Abstract
BackgroundThe neuromuscular decline impact in the functional independence of older women is determining the necessity of implementing new strategies focused on core strength training and postural stability maintenance to promote healthy aging.ObjectivesTo define whether Pilates or resistance training is better at improving (a) core isometric and isokinetic muscular strength, and (b) static and dynamic balance, in older women.MethodsThis was a cluster randomized controlled trial. Physically independent older women (60–80 years) from day centers were randomly allocated to Pilates, Muscular and Control Groups (PG, MG and CG) using a block randomization method. Only the research staff performing the assessment and statistical analysis were blinded. Exercise groups trained twice a week (1 h per session) for 18 weeks in a moderate-to-vigorous intensity. Core strength (primary outcome): trunk and hip isometric and hip isokinetic muscular strength (Biodex System III Pro Isokinetic Dynamometer), alongside one leg static balance (portable force platform Kistler 9286AA) and dynamic balance (timed up and go (TUG)) were assessed.ResultsA total of 60 participants were randomized (PG, n = 20; MG, n = 20; CG, n = 20) and 49 completed the trial (PG, n = 16; MG, n = 19; CG, n = 14). Regarding hip isometric extension strength, PG was statistically better than CG (P = 0.004). There were no differences between groups regarding isokinetic strength or balance. Intra-group comparisons showed significant improvements (P < 0.05) in the dynamic balance and trunk and hip isometric extension strength for PG and MG, whereas every hip isokinetic measurement was improved in MG. Exercise programs did not produce any adverse event.ConclusionsThe Pilates training program was more effective for improving isometric hip and trunk extension strength, while the Muscular training program generated greater benefits on trunk and hip isokinetic strength. Moreover, both training programs showed moderate effects for the TUG.Clinical Trial RegistrationThe trial was registered at ClinicalTrials.gov (identifier: NCT02506491).
Highlights
The female gender is associated with lower odds of healthy aging with advancing age (Rodriguez-Laso et al, 2018)
Due to their age-related hormone changes, women are more affected by this neuromuscular decline, which contributes to a worsening of functional independence and disability (Newman et al, 2003) and an increased risk of hospitalization and mortality (Guadalupe-Grau et al, 2017)
Sarcopenia and muscle strength are negatively associated with balance and the risk and fear of falling in older women (Gadelha et al, 2018), falls and injuries are more frequent in women than in men (Gioffrè-Florio et al, 2018)
Summary
The female gender is associated with lower odds of healthy aging with advancing age (Rodriguez-Laso et al, 2018). One of the primary objectives for functional maintenance in older women should be keeping postural stability (i.e., controlling the body’s center of pressure) (Horak, 2006) and improving core strength, because research has shown a strong association between core strength and balance in the older generation (Granacher et al, 2013). In this way, the timed up and go (TUG) test is a quick way to determine the influential balance issues on elderlies’ daily lives and for the prediction of future falls (Sai et al, 2010). Clinical Trial Registration: The trial was registered at ClinicalTrials.gov (identifier: NCT02506491)
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