%0 Journal Article
%T Effect of Dietary Nitrate Combined With Resistance Training on Postoperative Muscle Function in Sarcopenic Middle-Aged Women Undergoing Knee Osteoarthritis Surgery
%A Carlos Ramirez
%A Elena Torres
%A Pablo Ortega
%A Sofia Mendes
%J Bulletin of Pioneering Researches of Medical and Clinical Science
%@ 3006-2659
%D 2026
%V 6
%N 1
%R 10.51847/2bvOIPymjG
%P 200-214
%X Sarcopenia is characterized by the progressive loss of muscle mass and strength. This condition frequently coexists with osteoarthritis (OA) in middle-aged women and often intensifies following surgical procedures. Resistance exercise (RE) is known to help reverse sarcopenia, yet muscle function often remains incomplete in many cases. Supplementation with nitrate (NO3−) may offer additional support for muscle repair and work synergistically with RE. The present study evaluated whether adding NO3− supplementation to an RE program could better preserve thigh muscle mass and improve strength in middle-aged women during the postoperative rehabilitation phase. A prospective, randomized, placebo-controlled, double-blind trial was conducted involving 36 middle-aged women who had sarcopenia along with cartilage defects and underwent mesenchymal stem cell implantation. Participants were randomly assigned to either the RE plus NO3− supplementation group (NG, n = 18) or the RE plus placebo group (PG, n = 18). Both groups participated in a 12-week supervised RE program. Primary outcome measures included thigh muscle cross-sectional area (CSA) and knee strength. Secondary outcomes consisted of functional and clinical assessments, namely the Short Physical Performance Battery (SPPB), skeletal muscle index (SMI), International Knee Documentation Committee (IKDC) score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Thigh muscle CSA declined in the PG, whereas it was maintained in the NG. Knee extension strength demonstrated significantly greater gains in the NG compared to the PG at both the 6-week and 12-week time points. Knee flexion strength recovered more rapidly in the NG, with a clear improvement already evident at 6 weeks. The NG also exhibited significant enhancements in SPPB and IKDC scores. In contrast, improvements in WOMAC scores were comparable between the two groups. Combining NO3− supplementation with RE proved effective in preventing muscle atrophy and promoting greater strength gains among the participants. These findings suggest that this approach holds promise for optimizing postoperative recovery in this population‎.
%U https://bprmcs.com/article/effect-of-dietary-nitrate-combined-with-resistance-training-on-postoperative-muscle-function-in-sarc-lmk5tfsnvl3a6h0