Abstract
BackgroundOlder adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults.MethodsFor this study, 117 participants, 71 to 90 years old, were randomized in immediate intervention group and a control group (delayed intervention group). The intervention consisted of daily endurance and twice-a-week strength training. The method was based on a randomized-controlled cross-over design. Short Physical Performance Battery (SPPB), 8 foot up-and-go test, strength performance, six min walking test (6 MW), physical activity, BMI and quality of life were obtained at baseline, after a 6-month intervention- and control phase, again after 6-month crossover- and delayed intervention phase, and after anadditional 6-month follow-up.ResultsAfter 6 months of MTI, the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery (SPPB) score (mean diff = 0.6, 95 % CI: 0.1, 1.0) and 8-foot up-and-go test (mean diff = −1.0 s, 95 % CI: -1.5, -0.6), and in endurance performance via 6-minute walking test (6 MW) (mean diff = 44.2 meters, 95 % CI: 17.1, 71.2). In strength performance via knee extension the intervention group improved while control group declined (mean diff = 55.0 Newton, 95 % CI: 28.4, 81.7), and also in PA (mean diff = 125.9 cpm, 95 % CI: 96.0, 155.8). Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4: SPPB (1.1 points, 95 % CI: 0.8, 1.4); 8-foot up-and-go (−0.9 s, 95 % CI: -1.2, -0.6); 6 MW (18.7 m, 95 % CI: 6.5, 31.0); knee extension (4.2 Newton, 95 % CI: -10.0, 18.3); hand grip (6.7 Newton, 95 % CI: -4.4, 17.8); PA (−4.0 cpm, 95 % CI: -33.9, 26.0); BMI (−0.6 kg/m2, 95 % CI: -0.9, -0.3) and Icelandic quality of life (0.3 points, 95 % CI: -0.7, 1.4).ConclusionsOur results suggest that regular MTI can improve and prevent decline in functional fitness in older individuals, influence their lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care.Trial registrationThis study was approved by the National Bioethics Committee in Iceland, VSNb20080300114/03-1
Highlights
Older adults have the highest rates of disability, functional dependence and use of healthcare resources
The trial was conducted in four phases: 1) Enrolment and the baseline assessment, where the participants were randomized into an immediate training intervention group (Group 1) and a delayed intervention group (Group 2), 2) the immediate intervention phase, where Group 1 underwent training for 6 months and Group 2 served as a control group, 3) the crossover- and delayed intervention phase in which participants in Group 2 received the same training intervention for 6 months as Group 1 received, which from that time-point did not receive any further intervention, and 4) additional 6-month follow-up without intervention (Figure 1)
Significant differences at baseline characteristics were seen in age between the 98 subjects who completed the 6-month multimodal training intervention (MTI) (78.9 ± 4.5) and the 19 subjects who were randomized but did not complete the intervention (82.6 ± 3.5), in 8-foot up-and-go test (6.3 ± 1.2 seconds by MTI vs 7.4 ± 1.3 seconds; p < .01), and in strength, kneeextension (340.6 ± 94.3 Newton by MTI vs 273.6 ± 70.9 Newton; p < .05)
Summary
Older adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults. Older adults have the highest rates of disability, functional dependence and use of healthcare resources, so effective interventions for older individuals are of special interest [1,2]. Regular physical activity (PA) has many health benefits for older people, contributing to a healthy and independent lifestyle and improvements in functional capacity, quality of life, and body composition [3,4,5]. Few have investigated how multimodal training programs can influence older people’s long-term lifestyle [11,12,13]
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