise programs should be considered a key component in the prevention and management of age-related muscle strength loss.

Anahtar Kelimeler

• Dynapenia
• Exercise
• Resistance Training
• Older Adults.

Destekleyen Kurum

Akdeniz University

Kaynakça

1. Borde, R., Hortobágyi, T., & Granacher, U. (2015). Dose-response relationships of resistance training in healthy old adults: A systematic review and meta-analysis. Sports Medicine (Auckland, N.Z.), 45(12), 1693–1720. https://doi.org/10.1007/s40279-015-0385-9
2. Carneiro, M. A. S., Franco, C. M. C., Silva, A. L., Castro-E-Souza, P., Kunevaliki, G., Izquierdo, M., Cyrino, E. S., & Padilha, C. S. (2021). Resistance exercise intervention on muscular strength and power, and functional capacity in acute hospitalized older adults: A systematic review and meta-analysis of 2498 patients in 7 randomized clinical trials. GeroScience, 43(6), 2693–2705. https://doi.org/10.1007/s11357-021-00446-7
3. Chang, C. C., Chen, J., Lai, T. F., Park, J. H., & Liao, Y. (2025). Longitudinal association of intensity-specific physical activity and sedentary behavior with dynapenia among older Taiwanese adults. European review of aging and physical activity : Official journal of the European Group for Research into Elderly and Physical Activity, 22(1), 20. https://doi.org/10.1186/s11556-025-00382-x
4. Clark, B. C., & Manini, T. M. (2008). Sarcopenia =/= dynapenia. The journals of gerontology. Series A, Biological Sciences and Medical Sciences, 63(8), 829–834. https://doi.org/10.1093/gerona/63.8.829
5. Clark, B. C., & Manini, T. M. (2012). What is dynapenia?. Nutrition (Burbank, Los Angeles County, Calif.), 28(5), 495–503. https://doi.org/10.1016/j.nut.2011.12.002
6. Correa, C. S., Cunha, G., Marques, N., Oliveira-Reischak, Ã., & Pinto, R. (2016). Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults. Clinical Physiology and Functional Imaging, 36(4), 306–310. https://doi.org/10.1111/cpf.12230
7. Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., Schneider, S. M., Sieber, C. C., Topinkova, E., Vandewoude, M., Visser, M., Zamboni, M., & Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2 (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(4), 601. https://doi.org/10.1093/ageing/afz046
8. de Carvalho Bastone, A., Nobre, L. N., de Souza Moreira, B., Rosa, I. F., Ferreira, G. B., Santos, D. D. L., Monteiro, N. K. S. S., Alves, M. D., Gandra, R. A., & de Lira, E. M. (2020). Independent and combined effect of home-based progressive resistance training and nutritional supplementation on muscle strength, muscle mass and physical function in dynapenic older adults with low protein intake: A randomized controlled trial. Archives of Gerontology and Geriatrics, 89, 104098. https://doi.org/10.1016/j.archger.2020.104098

9. de Mello, R. G. B., Dalla Corte, R. R., Gioscia, J., & Moriguchi, E. H. (2019). Effects of physical exercise programs on sarcopenia management, dynapenia, and physical performance in the elderly: A systematic review of randomized clinical trials. Journal of Aging Research, 2019, 1959486. https://doi.org/10.1155/2019/1959486
10. Fiatarone, M. A., Marks, E. C., Ryan, N. D., Meredith, C. N., Lipsitz, L. A., & Evans, W. J. (1990). High-intensity strength training in nonagenarians: effects on skeletal muscle. Jama, 263(22), 3029-3034.
11. Ghasemabad, K. H., Kamalden, T. F. T., Dev, R. D. O., Nekooei, P., Majlesi, S., Alemi, B., & Nekouei, P. (2022). The role of high-, moderate-, and low-intensity training in enhancing functional mobility and muscle strength of aged female: a randomized controlled trial. Pertanika J. Soc. Sci. Humanit, 30(1).
12. Lee, D. Y. (2025). Prevalence and associated factors of dynapenia, pre-sarcopenia, and sarcopenia in korean adults: A cross-sectional epidemiological study. Medicina (Kaunas, Lithuania), 61(4), 575. https://doi.org/10.3390/medicina61040575
13. Lexell, J. (1995). Human aging, muscle mass, and fiber type composition. The journals of gerontology. Series A, Biological Sciences and Medical Sciences, 50 Spec No, 11–16. https://doi.org/10.1093/gerona/50a.special_issue.11
14. Meigh, N. J., Keogh, J. W. L., Schram, B., Hing, W., & Rathbone, E. N. (2022). Effects of supervised high-intensity hardstyle kettlebell training on grip strength and health-related physical fitness in insufficiently active older adults: the BELL pragmatic controlled trial. BMC Geriatrics, 22(1), 354. https://doi.org/10.1186/s12877-022-02958-z
15. Miljkovic, N., Lim, J. Y., Miljkovic, I., & Frontera, W. R. (2015). Aging of skeletal muscle fibers. Annals of Rehabilitation Medicine, 39(2), 155–162. https://doi.org/10.5535/arm.2015.39.2.155
16. Mitchell, W. K., Williams, J., Atherton, P., Larvin, M., Lund, J., & Narici, M. (2012). Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Frontiers in Physiology, 3, 260. https://doi.org/10.3389/fphys.2012.00260
17. Newman, A. B., Kupelian, V., Visser, M., Simonsick, E. M., Goodpaster, B. H., Kritchevsky, S. B., Tylavsky, F. A., Rubin, S. M., & Harris, T. B. (2006). Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. The journals of gerontology. Series A, Biological Sciences and Medical Sciences, 61(1), 72–77. https://doi.org/10.1093/gerona/61.1.72
18. Pagan, J. I., Bradshaw, B. A., Bejte, B., Hart, J. N., Perez, V., Knowles, K. S., ... & Stock, M. S. (2024). Task-specific resistance training adaptations in older adults: Comparing traditional and functional exercise interventions. Frontiers in Aging, 5, 1335534.
19. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. bmj, 372.
20. Romero-García, M., López-Rodríguez, G., Henao-Morán, S., González-Unzaga, M., & Galván, M. (2021). Effect of a Multicomponent Exercise Program (VIVIFRAIL) on Functional Capacity in Elderly Ambulatory: A Non-Randomized Clinical Trial in Mexican Women with Dynapenia. The Journal of Nutrition, Health & Aging, 25(2), 148–154. https://doi.org/10.1007/s12603-020-1548-4
21. Rosenberg I. H. (1997). Sarcopenia: origins and clinical relevance. The Journal of Nutrition, 127(5 Suppl), 990S–991S. https://doi.org/10.1093/jn/127.5.990S
22. Silva, R. R., Galvão, L. L., Meneguci, J., Santos, D. D. A. T., Júnior, J. S. V., & Tribess, S. (2022). Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults. Sports Medicine and Health Science, 4(4), 253-259.
23. Sivritepe, R., Siyer, O. K., Tiril, S. M., & Basat, S. U. (2024). Do we know about dynapenia?. Northern Clinics of Istanbul, 11(6), 593.
24. Strasser, E. M., Hofmann, M., Franzke, B., Schober-Halper, B., Oesen, S., Jandrasits, W., Graf, A., Praschak, M., Horvath-Mechtler, B., Krammer, C., Ploder, M., Bachl, N., Quittan, M., Wagner, K. H., & Wessner, B. (2018). Strength training increases skeletal muscle quality but not muscle mass in old institutionalized adults: a randomized, multi-arm parallel and controlled intervention study. European Journal of Physical and Rehabilitation Medicine, 54(6), 921–933. https://doi.org/10.23736/S1973-9087.18.04930-4
25. Tejeswini, C. J., Siddhu, R., Syed, J., & Pereira, P. (2025). Prevalence & correlates of dynapenia in elderly with low skeletal muscle mass: A hospital-based cross-sectional study. The Indian Journal of Medical Research, 162(5), 681.
26. Vasconcelos, A. B. S., Resende-Neto, A. G., Nogueira, A. C., Aragão-Santos, J. C., Monteiro, M. R. P., Morais Junior, G. S., Avelar, G. G., Camargo, E. A., Nóbrega, O. T., & Da Silva-Grigoletto, M. E. (2020). Functional and traditional training improve muscle power and reduce proinflammatory cytokines in older women: A randomized controlled trial. Experimental gerontology, 135, 110920. https://doi.org/10.1016/j.exger.2020.110920
27. Yamada, M., Kimura, Y., Ishiyama, D., Nishio, N., Otobe, Y., Tanaka, T., Ohji, S., Koyama, S., Sato, A., Suzuki, M., Ogawa, H., Ichikawa, T., Ito, D., & Arai, H. (2019). Synergistic effect of bodyweight resistance exercise and protein supplementation on skeletal muscle in sarcopenic or dynapenic older adults. Geriatrics & gerontology international, 19(5), 429–437. https://doi.org/10.1111/ggi.13643
28. Yánez, C. A., Pascagaza, Y., Sanclemente, Y., & Ochoa, N. (2025). Flywheel training: body composition and neuromuscular performance in older women: a pilot study. Human Movement, 26(2), 102-109.