Layout 1 Quadrelli et al.’s comments on “home Gym-Bed” exercises and sarcopenia Eur J Transl Myol 34 (3) 13135, 2024 doi: 10.4081/ejtm.2024.13135 We appreciate the thorough and insightful comments provided by Josef Finsterer regarding our study on the prevention of sarcopenia using the "Gym Bed" exercise regimen. We welcome the opportunity to address the points raised and to elaborate on the implications and limitations of our research. Response to specific points Influence of diet, sympathetic tone, genetics, and hormones on muscle mass We acknowledge the multifactorial nature of muscle mass maintenance, encompassing diet composition, hormonal balance, genetic predisposition, and sympathetic tone. While our study primarily focused on the impact of a structured exercise regimen, we concur that future re- search should integrate these additional variables to pro- vide a more comprehensive understanding. Our findings, though promising, are part of a broader strategy to address sarcopenia, and we recognize the importance of consid- ering these factors in subsequent studies. Consideration of comorbidities and medications The absence of significant comorbidities and medications in our patient was a deliberate choice to isolate the effects of the exercise regimen. We agree that chronic conditions and concurrent medications can complicate muscle mass dynamics and should be accounted for in future research to validate and extend our findings across more diverse populations. Standardization of imaging techniques We appreciate the emphasis on methodological rigor in imaging procedures. Our study utilized consistent imaging parameters with the same 256-slice CT scanner and dose reduction technology across the study period. This stan- dardization was critical for ensuring the reliability and comparability of our measurements, and we fully endorse this practice for future longitudinal studies. Previous study on in-bed exercise We are aware of the study involving 22 patients that re- ported no significant impact of in-bed exercises on sar- copenia.5 Our study contributes an in-depth, long-term perspective that complements existing literature. We agree that larger, randomized controlled trials are necessary to robustly assess the efficacy of the "Gym Bed" regimen. Our results, while encouraging, are preliminary and should be interpreted as a step towards a more compre- hensive understanding of exercise-based interventions for sarcopenia. Genetic predisposition and neuromuscular disorders We concur that genetic factors and neuromuscular dis- orders can influence muscle wasting and may confound the diagnosis of sarcopenia. Our exclusion criteria were designed to minimize these confounding factors, yet we acknowledge the need for future studies to include genetic screening and a broader range of participants to better un- derstand these influences. Conclusions We appreciate the opportunity to address these important points. Our study, while limited by its single-case design, provides valuable insights into the potential of non-phar- macological interventions like the "Gym Bed" regimen. We strongly support the call for larger, randomized, dou- ble-blind, placebo-controlled trials to conclusively deter- mine the effectiveness of such interventions in preventing sarcopenia. Our work adds to the growing evidence that regular physical exercise is essential for maintaining mus- cle health in the elderly and serves as a preliminary results for future research. Thank you for the opportunity to engage in this important discussion. We look forward to contributing further to the understanding and prevention of sarcopenia through con- tinued research. Key Words: Quantitative 3D-CT Imaging, sarcopenia mitigation in elderly, full-body in-bed gym. Eur J Transl Myol 34 (3) 13135, 2024 doi: 10.4081/ejtm.2024.13135 Quadrelli et al.’s comments on Cohort studies using 3D-CT are needed to assess whether “home Gym-Bed” exercises are beneficial against sarcopenia Marco Quadrelli,1 Tommaso Baccaglini,1 Aldo Morra1,2 1Synlab Euganea Medica Padova, Italy; 2Synlab IRCCS SDN S.p.A., Napoli, Italy. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (CC BY-NC 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. - 127 - Non -co mmerc ial us e o nly Quadrelli et al.’s comments on “home Gym-Bed” exercises and sarcopenia Eur J Transl Myol 34 (3) 13135, 2024 doi: 10.4081/ejtm.2024.13135 Acknowledgments A&C M-C Foundation for Translational Myology, Pa- dova, Italy and PAGEpress, Scientific Publications, Pavia, Italy sponsored publication of this reply. Funding The authors received no specific funding for this work. Conflict of Interest The authors declare no financial, personal, or other con- flicts of interest. Ethical Publication Statement Not applicable. Corresponding Author Aldo Morra, Synlab IRCCS Istituto di Diagnostica Nu- cleare, Napoli, Italy. ORCID ID: 0000-0003-4378-5453 E-mail: aldo.morra@synlab.it Marco Quadrelli E-mail: marco.quadrelli@synlab.it ORCID ID: 0000-0002-3811-7859 Tommaso Baccaglini E-mail: tommaso.baccaglini@synlab.it ORCID ID: 0009-0009-4491-4940 Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their af- filiated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Submitted: 20 September 2024. Accepted: 20 September 2024. Early access: 20 September 2024. - 128 - Non -co mmerc ial us e o nly mailto:aldo.morra@synlab.it