Impact of Tailored Multicomponent Exercise for Preventing Weakness and Falls on Nursing Home Residents' Functional Capacity.

Abstract

We aimed to determine whether the benefits of long (24weeks) and short (4weeks) training programs persisted after short (6weeks) and long (14weeks) periods of inactivity in older adult nursing home residents with sarcopenia. Multicenter randomized trial. The Vivifrail tailored, multicomponent exercise program (http://vivifrail.com) was conducted to individually prescribe exercise for frail older adults, depending on their functional capacity. The training included 4 levels combining strength and power, balance, flexibility, and cardiovascular endurance exercises. Twenty-four institutionalized older adults (87.1 ± 7.1years, 58.3% women) diagnosed with sarcopenia were allocated into 2 groups: the Long Training-Short Detraining (LT-SD) group completed 24weeks of supervised Vivifrail training followed by 6weeks of detraining; the Short Training-Long Detraining (ST-LD) group completed 4weeks of training and 14weeks of detraining. Changes in functional capacity and strength were evaluated at baseline, and after short and long training and detraining periods. Benefits after short and long exercise interventions persisted when compared with baseline. Vivifrail training was highly effective in the short term (4weeks) in increasing functional and strength performance (effect size= 0.32-1.44, P < .044) with the exception of handgrip strength. Continued training during 24weeks produced 10% to 20% additional improvements (P < .036). Frailty status was reversed in 36% of participants, with 59% achieving high self-autonomy. Detraining resulted in a 10% to 25% loss of strength and functional capacity even after 24weeks of training (effects size= 0.24-0.92, P < .039). Intermittent strategies such as 4weeks of supervised exercise 3 times yearly with no more than 14weeks of inactivity between exercise periods appears as an efficient solution to the global challenge of maintaining functional capacity and can even reverse frailty in vulnerable institutionalized older adults.