Abstract
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 (NCT 04842396).
Highlights
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
The limitation of the aforementioned World Health Organization (WHO) recommendation lies in its underlying scientific evidence, which is mainly based on studies with healthy older adults and may not be applicable in older people who are habitually characterized by low physical fitness and/or NCDs11,12
There was a significant interaction of time x group in weight (t20 = 3.01, p = 0.007) and waist circumference (WC) (t22 = −3.14, p = 0.005), revealing that participants in the experimental group (EG) moderately increased their weight (with stochastic superiority of the interaction of the time and the group [exercise group (EG) vs. control group (CG)] (AEG-CG) = 73%) and largely decreased their WC (AEG-CG = 17%)
Summary
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. The limitation of the aforementioned WHO recommendation lies in its underlying scientific evidence, which is mainly based on studies with healthy older adults and may not be applicable in older people who are habitually characterized by low physical fitness and/or NCDs11,12 These recommendations, which are the basis of the physical activity promotion policies in some health national departments, have been criticized for the possible discouraging effect that they can cause by posing a barrier for inactive individuals to be "activated"[12,13,14]. Lower doses of exercise intensity and volume, i.e., below those recommended by the WHO, have been demonstrated to improve physical fitness and other health-related markers (body composition, functional status, glucose homeostasis, bone health, psychological well-being, and overall quality of life) in adult populations of all a ges[17,18]. The present work aimed to study the effects of perception-regulated low-volume and low-to-moderate intensity training on body composition, hemodynamic parameters, and functional performance in older adults with multimorbidity
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