Functional Capacity In Older Adults Research Articles

Relationship Between Dual-Energy X-Ray Absorptiometry, Ultrasonography, and Anthropometry Methods to Estimate Muscle Mass and Muscle Quality in Older Adults.

Decreased muscle quality (MQ) may explain functional capacity impairments during aging. Thus, it is essential to verify the interaction between MQ and functional capacity in older adults. We investigated the relationship between MQ and functional capacity in older adults (n = 34; 66.3 ± 4.6year). MQ was estimated by maximum strength of knee extensors normalized to thigh muscle mass. Maximum strength was assessed on an isokinetic dynamometer (peak torque), while dual-energy X-ray absorptiometry (DXA), ultrasonography, and anthropometry were used to determine thigh muscle mass. Functional capacity was verified by 30-s sit to stand and timed up and go tests. Significant correlations were found between MQ assessed by DXA with 30-s sit to stand (r = .35; p < .05) and timed up and go (r = -.47; p < .05), and MQ assessed by anthropometry with timed up and go (r = -.41; p < .05), but not between MQ assessed by ultrasonography with functional capacity (p > .05). No significant relationship between muscle mass with functional capacity was observed. Thus, MQ assessed by DXA and MQ assessed by anthropometry may partially explain functional capacity in older adults. Interestingly, muscle mass alone did not explain performance in functional tests in this population.

Effects of SARS-CoV-2 infection on health and functional capacity in institutionalized older adults.

To assess the effect of SARS-CoV-2 infection on the health conditions and functional capacity of older adults living in long-term care units in Maceió City - Alagoas State. A prospective cohort was conducted with institutionalized older adults of both sexes. Older adults were assessed for clinical conditions (diagnosis of chronic diseases and biochemical tests), functional capacity, and nutritional status. All assessments were repeated on two occasions, maintaining a 6-month interval between them. The sample was composed of 289 older adults. Of the total, 98 (33.9%) were positive for COVID-19 and eight died (2.8%). Men were more likely to have COVID-19 (OR = 3.50; p < 0.01). It was observed that the disease contributed to increasing the frequency of dependent older adults after six months (OR = 1.38; p-interaction < 0.01). It was also observed that after six months of positive diagnosis for COVID-19, there was greater weight loss (p < 0.01), reduced BMI (p < 0.01), increased mean SBP (p = 0.04), and DBP (p = 0.03). Effects of COVID-19 in institutionalized older adults go beyond acute complications and compromise blood pressure control, functional capacity, and favor weight loss.

Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis.

regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults. systematic review and meta-analysis. community-dwelling older adults over 65years. exercises at home through DHI. physical function, HRQoL and falls. twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, -0.56s, 95% confidence interval, CI -1.00 to -0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD -0.23; 95% CI -0.45 to -0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004). the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility.

Supervised high-load resistance training for improving muscle strength and quality in prediabetic older adults: A pilot randomized controlled trial

ObjectiveTo investigate the effects of high- and low-load supervised, volume-matched resistance training (RT) on body composition, muscle function, and functional capacity in older adults with prediabetes. MethodsOlder adults with prediabetes were recruited and randomly assigned to high-load RT (n = 13), low-load RT (n = 12), or control groups (n = 12). ResultsNo significant differences were observed in body composition at postintervention. High-load and low-load RT groups exhibited significant improvements in functional tests at postintervention compared with the control group. The high-load RT group exhibited a greater improvement in muscle strength and muscle quality at postintervention compared with the low-load RT group. ConclusionSupervised RT is useful in the prevention of muscle functional loss in older adults with prediabetes. High-load RT is superior for enhancing muscle strength and muscle quality, despite a similar increase in functional capacity.

Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study.

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (−0.7 ± 1.3), and FTS-5 (−5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (−1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Effects of maximal-versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults: a systematic review and meta-analysis

The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT’s) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move ‘as fast as possible’ during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: − 1.74 [95% CI − 2.79, − 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: − 1.21, [95% CI − 2.17, − 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: − 0.84, [95% CI − 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: − 0.57, [95% CI − 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality (“low” PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible.

Smartphone-Based Gait Cadence to Identify Older Adults with Decreased Functional Capacity

Background: Functional capacity assessment is a critical step in the preoperative evaluation to identify patients at increased risk of cardiac complications and disability after major noncardiac surgery. Smartphones offer the potential to objectively measure functional capacity but are limited by inaccuracy in patients with poor functional capacity. Open-source methods exist to analyze accelerometer data to estimate gait cadence (steps/min), which is directly associated with activity intensity. Here, we used an updated Step Test smartphone application with an open-source method to analyze accelerometer data to estimate gait cadence and functional capacity in older adults. Methods: We performed a prospective observational cohort study within the Frailty, Activity, Body Composition and Energy Expenditure in Aging study at the University of Chicago. Participants completed the Duke Activity Status Index (DASI) and performed an in-clinic 6-min walk test (6MWT) while using the Step Test application on a study smartphone. Gait cadence was measured from the raw accelerometer data using an adaptive empirical pattern transformation method, which has been previously validated. A 6MWT distance of 370 m was used as an objective threshold to identify patients at high risk. We performed multivariable logistic regression to predict walking distance using a priori explanatory variables. Results: Sixty patients were enrolled in the study. Thirty-seven patients completed the protocol and were included in the final data analysis. The median (IQR) age of the overall cohort was 71 (69–74) years, with a body mass index of 31 (27–32). There were no differences in any clinical characteristics or functional measures between participants that were able to walk 370 m during the 6MWT and those that could not walk that distance. Median (IQR) gait cadence for the entire cohort was 110 (102–114) steps/min during the 6MWT. Median (IQR) gait cadence was higher in participants that walked more than 370 m during the 6MWT 112 (108–118) versus 106 (96–114) steps/min; p = 0.0157). The final multivariable model to identify participants that could not walk 370 m included only median gait cadence. The Youden’s index cut-point was 107 steps/min with a sensitivity of 0.81 (95% CI: 0.77, 0.85) and a specificity of 0.57 (95% CI: 0.55, 0.59) and an AUCROC of 0.69 (95% CI: 0.51, 0.87). Conclusions: Our pilot study demonstrates the feasibility of using gait cadence as a measure to estimate functional capacity. Our study was limited by a smaller than expected sample size due to COVID-19, and thus, a prospective study with preoperative patients that measures outcomes is necessary to validate our findings.

Sex Differences in Functional Capacity in Older Adults With Stroke: An Analysis of Data From the National Health and Aging Trends Study.

Women experience greater disability following stroke, but biological sex differences in both overall and specific domains of functional capacity are not well understood. The primary objective of this study was to examine sex differences in overall functional capacity (Short Physical Performance Battery [SPPB] score) cross-sectionally and longitudinally over a 3-year follow-up period. The secondary objective was to determine whether sex differences exist in specific domains of functional capacity of walking speed and lower extremity functional strength. This study was a secondary analysis of data of individuals with stroke from the National Health and Aging Trends Study. For the cross-sectional analyses, general linear models were used to examine differences between 293 men and 427 women in SPPB, walking speed, and the 5-Times Sit-to-Stand Test (5XSST). For the longitudinal analysis, survey-weighted, multivariable-adjusted generalized linear mixed models were used to compare 3-year trajectories in SPPB scores between the sexes (87 men, 153 women). Women had lower SPPB scores at baseline (difference = 0.9, linearized SE = 0.3) and over 3years. SPPB scores declined similarly between men and women. Women had lower walking speed (difference = 0.08m/s, SE = 0.02) as compared with men, but men and women had similar 5XSST scores (difference = 0.6seconds, SE = 0.5). Older women with stroke have clinically meaningfully lower overall functional capacity as compared with older men but decline at a similar rate over time. Walking speed was lower in older women with stroke, but similar between sexes in 5XSST. Women with stroke have poorer functional capacity compared with men, which reinforces the importance of targeted stroke rehabilitation strategies to address these sex-specific disparities. Women with stroke have poorer outcomes in terms of their ability to move around the community when compared with men. However, both men and women with stroke have similar physical functioning over time.

English

Background: The aging of the population together with sedentary lifestyle, can cause a functional deterioration that leads to the decrease of physical condition and quality of life. Promoting active aging can improve the quality of life and physical condition of our elders. Objective: This work aims to investigate the available scientific evidence on the effect of physical activity in older adults, in terms of quality of life, physical condition, and maintenance of functional independence. Material and method: A systematic review was performed in the WOS, SCOPUS and PubMed databases. Selection of articles: Intervention studies evaluating the quality of life and functional capacity of older adults were included. The studies were evaluated according to methodological quality with the PEDro scale. Results: 1331 articles were found, of which 17 were included. Interventions included resistance, strength, balance, coordination, and gait speed exercises. The main findings indicated that a higher rate of physical activity was associated with less impairment of physical and cognitive functions in older adults and, therefore, with a better quality of life. Conclusions: an active lifestyle is associated with a better quality of life, better physical condition and maintenance of functional independence. Other studies, with greater homogeneity in the data collection instruments, with greater frequency of interventions, would be convenient to define the most appropriate exercise programs and to increase the scientific evidence.

Regulatory Emotional Self-Efficacy Buffers the Effect of Heart Rate Variability on Functional Capacity in Older Adults With Chronic Low Back Pain.

IntroductionChronic low back pain is one of the leading causes of disability globally among older adults. Prevailing research suggests that autonomic dysregulation places individuals at increased risk for chronic pain. This study examines the moderating role of emotional self-efficacy (ESE) on the relationship between heart rate variability (HRV) and pain related-outcomes, including movement-evoked pain (MEP) and physical functioning.MethodsIn a secondary analysis of the Adaptability and Resilience in Aging Adults (ARIAA) study, a total of 58 adults (aged 60 and older) with chronic low back pain (cLBP) completed the PROMIS self-efficacy for managing emotions questionnaire and the 6-minute walk test (6 MWT) to assess functional capacity and MEP. Heart rate variability, indexed by the frequency domain, was assessed for 5 min during rest.ResultsFor pain-related outcomes, having a lower body mass index (p = 0.03) was associated with better functional capacity on the 6MWT, while higher education level (p = 0.01) and less pain duration (p = 0.00) were correlated with lower MEP. After controlling for sex, age, and body mass index, an increase in low-frequency HRV (LF-HRV) was associated with poorer physical functioning among individuals low in ESE (b = −0.12 p = 0.03). No significant moderation effects were observed for MEP.ConclusionOur results bring attention to the degree to which ESE influences the relationship between LF-HRV and physical functioning. Interventions that enhance adaptive psychological processes such as ESE may dampen ANS dysregulation and mitigate risk for adverse pain outcomes among older adults with cLBP.

Physical, social, and dietary behavioral changes during the COVID-19 crisis and their effects on functional capacity in older adults

BackgroundThis two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults. MethodsAltogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. ResultsUsing latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =−1.56 [−1.98, −1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =−0.99 [−1.60, −0.37]), face-to-face interaction (B =−0.65 [−1.16, −0.13]), and non-face-to-face interactions (B =−0.80 [−1.36, −0.25]) were associated with a decline in functional capacity. ConclusionOur results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches

Sustainable built environment for facilitating public health of older adults: Evidence from Hong Kong

AbstractIn response to the United Nations' call to build a sustainable and age‐friendly society, older adults' public health, normally measured by functional capacity, has been of increasing concern on a global scale. The built environment is closely intertwined with the functional capacity of older adults, as evidenced by extensive studies. However, most studies have focused on exploring linear relationships between the built environment and functional capability yet overlooking non‐linear relationships. This study aims to investigate non‐linear relationships between the built environment and older adults' functional capability. Therefore, this study conducted in 2018 adopts a generalized additive mixed model based on a sample of 1083 participants in a typical aging society of Hong Kong. The results discover improved functional capability among older adults who are younger, female, living with family members, with a longer care cycle and fewer comorbidities. The results also support non‐linear relationships between the built environment and older adults' functional capability. The optimal functional capability of older Hong Kong adults was found under a specific threshold of built environment factors, such as park density with a desirable number of 5 ± 2, intersection density with a maximal threshold of 200, the highest sky view percentage possibly, and land‐use diversity with a minimum threshold of 0.6 for entropy index. The study is of value for relevant stakeholders and policymakers to implement sustainable and age‐friendly urban planning for the built environment for facilitating older adults' public health.

Low Friend Connection Leads to Low Functional Capacity of Older Adults: Findings From a 2-year Longitudinal Study

Given the rapid growth of older Americans and the increased incidence of divorce among this population, it is paramount to identify negative health outcomes following marital transition and investigate the potential protective role of social support. Our study aims to identify relationships between change in depression and marital transitions, test whether social support moderates this association, and to examine variation by gender. The sample included 3,705 participants from the Health and Retirement Study, who reported being married or partnered in 2012. Changes in marital status were measured between 2012 and 2014 (remained married/partnered (reference), divorced/separated, and widowed). Depression was measured using the Center for Epidemiological Studies Depression short form (CESD-8). Three types of social support from family, friends, and children were assessed: social support, social strain, and social contact. Autoregressive multiple regression was used to examine the relationship between change in depression, marital transitions, social support, and gender. Widowhood and social strain were independently associated with an increase in CESD-8 scores between 2012 and 2014. Significant interactions between social support and social strain, and separation/divorce were identified, and the relationship between social support, depression, and divorce varied by gender. Change in depression was positively associated with social support for separated/divorced females, but not separated/divorced males. These results indicate that social support may modify the influence of divorce on changes in depression among recently divorced older females. These findings can help mental health service providers more effectively target older adults at the greatest risk of depression after experiencing a marital transition.

Abstract 14259: Exercise Training Attenuates Activin Type II Receptor Signaling in the Aged Heart

Introduction: Exercise training (ExT) improves functional capacity in older adults with heart failure (HF). However, the molecular mechanisms by which ExT exerts these benefits are unclear. We previously showed that cardiac activin type II receptor (ActRII) signaling increases in aging and HF, and that ActRII inhibition can improve cardiac exercise capacity in aged C57BL/6 mice, a model of age-related HFpEF. Whether cardiac ActRII signaling is modulated by ExT is unknown. Hypothesis: We hypothesized that ExT would attenuate cardiac ActRII signaling in aged mice. Methods: A moderate intensity ExT protocol (treadmill running, 10m/min, 10° incline, 45min/day, 8 weeks) was performed in 25month-old (mo) female C57BL/6 mice (OE). Functional (exercise capacity), molecular, and gravimetric assessments of HF were compared to young (YS, 4mo) and old (OS, 27mo) sedentary controls, along with indicators of downstream ActRII signaling (FSTL3 expression, SMAD3 phosphorylation, senescence, apoptosis markers). Results: After 8 weeks of ExT, exercise capacity increased in OE mice by 2.5±9.9% versus -24.1±4.6% in OS mice (p=0.05). ExT did not induce significant changes in cardiac hypertrophy or natriuretic peptide expression in aged mice, but decreased lung weight to body weight ratios (3.8±0.2(YS) vs 7.4±0.7(OS) vs 5.3±0.4(OE) mg/g, p=0.001). Cardiac ActRII signaling increased with aging and was attenuated with ExT (FSTL3/GAPDH: 1.0±0.01(YS) vs. 2.9±0.1(OS) vs. 1.0±0.2(OE) p=0.01; pSMAD3/SMAD3: 0.8±0.2(YS) vs. 1.5±0.04(OS) vs. 1.1±0.1(OE), p=0.1). Moreover, parallel changes occurred in markers of cardiac senescence (p16: 1.0±0.02(YS) vs. 1.6±0.1(OS) vs. .3±0.02(OE), p=0.02) and apoptosis (BAX: 0.8±0.2(YS) vs. 1.8±0.05(OS) vs. 1.1±0.1(OE), p=0.0007; cleaved caspase 3: 0.8±0.01(YS) vs. 2.2±0.01(OS) vs. 1.0±0.02(OE), p=0.0001), which have been shown to be regulated by ActRII signaling. Conclusions: These findings suggest aerobic ExT attenuates the cardiac ActRII signaling observed in aged mice and slows the age related decline in exercise capacity. Age-associated pathologies linked to ActRII signaling, including cellular senescence and apoptosis, were similarly modulated by ExT.

Looking at the bigger PICture: understanding and counteracting the decline of persistent inward currents in older adults.

Looking at the bigger PICture: understanding and counteracting the decline of persistent inward currents in older adults.

Contribution of a multicomponent intervention on functional capacity and independence on activities of daily living in individuals with neurocognitive disorder

BackgroundTo examine the effects of a 6-month multicomponent (MT) exercise intervention in the functional capacity and ability to independently perform activities of daily living (ADL) of individuals diagnosed with neurocognitive disorder (NCD).MethodsA quasi-experimental controlled trial with a parallel design study was conducted in multicentered community-based settings. Forty-three individuals (N Female: 30) were allocated to an exercise group (EG; N: 23; mean 75.09, SD = 5.54 years) or a control group (CG; N:20; mean 81.90, SD = 1.33 years). The EG engaged in a 6-month MT program (60-min sessions, twice a week). Exercise sessions were divided into a warm-up, specific training (e.g., coordination and balance, lower and upper body strength, and aerobics), and cool down. Lower body function, mobility, and gait speed were evaluated through Short Physical Performance Battery (SPPB), Timed-Up and Go test (TUG) and 6-Meter Walk test, respectively. The Barthel Index (BI) was administered to assess individuals’ ADL independence. Evaluations were performed before and after the 6-month intervention.ResultsLinear Mixed Models revealed a statistically significant interaction (time X group) effect factor on SPPB (B = 2.33, 95% CI: 1.39–3.28, p < 0.001), TUG (B = − 11.15, 95% CI: − 17.23 – − 5.06, p = 0.001), and 6-Meter Walk test (B = 0.17, 95% CI: 0.08–0.25, p < 0.001). No differences between groups or assessment moments were found in the ability of individuals to independently perform ADL.ConclusionsThe 6-month MT exercise intervention improves the functional capacity of older adults living with NCD.Trial registrationClinicalTrials.gov – identifier number NCT04095962; retrospectively registered on 19 September 2019.

Effects of Xbox Kinect exercise training on sleep quality, anxiety and functional capacity in older adults

The aim of this study was to examine the effects of an Xbox Kinect exercise program on sleep quality, anxiety and functional capacity in older adults. Twenty-nine older adults were randomized into two treatment groups: XBOX (n = 15) or CONTROL (n = 14). The XBOX group performed exercise with an Xbox Kinect for 60 min, three times per week for 6 weeks. The CONTROL group did not exercise. Improvements in sleep quality (p = 0.04), anxiety (p = 0.007), aerobic endurance (p = 0.003), agility/balance (p = 0.02), and lower limb strength (p = 0.05) were observed in the XBOX group compared with the CONTROL. Xbox Kinect exercise program improved sleep quality, reduced anxiety, and increased the functional capacity of older adults. These results support the value of exercise in the Xbox Kinect for sleep quality and anxiety in older adults. (Clinical Trials Registration NCT04692272).

Effects Of Equal-volume Resistance Training With Different Intensity On Muscle Quality In Prediabetes Elders.

Aging is accompanied by a progressive decline in skeletal muscle system. These problems could increase the risks of chronic diseases, falls, and mortality. Resistance training (RT) is an effective strategy to enhance muscle strength, mass, and quality in older populations. However, few studies have examined the influence of different resistance training intensity on skeletal muscle system in prediabetes elders. PURPOSE: The present study is to investigate the effects of high-intensity versus low-intensity RT on muscle strength, body composition, muscle quality, and functional capacity in older adults with prediabetes. METHODS: Twenty-five prediabetes elders (67 ± 4 yrs) were randomized into 1 of 2 groups: high intensity RT (HIGH, 3 × 8 × 80% of 1RM, n = 13) and low intensity RT (LOW, 3 × 16 × 40% of 1RM, n = 12). The 8-week RT program performed 3d·wk-1, using 8 exercises for the whole body. Anthropometric, muscle strength, body composition, muscle quality, and functional capacity were measured pre- and post-training. RESULTS: No significant difference was observed in body composition in both groups (p > 0.05). Both groups presented significant improvement for functional capacity (grip strength, time up and go test and 30-second chair stand; p < 0.05) with no difference between groups (p > 0.05). The HIGH showed significant improvements in muscle strength compared with the LOW (p < 0.05) for total 1RM (HIGH = 22.9%; LOW = 15%), seated row 1RM (HIGH = 24.2%; LOW = 9.9%), back extension 1RM (HIGH = 29%; LOW = 17.5%), leg curl 1RM (HIGH = 22.3%; LOW = 13.7%), leg press 1RM (HIGH = 20.4%; LOW = 11.6%), total muscle quality (HIGH = 21.3%; LOW = 11.8%), upper muscle quality (HIGH = 22.6%; LOW = 12.8%), and lower muscle quality (HIGH = 21.8%; LOW = 11.2%). CONCLUSION: These results suggest that both HIGH and LOW, characterized by the same training volume, improve functional capacity and maintain body composition, whereas HIGH is superior for enhancing muscle strength and muscle quality in older adults with prediabetes.

Exergames to Prevent the Secondary Functional Deterioration of Older Adults during Hospitalization and Isolation Periods during the COVID-19 Pandemic

The COVID-19 pandemic is having an intense impact on the functional capacity of older adults, making them more vulnerable to frailty and dependency. The development of preventive and rehabilitative measures which counteract the consequences of confinement or hospitalization is an urgent need. Exergaming can promote physical activity, prevent falls, and maintain functional and cognitive capacity. However, although the use of exergames in health programs for the elderly is promising, their widespread use should not be considered without the supervision of a social health professional. Therefore, the objective of this work was to evaluate and analyze three video game consoles (Nintendo Wii®, Xbox-Kinect® and Play Station 4®) and 26 commercial exergames with the aim of identifying their usefulness for the prevention of functional deterioration. Three occupational therapists analyzed the data independently, and subsequently agreed on the results. The examination of the commercial consoles met three criteria: components, interaction channels and the type of the exergame. Each exergame was analyzed taking into account its ability to train postural control, balance, upper limb functionality and cognitive function. The results of the evaluation showed that exergames contain game activities that can be part of the rehabilitative treatment aimed at the prevention of the functional impairment of older people affected by COVID.

Effects of Flywheel Training With Eccentric Overload on Standing Balance, Mobility, Physical Function, Muscle Thickness, and Muscle Quality in Older Adults

Hill, MW, Roberts, M, Price, MJ, and Kay, AD. Effects of flywheel training with eccentric overload on standing balance, mobility, physical function, muscle thickness, and muscle quality in older adults. J Strength Cond Res 36(11): 3190-3199, 2022-This study investigated the effects of a 6-week eccentric overload flywheel training program on vastus lateralis (VL) and gastrocnemius medialis (GM) muscle thickness and muscle quality (echo intensity), mobility (Timed Up and Go [TUG]), physical function (sit-to-stand), and balance (postural sway) performance. Nineteen subjects were assigned to either a flywheel training group ( n = 11, age = 66.4 ± 5.2 years) or a control group ( n = 8, age = 65.9 ± 3.8 years). The flywheel group underwent twice weekly squat and calf raise exercises for 6 weeks with outcome measures assessed before and after training or a time-matched control period. Throughout the training, subjects were instructed to contract as fast as possible with maximal effort during the concentric phase and to maximally resist the pull during the eccentric phase. The alpha value was a priori set at p < 0.05. Statistically significant ( p < 0.05) mean ( SD ) increases in right and left VL (7.6-9.6 ± 7.7-9.8%) and GM (8.6-8.7 ± 6.4-11.5%) muscle thickness and a reduction in VL (10.2-11.3 ± 5.9-7.9%) and GM (11.7-11.9 ± 5.6-9.6%) echo intensity were accompanied by faster TUG time (13.7 ± 7.0%) improved sit-to-stand performance (17.8-23.5 ± 7.6 - 13.4%) and reduced postural sway (29.7-42.3 ± 13.2-24.2%) after 6 weeks of flywheel training. There were no differences in any outcome measures between the treatment and control group at baseline ( p > 0.05). Overall, we observed substantial gains in muscle thickness and muscle quality, in addition to enhanced physical function, balance, and mobility performance among older adults after flywheel training, which may have important implications for preserving the functional capacity of older adults.