Sarcopenia is the age-related loss of muscle and physical decline that plague the elderly. A selective loss of glycolytic-muscle fibres and their skeletal muscle satellite cell pool characterise sarcopenia, whereas the number of oxidative-fibre-associated satellite cells was similar with age. Specifically, sarcopenic glycolytic fibres exhibit a pronounced loss in cross-sectional area (~26%), whereas the cross-sectional area of oxidative fibres was unchanged relative to the young. Mitochondrial dysfunction was also more prevalent in glycolytic muscle in ageing mice but was maintained in oxidative muscle. In an intriguing parallel to DMD, oxidative fibres exhibit superior survival potential. One interpretation of the available evidence is that oxidative muscle confers survival to the individual during age-related muscle loss, reflecting frailty merely by association, and may, hence, represent a viable target for therapeutic intervention.

Resistance exercise, and endurance exercise to a lesser degree, produce mechanical stress and microdamage, which may serve as a stimulus to spur muscle regrowth. In this respect, physical exercise also creates a biosynthetic regenerative energy debt that will need to be allocated towards the repair and rebuilding of damaged muscle tissue. Inadvertently, this will limit biosynthetic energy availability to implement metabolic adaptations. ELF-PEMF (extremely low frequency, pulsing electromagnetic fields) exposure, as it is low energy and non-mechanical, represents a more focussed form of mitochondrial stimulation. ELF-PEMF exposure may thus render stronger mitochondrial responses via the PCG-1α and Nrf2 transcriptional pathways, while producing relatively less impetus for muscle hypertrophic remodelling. It would thus be better to combine PEMF therapy with exercise, if and when possible, for greatest physiological synergism. It was shown that functional mobility improved in conjunction with reduced pain in a group of elderly subjects receiving weekly ELF-PEMF treatment. These results suggest that magnetic therapy may represent one manner to capacitate the elderly to undertake exercise more readily. In support of potential magnetic-therapy–exercise synergism, it was previously shown that mice, having received ELF-PEMF treatment, exhibited improved running performance after five weeks (10 min of exposure per week). Magnetic therapy may serve as an option for such frail demographics to maintain metabolic balance and to exploit the systemic regenerative benefits conferred by the muscle secretome whilst combating sarcopenia.