For Healthcare Professionals

Mechanism of Action

Mechanisms of Muscle Strength Improvement

The programme achieves a large effect on lower-extremity muscle strength (SMD ≈ 0.84–0.93), whereas upper-extremity strength and grip strength are hardly or not at all affected. This corresponds to the programme's targeted focus on the leg muscles. [3][7]

• Progressive strength training and increasing loading of the leg muscles. The strengthening exercises use ankle weight cuffs and the body's own weight. Training focuses in particular on knee extension and flexion, hip abduction and raising and lowering the foot at the ankle joint. The load is progressively increased up to higher proportions of individual maximum strength. This progressive overload is a classic training stimulus for building muscle strength. [1–2]
• Increase of muscle protein synthesis and muscle mass. Strength exercises under weight load, especially for the knee and hip muscles, increase the demand for muscle proteins and stimulate muscle protein synthesis as well as muscle oxygen consumption. Muscle mass and strength of the lower extremities can thereby increase. When Manabi is explicitly supplemented with additional resistance training, significant increases in skeletal muscle mass, skeletal muscle index and grip strength are observed. This directly demonstrates the adaptation of muscle mass and strength to the training. [5][10]
• Neuromuscular adaptation and preservation of muscle function. Repeated muscle contractions improve the activation and interplay of motor units. At the same time, stretching and mobility exercises help preserve the extensibility of the muscles and tendons of the lower extremities and counteract the age-related loss of muscle function. [5]
• Counteracting sarcopenia and frailty. In frail and pre-frail older people, Manabi can reduce frailty and improve functional muscle strength, for example in the five-times sit-to-stand test. This indicates that muscle loss caused by inactivity can be counteracted. [10–11]

The strength gain depends on training volume and intensity: sessions of more than 30 minutes and programmes of sufficient duration lead to greater improvements in lower-extremity muscle strength. To achieve the greatest possible effect, the external load – for example through progressively heavier weight cuffs – must also be increased step by step. [2–3]