Low-volume cycling training improves body composition and functionality in older people with multimorbidity: a randomized controlled trial.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
28 06 2021
28 06 2021
Historique:
received:
18
08
2020
accepted:
14
06
2021
entrez:
29
6
2021
pubmed:
30
6
2021
medline:
3
11
2021
Statut:
epublish
Résumé
Physical exercise, when practiced regularly and in adequate doses, is a proven nonpharmacological measure that helps to prevent and reverse noncommunicable diseases, as well as reduce mortality rates from any cause. In general, older adults perform insufficient physical activity and do not meet the doses recommended by the World Health Organization for the improvement of health through physical activity. However, there is little evidence on adequate doses of exercise in older people, especially in those with multimorbidity. Our main aim was to evaluate the effect of a 6-week intervention on health-related outcomes (body composition, hemodynamic and functionality changes) in 24 individuals aged 65 and older with multimorbidity in a randomized controlled trial. The intervention consisted of a very low volume (60 min per week) of low-to-moderate intensity exercise training (perception of effort from 3 to 6 on an 11-point scale). After the intervention, blood pressure was significantly (p = 0.038) reduced in the exercise group (EG), with a higher reduction in men. Furthermore, the EG decreased their waist circumference (p = 0.005), a proxy of abdominal adiposity, and demonstrated an increased likelihood (73%) that a randomly selected change in muscle mass score from the EG would be greater than a randomly selected change score from the control group. The exercise intervention was particularly effective in enhancing the functionality of older adults with multimorbidity, especially in walking speed and balance skills. Perceptually regulated intensity during exercise training seemed to be a very interesting strategy to train individuals with low physical fitness and comorbidities. This study is registered with Clinicaltrials.gov (NCT04842396).
Identifiants
pubmed: 34183717
doi: 10.1038/s41598-021-92716-9
pii: 10.1038/s41598-021-92716-9
pmc: PMC8238960
doi:
Banques de données
ClinicalTrials.gov
['NCT04842396']
Types de publication
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
13364Références
Nunes, B. P., Flores, T. R., Mielke, G. I., Thumé, E. & Facchini, L. A. Multimorbidity and mortality in older adults: A systematic review and meta-analysis. Arch. Gerontol. Geriatr. 67, 130–138 (2016).
pubmed: 27500661
doi: 10.1016/j.archger.2016.07.008
Booth, F. W., Roberts, C. K. & Laye, M. J. Lack of exercise is a major cause of chronic diseases. Compr. Physiol. 2, 1143–1211 (2012).
pubmed: 23798298
pmcid: 4241367
doi: 10.1002/cphy.c110025
Pedersen, B. K. The physiology of optimizing health with a focus on exercise as medicine. Annu. Rev. Physiol. 81, 607–627 (2019).
pubmed: 30526319
doi: 10.1146/annurev-physiol-020518-114339
Fiuza-Luces, C., Garatachea, N., Berger, N. A. & Lucia, A. Exercise is the real polypill. Physiology 28, 330–358 (2013).
pubmed: 23997192
doi: 10.1152/physiol.00019.2013
Campbell, J. P. & Turner, J. E. Debunking the myth of exercise-induced immune suppression: Redefining the impact of exercise on immunological health across the lifespan. Front. Immunol. 9, 648 (2018).
pubmed: 29713319
pmcid: 5911985
doi: 10.3389/fimmu.2018.00648
Cunningham, C., O’Sullivan, R., Caserotti, P. & Tully, M. A. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand. J. Med. Sci. Sports. 30, 816–827 (2020).
pubmed: 32020713
doi: 10.1111/sms.13616
Groot, C. et al. The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Res. Rev. 25, 13–23 (2016).
pubmed: 26607411
doi: 10.1016/j.arr.2015.11.005
Guthold, R., Stevens, G. A., Riley, L. M. & Bull, F. C. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob. Health. 6, e1077–e1086 (2018).
pubmed: 30193830
doi: 10.1016/S2214-109X(18)30357-7
World Health Organization. Global action plan on physical activity 2018–2030: More active people for a healthier world https://apps.who.int/iris/bitstream/handle/10665/272722/9789241514187-eng.pdf?ua=1 (2018).
World Health Organization. Global recommendations on physical activity for health https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf?sequence=1 . (2010).
Holland, A. E. & Lee, A. L. Precision medicine, healthy living and the complex patient: Managing the patient with multimorbidity. Prog. Cardiovasc. Dis. 62, 29–33 (2019).
pubmed: 30610880
doi: 10.1016/j.pcad.2018.12.010
Warburton, D. E. R. & Bredin, S. S. D. Reflections on physical activity and health: What should we recommend?. Can. J. Cardiol. 32, 495–504 (2016).
pubmed: 26995692
doi: 10.1016/j.cjca.2016.01.024
Füzéki, E. & Banzer, W. Physical activity recommendations for health and beyond in currently inactive populations. Int. J. Environ. Res. Public Health 15, 1042 (2018).
pmcid: 5982081
doi: 10.3390/ijerph15051042
Geidl, W., Abu-Omar, K., Weege, M., Messing, S. & Pfeifer, K. German recommendations for physical activity and physical activity promotion in adults with noncommunicable diseases. Int. J. Behav. Nutr. Phys. Act. 17, 12 (2020).
pubmed: 32024526
pmcid: 7003325
doi: 10.1186/s12966-020-0919-x
O’Caoimh, R. et al. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: A systematic review and meta-analysis. Ann. Ist. Super. Sanita 54, 226–238 (2018).
pubmed: 30284550
Kojima, G. Prevalence of frailty in nursing homes: A systematic review and meta-analysis. J. Am. Med. Dir. Assoc. 16, 940–945 (2015).
pubmed: 26255709
doi: 10.1016/j.jamda.2015.06.025
Foulds, H. J. A., Bredin, S. S. D., Charlesworth, S. A., Ivey, A. C. & Warburton, D. E. R. Exercise volume and intensity: A dose-response relationship with health benefits. Eur. J. Appl. Physiol. 114, 1563–1571 (2014).
pubmed: 24770699
doi: 10.1007/s00421-014-2887-9
Wen, C. P. et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. Lancet 378, 1244–1253 (2011).
pubmed: 21846575
doi: 10.1016/S0140-6736(11)60749-6
van Baak, M. A. Beta-adrenoceptor blockade and exercise. An update. Sports Med. 5, 209–225 (1988).
pubmed: 2897710
doi: 10.2165/00007256-198805040-00002
Abbiss, C. R., Peiffer, J. J., Meeusen, R. & Skorski, S. Role of ratings of perceived exertion during self-paced exercise: What are we actually measuring?. Sports Med. 45, 1235–1243 (2015).
pubmed: 26054383
doi: 10.1007/s40279-015-0344-5
Mitchell, B. L., Davison, K., Parfitt, G., Spedding, S. & Eston, R. G. Physiological and perceived exertion responses during exercise: Effect of β-blockade. Med. Sci. Sports Exerc. 51, 782–791 (2019).
pubmed: 30439785
doi: 10.1249/MSS.0000000000001845
McAuliffe, L. et al. Combining perceptual regulation and exergaming for exercise prescription in low-active adults with and without cognitive impairment. BMC Sports Sci. Med. Rehabil. 10, 2 (2018).
pubmed: 29435333
pmcid: 5791381
doi: 10.1186/s13102-018-0091-7
LaMonte, M. J. et al. Both light intensity and moderate-to-vigorous physical activity measured by accelerometry are favorably associated with cardiometabolic risk factors in older women: The objective physical activity and cardiovascular health (opach) study. J. Am. Heart Assoc. 6, e007064 (2017).
pubmed: 29042429
pmcid: 5721888
doi: 10.1161/JAHA.117.007064
Loprinzi, P. D., Lee, H. & Cardinal, B. J. Evidence to support including lifestyle light-intensity recommendations in physical activity guidelines for older adults. Am. J. Health Promot. 29, 277–284 (2015).
pubmed: 24575724
doi: 10.4278/ajhp.130709-QUAN-354
Cartee, G. D., Hepple, R. T., Bamman, M. M. & Zierath, J. R. Exercise promotes healthy aging of skeletal muscle. Cell Metab. 23, 1034–1047 (2016).
pubmed: 27304505
pmcid: 5045036
doi: 10.1016/j.cmet.2016.05.007
Cornelissen, V. A. & Smart, N. A. Exercise training for blood pressure: A systematic review and meta-analysis. J. Am. Heart Assoc. 2, e004473 (2013).
pubmed: 23525435
pmcid: 3603230
doi: 10.1161/JAHA.112.004473
Naci, H. et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. Br. J. Sports Med. 53, 859–869 (2019).
pubmed: 30563873
doi: 10.1136/bjsports-2018-099921
Parker, B. A., Kalasky, M. J. & Proctor, D. N. Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity. Eur. J. Appl. Physiol. 110, 235–246 (2010).
pubmed: 20480371
pmcid: 2929283
doi: 10.1007/s00421-010-1506-7
Ribeiro, A. S., Nunes, J. P. & Schoenfeld, B. J. Selection of resistance exercises for older individuals: The forgotten variable. Sports Med. 50, 1051–1057 (2020).
pubmed: 32008175
doi: 10.1007/s40279-020-01260-5
Beaudart, C. et al. Assessment of muscle function and physical performance in daily clinical practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif. Tissue Int. 105, 1–14 (2019).
pubmed: 30972475
doi: 10.1007/s00223-019-00545-w
Valenzuela, P. L. et al. Physical exercise in the oldest old. Compr. Physiol. 9, 1281–1304 (2019).
pubmed: 31688965
doi: 10.1002/cphy.c190002
Faber, M. J., Bosscher, R. J. & van Wieringen, P. C. W. Clinimetric properties of the performance-oriented mobility assessment. Phys. Ther. 86, 944–954 (2006).
pubmed: 16813475
doi: 10.1093/ptj/86.7.944
Reid, K. F. & Fielding, R. A. Skeletal muscle power. A critical determinant of physical functioning in older adults. Exerc. Sport Sci. Rev. 40, 4–12 (2012).
pubmed: 22016147
pmcid: 3245773
doi: 10.1097/JES.0b013e31823b5f13
Tschopp, M., Sattelmayer, M. K. & Hilfiker, R. Is power training or conventional resistance training better for function in elderly persons? A meta-analysis. Age Ageing 40, 549–556 (2011).
pubmed: 21383023
doi: 10.1093/ageing/afr005
Reisberg, B., Ferris, S., de Leon, M. & Crook, T. The global deterioration scale for assessment of primary degenerative dementia. Am. J. Psychiatry 139, 1136–1139 (1982).
pubmed: 7114305
doi: 10.1176/ajp.139.9.1136
Mezzani, A. et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitati on. Eur. J. Prev. Cardiol. 20, 442–467 (2013).
pubmed: 23104970
doi: 10.1177/2047487312460484
Charlson, M. E., Pompei, P., Ales, K. L. & MacKenzie, R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic Dis. 40, 373–383 (1987).
pubmed: 3558716
doi: 10.1016/0021-9681(87)90171-8
Tinetti, M. E. Performance-oriented assessment of mobility problems in elderly patients. J. Am. Geriatr. Soc. 34, 119–126 (1986).
pubmed: 3944402
doi: 10.1111/j.1532-5415.1986.tb05480.x
Guralnik, J. M. et al. A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. J. Gerontol. 49, 85–94 (1994).
doi: 10.1093/geronj/49.2.M85
Guidetti, L. et al. Validation of the OMNI-cycle scale of perceived exertion in the elderly. J. Aging Phys. Act. 19, 214–224 (2011).
pubmed: 21727302
doi: 10.1123/japa.19.3.214
Noguchi, K., Gel, Y. R., Brunner, E., & Konietschke, F. nparLD: an R Software package for the nonparametric analysis of longitudinal data in factorial experiments. J. Stat. Softw. 50, (2012).
The jamovi project. jamovi [Internet]. https://www.jamovi.org (2020).
Lakens, D. Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front. Psychol. 4, 863 (2013).
pubmed: 24324449
pmcid: 3840331
doi: 10.3389/fpsyg.2013.00863
Rosenthal, J. Qualitative descriptors of strength of association and effect size. J. Soc. Serv. Res. 21(4), 37–59 (1996).
doi: 10.1300/J079v21n04_02
Vargha, A. & Delaney, H. D. A critique and improvement of the CL common language effect size statistics of McGraw and Wong. J. Educ. Behav. Stat. 25, 101–132 (2000).
Allen, M., Poggiali, D., Whitaker, K., Marshall, T. R. & Kievit, R. A. Raincloud plots: A multi-platform tool for robust data visualization. Wellcome Open Res. 4, 63 (2019).
pubmed: 31069261
pmcid: 6480976
doi: 10.12688/wellcomeopenres.15191.1