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. 2026 May 22;105(21):e49033. doi: 10.1097/MD.0000000000049033

The effects of electroacupuncture and the Otago Exercise Program in older adults with sarcopenia: A randomized controlled study

Wenzhe Wu a, Yanfei Cao a, Yiting Zhang a, Jinkuo Pang a, Hantong Hu a, Hong Gao a,*
PMCID: PMC13200971  PMID: 42175481

Abstract

Background:

The aim of this study was to investigate the effects of a combination of electroacupuncture (EA) and the Otago Exercise Program (OEP) for sarcopenia in older individuals and provide treatment recommendations for this patient population.

Methods:

In this assessor-blinded randomized controlled trial, 120 older patients with sarcopenia were randomly divided into an OEP group (n = 58) and an EA + OEP group (n = 62). The OEP group received OEP 5 times/week, with each session lasting 30 minutes, for a duration of 12 weeks. In addition to OEP treatment, the EA + OEP group was treated with EA at ST31, ST32, GB34 and ST36 for 30 minutes 3 times/week for 12 weeks. The appendicular skeletal muscle mass-height index (ASM/H2) was the primary outcome. The secondary outcomes included grip strength, 4-m gait speed and 6-min walk distance. Outcomes were measured before initiation and at 6 and 12 weeks after initiation.

Results:

Significant differences in ASM/H2, grip strength, 4-m gait speed and 6-min walk distance were detected between the 2 groups at week 12, whereas no differences were detected at weeks 0 and 6. In the EA + OEP group, as the treatment time increased, ASM/H2, grip strength, 4-m gait speed and 6-min walk distance increased significantly. In the OEP group, as the treatment time increased, no significant difference was found in ASM/H2, whereas grip strength, 4-m gait speed and 6-min walk distance increased significantly (P < .05).

Conclusion:

In older patients with sarcopenia, EA + OEP was associated with increased skeletal muscle mass, but no such effect was found for OEP alone. Moreover, EA + OEP was superior to OEP alone in terms of improving muscle strength and walking ability. EA + OEP may be considered an effective treatment for sarcopenia in older adults.

Keywords: electroacupuncture, older adults, sarcopenia

1. Introduction

Sarcopenia is a geriatric syndrome characterized by muscle atrophy and functional decline.[1] Globally, its prevalence in older adults can range from 8 to 40%,[2] with some studies indicating a greater burden in women than in men,[3] although this varies by age and diagnostic criteria. Geographical differences in reported prevalence exist, for example, between Asian, European, and North American populations, influenced by local factors and study methodologies.[2,4,5] Furthermore, sarcopenia is frequently complicated by comorbidities such as osteoporosis, type 2 diabetes, and heart failure which can accelerate its progression.[6–8] An average of 30% of skeletal muscle is lost after the age of 60, and this loss can reach 50% after the age of 80.[9,10] This condition can lead to muscle atrophy, decreased muscle strength, reduced mobility, and increased risk of falls and fragility fractures in older adults.[11] With the aging of the population, the prevalence of sarcopenia will increase to 22.3% by 2045.[12] Sarcopenia should receive attention because of the considerable burden it places on families and society.[13]

Sarcopenia treatments mainly include rehabilitation exercise and a high-protein diet.[14] Many older adults with sarcopenia suffer from a lack of appetite and it is difficult for them to follow a high-protein diet.[15] The Otago Exercise Program (OEP) is a home exercise program aimed at preventing falls in older people.[16,17] Moreover, it is also used as a rehabilitation program for older adults to alleviate sarcopenia.[18] The OEP involves resistance exercise, balance training and walking. Researchers have demonstrated that resistance exercise increases muscle strength and walking ability in older adults, thereby countering sarcopenia.[19–21] Moreover, resistance training combined with balance training could maximize the effectiveness of interventions to improve muscle function in older individuals with sarcopenia.[22] Therefore, the OEP that combines resistance exercise and balance training is an effective therapy for sarcopenia in older adults. However, the effect of OEP alone on increasing skeletal muscle mass is often unsatisfactory.[23,24]

Electroacupuncture (EA) increases skeletal muscle mass and is also regarded as an effective approach for treating sarcopenia in older adults.[25] EA can effectively increase muscle blood flow through the constant stimulation of electrical signals,[26] and the acceleration of circulation is beneficial for muscle growth. EA can increase the cross-sectional area and mass of skeletal muscle.[27] The mechanism may involve suppressing myostatin expression and regulating the muscle’s proangiogenesis process.[27,28] Since EA can increase skeletal muscle mass, OEP is good at improving muscle strength and walking ability. However, whether EA + OEP together can improve the treatment of sarcopenia in older people remains unclear.

Therefore, this study aimed to evaluate the effectiveness of EA + OEP compared with OEP alone for 12 weeks in older patients with sarcopenia. We hypothesized that EA + OEP would be superior to OEP alone, as measured by the appendicular skeletal muscle mass-height index (ASM/H2), grip strength, 4-m walk velocity and 6-min walk distance.

2. Materials and methods

2.1. Study design

This study was an assessor-blinded randomized controlled trial. A total of 120 older patients were randomly divided into the OEP group (n = 58) and the EA + OEP group (n = 62). The participants in both groups underwent 12 weeks of treatment. The protocol was approved by the Ethics Committee of The Third Affiliated Hospital of Zhejiang Chinese Medical University (approval document No. ZSLL-KY-2022-021-01). This study has been registered at Clinicaltrials.gov (identifier NCT05431010).

2.2. Randomization, blinding and quality control

Simple randomization was used in the present study. The subjects were grouped by employing a computer-generated random sequence. Sequentially numbered opaque envelopes were employed for distribution concealment. Sequential allocation, participant enrollment, and grouping arrangement were executed by 3 different researchers. And the researcher responsible for participant enrollment ensures non-replication of cases. In addition, data collection and entry were handled by 1 researcher exclusively. Both the raw data and the processed data were stored in 3 copies. One of the copies was kept in the secure archive of The Third Affiliated Hospital of Zhejiang Chinese Medical University. Moreover, a special rehabilitation therapist called the participants every week to urge them to complete the free follow-up.

2.3. Participant enrollment

Participants were enrolled from the outpatient and inpatient departments of The Third Affiliated Hospital of Zhejiang Chinese Medical University from June 12,2022, to December 18, 2024. The recruitment methods included advertising, posters and physician referrals. During the COVID-19 pandemic, all participants were required to wear masks and maintain a safe distance of 1.5 meters.

2.3.1. Inclusion criteria

Patients were aged 60 to 95 years; met the diagnostic criteria for sarcopenia from the Asian Working Group: Sarcopenia can be diagnosed when a participant with low ASM/H2 (< 7.0 kg/m2 for men and < 5.7 kg/m2 for women) combined with either low grip strength (< 28 kg for men and < 18 kg for women) or slow gait speed (4-m gait speed) < 1.0 m/s; and voluntarily enrolled in this study and provided informed consent.

2.3.2. Exclusion criteria

Patients suffered from severe diseases that interfere with intervention and assessment, such as myocardial infarction, malignant hypertension, chronic kidney disease, malignant tumor, neuromuscular disease, hemiplegia, hyperthyroidism, hypothyroidism or fracture in the preceding 3 months; had serious mental illnesses that affect communication or assessment, such as serious depression, schizophrenia or dementia; had electronic devices or metal objects implanted in their bodies; andparticipated in other exercise, acupuncture, drug, or massage trials.

2.4. Sample size calculation

According to the early small-sample results of this research, the average ASM/H2 of the OEP group was 5.31 ± 0.72 kg/m2. The estimated average ASM/H2 of the EA + OEP group was 5.74 ± 0.76 kg/m2. Assuming that α = .05 (bilateral) and β = 0.10, the sample sizes of both groups are N1 = N2 = 49. The sample sizes were calculated via PASS (version 21.0 for Windows, NCSS Inc). When considering that 10% of the patients would drop out or refuse to participate, the sample size for each group was set at 55 patients, and a total of at least 110 patients were recruited for inclusion in the study.

2.5. Outcome

2.5.1. Primary outcome

The primary outcome was the ASM/H2. The ASM/H2 is the ratio of appendicular skeletal muscle mass to the square of height. It was measured via bioimpedance analysis by using Tsinghua Tongfang BCA body composition analyzer. ASM/H2 is recommended by international guidelines as the primary indicator for assessing skeletal muscle mass in patients with sarcopenia.[29,30]

2.5.2. Secondary outcomes

The secondary outcomes included grip strength, the 4-m gait speed and the 6-min walk distance. As recommended by international guidelines,[29,30] muscle strength was assessed via grip strength, and grip strength was measured via a grip dynamometer. The grip dynamometer was squeezed 3 times with maximal force, and the average value was taken. Walking ability was assessed via the 4-m gait speed and 6-min walk distance. The starting point, the 4-m point and the terminal point were marked in a 30-meter-long corridor. The walking speed was measured over 4 m. The 6-min walk distance assessed the maximal distance covered by walking back and forth between the starting point and the 30-meter endpoint within 6 minutes. All outcomes were measured before initiation and at 6 and 12 weeks after initiation.

2.6. Intervention

2.6.1. The OEP group

The OEP group received only OEP. The OEP is composed of resistance exercise, balance training and walking. Resistance exercise included flexion and extension of the toe, ankle, knee and hip joints. Balance training included walking in a figure of 8, walking backwards, standing on 1 foot, walking on one’s toes, walking on one’s heels and rising from a seated position. Twenty minutes of resistance exercise and 10 minutes of balance training were executed every other day. For walking, a 30-minute walk was carried out 2 times a week during the period when resistance exercise and balance training were not needed. The subjects in this group underwent the OEP 5 times a week for 12 weeks. Implementation methods: The participants were informed that they were permitted to discontinue the study at any point. They were also told that they could call the researchers’ phone number provided if they had any problems. Then, the participants received detailed guidance from rehabilitation therapists until they learned how to perform the OEP. Afterward, the participants independently accomplished the OEP at home. The participants were given a booklet imprinted with the key points of the OEP movements. They were also provided with an ankle weight kit for lower limb resistance exercises, which weighed 1 kg. The rehabilitation therapists made phone calls to the participants every week to supervise and instruct them to complete the OEP. The rehabilitation therapists evaluated the participants in the hospital every 6 weeks and adjusted the exercise intensity based on the participants’ progress.

2.6.2. The EA + OEP group

For the EA + OEP group, the OEP treatment was the same as that described above. EA treatment was administered by a certified acupuncturist with more than 4 years of clinical experience from The Third Affiliated Hospital of Zhejiang Chinese Medical University. For the EA intervention, which was conducted 3 times per week for 12 weeks, disposable sterile acupuncture needles (0.3 mm × 40 mm, Suzhou Medical Supplies Co) were inserted bilaterally at Biguan (ST31), Futu (ST32), Zusanli (ST36), and Yanglingquan (GB34). After disinfection, acupuncture was administered to a depth of approximately 15 to 25 mm, varying with the acupoint location and the patient’s constitution, until a deqi sensation was obtained. The needles were then connected to an electronic acupuncture instrument (SDZ-II, Suzhou Medical Appliance Factory) using a discontinuous wave at a frequency of 2 Hz; the intensity was slowly increased to a level that the patients could tolerate, and each session of EA lasted for 30 minutes. The study utilized this fixed duration and frequency for all EA treatments over the 12-week period.

2.6.2.1. Rationale for acupoint selection

The selection of acupoints primarily on the Yangming (Stomach) meridian (ST31, ST32, ST36), along with Yanglingquan (GB34) from the Shaoyang (Gallbladder) meridian, aligns with TCM principles where the Yangming meridian is considered rich in Qi and Blood, crucial for nourishing muscles and sinews, thus addressing muscle weakness and atrophy characteristic of sarcopenia. For flaccidity in the upper thighs, Biguan (ST31) was selected. For flaccidity in the lower thighs, Futu (ST32) was selected. For flaccidity in the upper calves, Yanglingquan (GB34) was selected, and for flaccidity in the lower calves, Zusanli (ST36) was selected. Specifically, Zusanli (ST36), a key point on the Stomach meridian, is renowned for tonifying Qi and Blood and strengthening the entire body, including the muscles. Yanglingquan (GB34) is the influential point for sinews (muscles, tendons, ligaments) and is pivotal for musculoskeletal disorders. Stimulation of these points is intended to enhance local muscle function and promote systemic improvements in muscle mass and strength by improving nutritional flow and invigorating muscle activity, which is particularly relevant for older adult patients with sarcopenia. While direct stimulation to the bone level is complex, enhancing muscle strength and function through these points can indirectly support bone health by improving mechanical loading and reducing frailty.

2.7. Statistical analysis

The data were analyzed via SPSS (version 22.0 for Windows, IBM Inc). The measurement data are expressed as the mean ± SD (x ± s). For comparisons between groups, independent-sample t-tests were used for normally distributed data; moreover, nonparametric tests were used for nonnormally distributed data (see Table 2). Two-way repeated-measures analysis of variance was used to compare the differences at different time points, GROUP (E + +OEP vs OEP) was the between-subjects factor, and TIME (0, 6 and 12 weeks) was the within-subjects factor (see Fig. 2). Differences were considered significant if P < .05.

Table 2.

Comparison on outcome measures between the 2 groups.

Outcomes Time EA + OEP OEP Statistic P value
(n = 62) (n = 58)
ASM/H2 (kg/m2) 0 week 5.34 ± 0.80 5.32 ± 0.92 U = 1766.5 .87
6 week 5.44 ± 0.79 5.33 ± 0.92 U = 1668 .50
12 week 5.72 ± 0.80 5.34 ± 0.90 U = 1330 .01
Grip strength (kg) 0 week 17.80 ± 4.53 16.76 ± 4.27 t (118) = 1.295 .20
6 week 18.75 ± 4.92 17.39 ± 4.39 t (118) = 1.600 .11
12 week 19.93 ± 5.22 17.87 ± 4.46 t (118) = 0.891 .02
4-m walk velocity (m/s) 0 week 0.65 ± 0.13 0.70 ± 0.18 t (104.13) = −1.699 .09
6 week 0.73 ± 0.13 0.74 ± 0.19 t (99.35) = −0.333 .74
12 week 0.85 ± 0.14 0.78 ± 0.21 t (99.37) = 2.119 .04
6-min walk distance (m) 0 week 175.84 ± 69.09 177.31 ± 65.22 U = 1783.5 .94
6 week 205.63 ± 67.22 189.16 ± 78.52 t (118) = 1.237 .22
12 week 230.29 ± 66.53 202.10 ± 78.71 t (118) = 2.123 .04
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Values are Means ± SD.

ASM/H2 = appendicular skeletal muscle mass-height index, EA = electroacupuncture, kg = kilogram, m = metre, min = minutes, n = number of patients, OEP = Otago Exercise Program, s = seconds.

*

P values were determined using the 2 independent samples t-test or Mann–Whitney U-test.

Figure 2.

Figure 2.

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The appendicular skeletal muscle mass-height index (ASM/H2), grip strength, 4-m gait speed and 6-min walk distance were illustrated after treatment between electroacupuncture (EA) + Otago Exercise Program (OEP) and OEP group. Significance was indicated with *. ASM/H2 = appendicular skeletal muscle mass-height index, EA = electroacupuncture, kg = kilogram, m = metre, min = minutes, OEP = Otago Exercise Program, s = seconds.

3. Results

3.1. Participant characteristics

Among the 166 patients who were included, 126 were assigned to one of 2 groups. Some participants were excluded for the following reasons: unsatisfied with being allocated to the EA group and inability to be assessed at the agreed upon time. Sixty-two participants in the EA + OEP group and 58 participants in the OEP group met the full research requirements. 3 patients in the EA + OEP group withdrew (one due to scheduling conflicts and 2 due to an inability to adhere to EA treatment), and 3 patients in the OEP group withdrew (three due to time conflicts) (Fig. 1).

Figure 1.

Figure 1.

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Study flow chart. EA = electroacupuncture, OEP = Otago Exercise Program, N = number of patients.

3.2. Baseline comparisons

There were no significant differences between the 2 groups regarding age, gender, body mass index, comorbidities (osteoporosis, type 2 diabetes, and heart failure), ASM/H2, grip strength, 4-m gait speed or 6 -min walk distance (P > .05). While a comprehensive list of all individual comorbidities is extensive, common age-related conditions that were stable and did not meet the severity levels specified in the exclusion criteria (e.g., osteoporosis, type 2 diabetes and heart failure) were present in some participants. The randomization process was designed to ensure an equitable distribution of these baseline characteristics across the study groups. As detailed in Table 1 and confirmed by baseline statistical comparisons, there were no significant differences between the OEP and EA + OEP groups in key demographic and clinical measures at the outset of the study, providing a comparable basis for evaluating the effects of the interventions.

Table 1.

Demographic and clinical characteristics of the patients at baseline.

Characteristics EA + OEP (n = 62) OEP (n = 58) Statistic P value
Age (yr) 74.27 ± 9.35 77.22 ± 9.09 U = 1467.5 .08
Sex, n/N (%) χ2 = 0.020 .89
 Male 35 32
 Female 27 26
BMI (kg/m2) 19.21 ± 1.58 19.63 ± 1.93 U = 1503.5 .12
 with osteoporosis 8 6 χ2 = 0.190 .66
 with type 2 diabetes 7 5 χ2 = 0.237 .63
 with heart failure 9 6 χ2 = 0.477 .59
ASM/H2 (kg/m2) 5.34 ± 0.80 5.32 ± 0.92 U = 1766.5 .87
Grip strength (kg) 17.80 ± 4.53 16.76 ± 4.27 t (118) = 1.295 .20
4-m gait speed (m/s) 0.65 ± 0.13 0.70 ± 0.18 t (104.13) = −1.699 .09
6-min walk distance (m) 175.84 ± 69.09 177.31 ± 65.22 U = 1783.5 .94
Open in a new tab

Values are number or means ± SD.

ASM/H2 = appendicular skeletal muscle mass-height index, BMI = body mass index, EA = electroacupuncture, kg = kilogram, m = metre, min = minutes, n/N = number of patients, OEP = Otago Exercise Program, s = seconds, SD = standard deviation, yr = year.

*

P values were determined using the 2 independent samples t-test or Mann–Whitney U-test or Pearson chi-squared test.

3.3. Comparison between the 2 groups

As shown in Table 2, at week 0, there was no significant difference in the ASM/H2 (EA + OEP: 5.34 ± 0.80 kg/m2, OEP: 5.32 ± 0.92 kg/m2; U = 1766.5, P = .87), grip strength (EA + OEP: 17.80 ± 4.53 kg, OEP: 16.76 ± 4.27 kg; t = 1.295, P = .20), 4-m gait speed (EA + OEP: 0.65 ± 0.13 m/s, OEP: 0.70 ± 0.18 m/s; t = -1.699, P = .09) or 6-min walk distance (EA + OEP: 175.84 ± 69.09 m, OEP: 177.31 ± 65.22 m; U = 1783.5, P = .94) between the 2 groups. At week 6, there was no significant difference in the ASM/H2 (EA + OEP: 5.44 ± 0.79 kg/m2, OEP: 5.33 ± 0.92 kg/m2; U = 1668, P = .50), grip strength (EA + OEP: 18.75 ± 4.92 kg, OEP: 17.39 ± 4.39 kg; t = 1.600, P = .11), 4-m gait speed (EA + OEP: 0.73 ± 0.13 m/s, OEP: 0.74 ± 0.19 m/s; t = 0.333, P = .74) or 6-min walk distance (EA + OEP: 205.63 ± 67.22 m, OEP: 189.16 ± 78.52 m; t = 1.237, P = .22) between the 2 groups. However, at week 12, the ASM/H2 (EA + OEP: 5.72 ± 0.80 kg/m2, OEP: 5.34 ± 0.90 kg/m2; U = 1330, P = .01), grip strength (EA + OEP: 19.93 ± 5.22 kg, OEP: 17.87 ± 4.46 kg; t = 0.891, P = .02), 4-m gait speed (EA + OEP: 0.85 ± 0.14 m/s, OEP: 0.78 ± 0.21 m/s; t = 2.119, P = .04) and 6-min walk distance (EA + OEP: 230.29 ± 66.53 m, OEP: 202.10 ± 78.71 m; t = 2.123, P = .04) were significantly different between the 2 groups.

3.4. Comparison at different time points

In this research, the result of the sphericity test was P < .001, indicating that the data failed to meet the sphericity assumption. Hence, the corrected Greenhouse-Geisser results were used for further statistical analysis. All 4 outcomes showed a significant main effect of time (P < .001), whereas the main effect of group was not significant (P > .05). The interaction effect between group and time was statistically significant for the ASMH2 (F = 22.682, P < .001,ηp2 = 0.161), grip strength (F = 9.444, P = .001,ηp2 = 0.074), 4-m gait speed (F = 39.146, P < .001,ηp2 = 0.249) and 6-min walk distance (F = 20.469, P < .001,ηp2 = 0.148).

As shown in Figure 2, for the EA + OEP group, as the treatment time increased, the ASM/H2 (F = 33.688, P < .001, ηp2 =0.365, Fig. 2A), grip strength (F = 77.990, P < .001, ηp2 =0.571, Fig. 2B), 4-m gait speed (F = 145.695, P < .001, ηp2 =0.714, Fig. 2C) and 6-min walk distance (F = 148.323, P < .001, ηp2 =0.717, Fig. 2D) increased significantly. For the OEP group, as the treatment time increased, no significant difference was found in ASM/H2 (F = 0.096, P = .91, ηp2 =0.002, Fig. 2A), whereas grip strength (F = 16.327, P < .001,ηp2 = 0.218, Fig. 2B), 4-m gait speed (F = 24.866, P < .001,ηp2 = 0.298, Fig. 2C) and 6-min walk distance (F = 33.321, P < .001,ηp2 = 0.363, Fig. 2D) increased significantly.

3.5. Safety and tolerability

Among the 120 participants, 5 experienced adverse events during the trial in the EA + OEP group. Specifically, all 5 participants in the EA + OEP group experienced bleeding after needle removal. All adverse events were of mild intensity and could be alleviated after a brief application of pressure to stop the bleeding, without any lasting consequences or sequelae.

4. Discussion

The data in this study show that EA + OEP could increase the skeletal muscle mass of older adults with sarcopenia, whereas the OEP alone could not. Muscle strength and walking ability increased with the extension of treatment time in both groups; however, older adults with sarcopenia who received the EA + OEP treatment presented greater skeletal muscle mass, greater muscle strength and better walking ability. These observations indicate that EA + OEP may be a good option for the clinical treatment of sarcopenia in older adults.

OEP can continuously induce the activity of the flexor muscles of the ankles and hip.[17] OEP can not only improve walking abilities, but also prevent muscle strength degradation.[19–21] However, in this study, OEP alone did not effectively improve skeletal muscle mass. Previous studies have reported that the OEP failed to increase skeletal muscle mass.[23,24] Therefore, additional therapy need to be employed to increase skeletal muscle mass.

This study demonstrated that EA + OEP improved skeletal muscle mass. Acupuncture plays a role in increasing skeletal muscle mass. Acupuncture can increase muscle blood flow in humans[31] and animals.[32] Accelerated blood circulation benefits muscle growth and slows muscle atrophy through an increase in the oxygen content in muscle tissue. Compared with conventional acupuncture, EA provides continuous and stable stimulation to muscle cells through electrical signals, which can better promote muscle growth. Clinical studies have shown that EA therapy can increase skeletal muscle mass in male patients with sarcopenia.[33] Experimental studies have confirmed that EA can increase the diameter of skeletal muscle and muscle fiber cross-sectional area.[27] EA may increase skeletal muscle mass through the following mechanisms. EA may inhibit myostatin expression, which resulted in a satellite cell-related proliferative response and repair in skeletal muscle.[28] Moreover, EA may delay muscle atrophy by regulating the proangiogenesis process and protein turnover in the skeletal muscle.[27]

Compared with OEP alone, EA + OEP was more effective not only in increasing skeletal muscle mass, but also in improving muscle strength and walking ability. EA can maintain normal muscle tension and enhance muscle fatigue resistance.[25] EA has been shown to improve the muscle strength of both limbs,[34] and is helpful for enhancing walking ability.[25] Our study suggested that EA + OEP may be a better regimen for the treatment of sarcopenia in older individuals.

We did not observe any severe side effects of EA or OEP according to the patients’ treatment logs or oral reports. 3 participants in the OEP group and 3 participants in the EA + OEP group dropped out halfway through due to scheduling conflicts.

There were several limitations in this study. First, the subjects could not be set up for blinding due to the nature of the EA. Second, the course of the EA + OEP group was 12 weeks. Therefore, our findings only demonstrate the efficacy advantage of EA + OEP compared to OEP over 3 months. Third, as the study was conducted in only 1 region, it is not clear whether our results can be generalized to different geographic regions and populations.

5. Conclusion

In summary, we found that both the EA + OEP intervention and the OEP intervention had positive effects on muscle strength and walking ability in older patients with sarcopenia. Compared with OEP alone, EA + OEP had an additional role in increasing skeletal muscle mass and more effectively improved muscle strength and walking ability. EA + OEP may be considered an effective treatment for sarcopenia in older adults.

Author contributions

Conceptualization: Wenzhe Wu, Hong Gao.

Methodology: Wenzhe Wu, Yanfei Cao, Jinkuo Pang, Hantong Hu, Hong Gao.

Software: Wenzhe Wu.

Writing – original draft: Wenzhe Wu.

Writing – review & editing: Wenzhe Wu, Hong Gao.

Data curation: Yanfei Cao, Yiting Zhang.

Investigation: Yiting Zhang.

Supervision: Jinkuo Pang, Hantong Hu.

Abbreviations:

ASM/H2 =
appendicular skeletal muscle mass-height index
EA
electroacupuncture
OEP
Otago Exercise Program

This study was financially supported by Zhejiang Traditional Chinese Medicine Administration (2022ZB186).

The authors have no conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

How to cite this article: Wu W, Cao Y, Zhang Y, Pang J, Hu H, Gao H. The effects of electroacupuncture and the Otago Exercise Program in older adults with sarcopenia: A randomized controlled study. Medicine 2026;105:21(e49033).

Contributor Information

Wenzhe Wu, Email: 2008777.1378@163.com.

Yanfei Cao, Email: hzjdcyf@126.com.

Yiting Zhang, Email: zhangqh0451@163.com.

Jinkuo Pang, Email: 275989289@qq.com.

Hantong Hu, Email: 413351308@qq.com.

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