Acute illness requiring hospitalization frequently is a sentinel event leading to long-term disability in older people. Prolonged bed rest increases the risk of developing cognitive impairment and ...dementia in acutely hospitalized older adults. Exercise protocols applied during acute hospitalization can prevent functional decline in older patients, but exercise benefits on specific cognitive domains have not been previously investigated. We aimed to assess the effects of a multicomponent exercise intervention for cognitive function in older adults during acute hospitalization.
We performed a secondary analysis of a single-blind randomized clinical trial (RCT) conducted from February 1, 2015, to August 30, 2017 in an Acute Care of the Elderly (ACE) unit in a tertiary public hospital in Navarre (Spain). 370 hospitalized patients (aged ≥75 years) were randomly allocated to an exercise intervention (n = 185) or a control (n = 185) group (usual care). The intervention consisted of a multicomponent exercise training program performed during 5-7 consecutive days (2 sessions/day). The usual care group received habitual hospital care, which included physical rehabilitation when needed. The main outcomes were change in executive function from baseline to discharge, assessed with the dual-task (i.e., verbal and arithmetic) Gait Velocity Test (GVT) and the Trail Making Test Part A (TMT-A). Changes in the Mini Mental State Examination (MMSE) test and verbal fluency ability were also measured after the intervention period. The physical exercise program provided significant benefits over usual care. At discharge, the exercise group showed a mean increase of 0.1 m/s (95% confidence interval CI, 0.07, 0.13; p < 0.001) in the verbal GVT and 0.1 m/s (95% CI, 0.08, 0.13; p < 0.001) in the arithmetic GVT over usual care group. There was an apparent improvement in the intervention group also in the TMT-A score (-31.1 seconds; 95% CI, -49.5, -12.7 versus -3.13 seconds; 95% CI, -16.3, 10.2 in the control group; p < 0.001) and the MMSE score (2.10 points; 95% CI, 1.75, 2.46 versus 0.27 points; 95% CI, -0.08, 0.63; p < 0.001). Significant benefits were also observed in the exercise group for the verbal fluency test (mean 2.16 words; 95% CI, 1.56, 2.74; p < 0.001) over the usual care group. The main limitations of the study were patients' difficulty in completing all the tasks at both hospital admission and discharge (e.g., 25% of older patients were unable to complete the arithmetic GVT, and 47% could not complete the TMT-A), and only old patients with relatively good functional capacity at preadmission (i.e., Barthel Index score ≥60 points) were included in the study.
An individualized, multicomponent exercise training program may be an effective therapy for improving cognitive function (i.e., executive function and verbal fluency domains) in very old patients during acute hospitalization. These findings support the need for a shift from the traditional (bedrest-based) hospitalization to one that recognizes the important role of maintaining functional capacity and cognitive function in older adults, key components of intrinsic capacity.
ClinicalTrials.gov Identifier: NCT02300896.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ABSTRACTFragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adultsposition statement from the national strength and conditioning ...association. J Strength Cond Res XX(X)000–000, 2019—Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts(a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.
ABSTRACTGrazioli, R, Loturco, I, Baroni, BM, Oliveira, GS, Saciura, V, Vanoni, E, Dias, R, Veeck, F, Pinto, RS, and Cadore, EL. Coronavirus disease-19 quarantine is more detrimental than traditional ...off-season on physical conditioning of professional soccer players. J Strength Cond Res 34(12)3316–3320, 2020—Beyond the severe health crisis, the coronavirus disease 2019 has also affected the high-performance sports scenario. In soccer, practitioners are concerned about the effects of long-term detraining on playersʼ conditioning, and caution is required when activities return. This study assessed body composition, jump and sprint performance, hamstring eccentric strength, and intermittent cardiorespiratory fitness of 23 male professional soccer players who returned to training activities after 63 days of quarantine. The results were compared with their physical condition assessed before a pre-season phase as soon as they returned to training after a regular 24-day off-season period. In comparison with after off-season assessments, the quarantine induced significant increases in body mass, body fat mass, 10- and 20-m sprint times as well as decreases in countermovement jump height (p < 0.05). There were no significant changes in hamstring eccentric strength, squat jump height, and cardiorespiratory fitness (p > 0.05). In summary, we showed that 63 days of quarantine impaired several physical performance measures compared with regular off-season in soccer players. Given the present results, special attention should be given to body composition–related and speed power–related capabilities after long-term detraining in professional soccer.
This randomized controlled trial examined the effects of multicomponent training on muscle power output, muscle mass, and muscle tissue attenuation; the risk of falls; and functional outcomes in ...frail nonagenarians. Twenty-four elderly (91.9 ± 4.1 years old) were randomized into intervention or control group. The intervention group performed a twice-weekly, 12-week multicomponent exercise program composed of muscle power training (8–10 repetitions, 40–60 % of the one-repetition maximum) combined with balance and gait retraining. Strength and power tests were performed on the upper and lower limbs. Gait velocity was assessed using the 5-m habitual gait and the time-up-and-go (TUG) tests with and without dual-task performance. Balance was assessed using the FICSIT-4 tests. The ability to rise from a chair test was assessed, and data on the incidence and risk of falls were assessed using questionnaires. Functional status was assessed before measurements with the Barthel Index. Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography. The intervention group showed significantly improved TUG with single and dual tasks, rise from a chair and balance performance (
P
< 0.01), and a reduced incidence of falls. In addition, the intervention group showed enhanced muscle power and strength (
P
< 0.01). Moreover, there were significant increases in the total and high-density muscle cross-sectional area in the intervention group. The control group significantly reduced strength and functional outcomes. Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population.
To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT) data.
We conducted a meta-analysis of exercise in older adults, addressing limitations of ...previous works. RCTs of exercise interventions in older people with depression (≥ 60 years) comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD) (95% confidence interval 95%CI), meta-regressions, and trim, fill, and fail-safe number analyses were conducted.
Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 95%CI -0.29 to -1.51), with a fail-safe number of 71 studies. Significant effects were found for 1) mixed aerobic and anaerobic interventions, 2) at moderate intensity, 3) that were group-based, 4) that utilized mixed supervised and unsupervised formats, and 5) in people without other clinical comorbidities.
Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.
ABSTRACTRamírez-Campillo, R, Gallardo, F, Henriquez-Olguín, C, Meylan, CMP, Martínez, C, Álvarez, C, Caniuqueo, A, Cadore, EL, and Izquierdo, M. Effect of vertical, horizontal, and combined ...plyometric training on explosive, balance, and endurance performance of young soccer players. J Strength Cond Res 29(7)1784–1795, 2015—The aim of this study was to compare the effects of 6 weeks of vertical, horizontal, or combined vertical and horizontal plyometric training on muscle explosive, endurance, and balance performance. Forty young soccer players aged between 10 and 14 years were randomly divided into control (CG; n = 10), vertical plyometric group (VG; n = 10), horizontal plyometric group (HG; n = 10), and combined vertical and horizontal plyometric group (VHG; n = 10). Players performance in the vertical and horizontal countermovement jump with arms, 5 multiple bounds test (MB5), 20-cm drop jump reactive strength index (RSI20), maximal kicking velocity (MKV), sprint, change of direction speed (CODS), Yo-Yo intermittent recovery level 1 test (Yo-Yo IR1), and balance was measured. No significant or meaningful changes in the CG, apart from small change in the Yo-Yo IR1, were observed while all training programs resulted in meaningful changes in explosive, endurance, and balance performance. However, only VHG showed a statistically significant (p ≤ 0.05) increase in all performance test and most meaningful training effect difference with the CG across tests. Although no significant differences in performance changes were observed between experimental groups, the VHG program was more effective compared with VG (i.e., jumps, MKV, sprint, CODS, and balance performance) and HG (i.e., sprint, CODS, and balance performance) to small effect. The study demonstrated that vertical, horizontal, and combined vertical and horizontal jumps induced meaningful improvement in explosive actions, balance, and intermittent endurance capacity. However, combining vertical and horizontal drills seems more advantageous to induce greater performance improvements.
Frailty has become the center of attention of basic, clinical, and demographic research because of its incidence level and the gravity of adverse outcomes with age. Moreover, with advanced age, motor ...variability increases, particularly in gait. Muscle quality and muscle power seem to be closely associated with performance on functional tests in frail populations. Insight into the relationships among muscle power, muscle quality, and functional capacity could improve the quality of life in this population. In this study, the relationship between the quality of the muscle mass and muscle strength with gait performance in a frail population was examined.
Twenty-two institutionalized frail elderly individuals (93.1 ± 3.6) participated in this study. Muscle quality was measured by segmenting areas of high- and low-density fibers as observed in computed tomography images. The assessed functional outcomes were leg strength and power, velocity of gait, and kinematic gait parameters obtained from a tri-axial inertial sensor.
Our results showed that a greater number of high-density fibers, specifically those of the quadriceps femoris muscle, were associated with better gait performance in terms of step time variability, regularity, and symmetry. Additionally, gait variability was associated with muscle power. In contrast, no significant relationship was observed between gait velocity and either muscle quality or muscle power.
Gait pattern disorders could be explained by a deterioration of the lower limb muscles. It is known that an impaired gait is an important predictor of falls in older populations; thus, the loss of muscle quality and power could underlie the impairments in motor control and balance that lead to falls and adverse outcomes.
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