Yijinjing Exercise for Musculoskeletal Health in Adults With Sarcopenia

Sarcopenia is a condition involving loss of muscle mass and strength that can make walking and other daily activities more difficult. This study will compare a modified seven-form Yijinjing exercise program with resistance training in 240 adults aged 50 years or older with sarcopenia at six hospitals in Beijing. Yijinjing is a traditional Chinese exercise that combines movements, breathing and focused attention. For the first 6 months, participants will be randomly assigned to Yijinjing or resistance training. Exercise is scheduled at least three times per week, with one supervised group session and two remotely supervised home sessions. Both groups will receive the same dietary counseling and health education. The main question is whether Yijinjing improves physical performance at 6 months by an amount that is not meaningfully worse than resistance training. Physical performance will be measured using the Short Physical Performance Battery, which includes balance, walking and repeated chair stands. After the 6-month assessment, participants in the resistance training group will switch to standard-duration Yijinjing. Eligible participants originally assigned to Yijinjing will be randomly assigned again to standard-duration or longer-duration Yijinjing for another 6 months. Participants who are not eligible for this second random assignment may continue standard-duration Yijinjing when clinically appropriate. Assessments at baseline, 6 months and 12 months will examine muscle mass and strength, physical function, quality of life and other health measures. Exercise-related adverse events will be monitored throughout the 12-month intervention.

Inclusion Criteria: * Adults aged 50 years or older, of either sex. * Confirmed sarcopenia with both low muscle mass and low handgrip strength according to the protocol. For ages 50-64: ASMI \