Abstract
Exercise counteracts aging and pathology symptoms, but there is still scarce research on exercise programs for multimorbid and/or palliative old patients (MPO-Ps). In order to analyze whether the multicomponent physical–cognitive training is beneficial for this population, 17 MPO-Ps (81.59 ± 5.63 years) completed a >26 weeks home-based intervention (20–50 min/session, three sessions/week). Twenty-eight supervised and thirty-two autonomous sessions were gradually distributed along three phases: supervised training (ST), reduced supervision training (RST), and autonomous training (AT). Physical function (gait speed, hand grip and lower-limb strength, balance, and agility), mental status (MMSE), and autonomy in daily living (the Barthel Index) were assessed. Categorical analyses regarding the changes in the walking aids used in the test were added to improve the assessment of strength and agility along the intervention. Despite important study limitations, such as the small sample size and lack of a control group, and despite the MPO-Ps’ very low baseline fitness and initial exercise intolerance, they benefited from the dual-tasking approach, especially in autonomy, lower-limb strength, and balance. Agility improvements were shown only by categorical analyses. As expected, most benefits increased the supervision (ST phase). Gait speed and cognitive status maintained despite the total autonomy in training in the last phase. Further research with larger samples should confirm if multicomponent physical–cognitive exercise, individualized and tailored on daily-basis, together with technical assistance and medical supervision, benefits this MPO-Ps population, and if it can be prescribed to them with security, in spite some of them already being palliative patients.
Highlights
Sedentarism and physical inactivity are among the main risk factors susceptible of being modified to counteract the development of non-communicable diseases [1,2]
Baseline data confirmed advanced age, obesity, low SaO2, and low functional capacity in the multimorbid and/or palliative old patients (MPO-Ps), together with the inability of some of them to carry out the tests (Table 1)
Control group, MC TP benefited the sample of MPO-Ps notwithstanding their very low functionalcapacity capacityand andlevel level dependency at baseline
Summary
Sedentarism and physical inactivity are among the main risk factors susceptible of being modified to counteract the development of non-communicable diseases [1,2]. Sedentarism and physical inactivity share direct and negative involvement in the aging process [1,4,5,6,7,8,9], enhancing major immobility, muscular power/mass loss [10,11], and the increase in inflammatory processes [4,12,13] Both are associated with greater risk of falls [1,10], weakness increasement [10,11,14], the risk of becoming dependent or being admitted to a hospital [10,15,16], and, in the worst-case scenario, increased mortality risk between 20–30% [17].
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