Multicomponent Training Research Articles

A prehabilitation programme is feasible and acceptable for mild-to-moderately frail patients undergoing cardiac surgeries

Abstract Background Preoperative frailty is a strong prognostication in cardiac surgical patients to predict poorer health outcomes. Intervening at the preoperative stage through prehabilitation is gaining increasing research attention. Previous studies tested a single frailty-reversing strategy, either nutritional or exercise, the exercise protocols were mainly aerobic-focused, which deviates from the exercise prescription principles suggested for frailty management, rendering an effective prehabilitation intervention is yet to be developed in cardiac surgical patients. Purpose This study aimed to examine the preliminary effects and explore the feasibility of a multi-component frailty-specific prehabilitation programme for mild-to-moderately frail patients undergoing cardiac surgeries/procedures. We hypothesised that compared with patients who receive usual care, patients awaiting cardiac surgeries who participate in the prehabilitation programme would have improved functional capacity, frailty status, quality of life and psychological outcomes, increased serum albumin and reduced C-reactive protein. Methods This study adopted a mixed-method design comprising a pilot randomised controlled trial and a qualitative study. Adult patients with a Clinical Frailty Scale score between 4 and 6, waiting for coronary artery bypass grafting surgery and/or valve repair/replacement, with at least 5 weeks of procedural waiting time and without contraindications for exercise were recruited. They were randomized in a 1:1 ratio to receive the prehabilitation programme or usual care. The programme comprised a structured preoperative education, nutritional optimization, stress management; and a multi-component exercise training with 3 sessions/week and 60 minutes/session. The exercise training lasted at least 4 weeks and maintained throughout the preoperative period. Results Twenty participants were randomized into the intervention (n = 11) or control (n = 9) group. The programme was feasible, acceptable and no severe adverse events were recorded. The lost to follow-up rate was 7.9%, and the overall attendance was 96%. The intervention group showed significantly greater improvement in functional capacity, frailty status and psychological outcomes than the control group at post-intervention. Participants gave positive comments about the programme and its delivery mode. They expressed that the one-on-one home-based practice enabled them greater confidence to overcome kinesiophobia. Two participants voiced out the preference for exclusive home-based training, rather than having hospital-based training in the first two weeks. Conclusion(s) The prehabilitation programme is feasible and acceptable for patients waiting for cardiac surgeries. It improves the functional performance, frailty status and psychological outcomes in these patients. A full-scale randomised controlled trial is warranted to investigate its longer-term and clinical effects.

Distractor filtering and task load in working memory training in healthy older adults.

Filtering efficiency (FE) has been suggested as a task-related process of working memory (WM) in older adults, but the interaction of distractors with WM when implemented as a training to improve WM capacity is unclear. To investigate the effect of manipulations of WM and/or FE load in a multicomponent model-based WM training in improving WM capacity. 205 healthy older adults (129 women; aged 64.0 ± 8.3 years) were randomised into three WM training groups with manipulations of WM and FE load (high WM; low FE load, high WM; high FE load and low WM; high FE load). All groups underwent three online cognitive testing sessions and twelve 40-min training sessions over three weeks using the SmartBrain smartphone application. WM capacity was measured with complex span tasks and FE using the Change Detection Task. Linear mixed-effect models adjusted for age, sex, education and pre-baseline performance showed increased WM capacity post-training, but no difference between groups. While both distractors and WM are needed to improve WM in the absence of distraction, manipulations of the FE and WM load do not influence improvements following training.

Mediterranean Diet-Based Sustainable Healthy Diet and Multicomponent Training Combined Intervention Effect on Body Composition, Anthropometry, and Physical Fitness in Healthy Aging

Background: Diet and exercise interventions have been associated with improved body composition and physical fitness. However, evidence regarding their combined effects in older adults is scarce. This study aimed to investigate the impact of a combined 12-week Mediterranean diet-based sustainable healthy diet (SHD) and multicomponent training (MT) intervention on body composition, anthropometry, and physical fitness in older adults. Methods: Diet intervention groups received a weekly SHD food supply and four sessions, including a SHD culinary practical workshop. The exercise program included MT 50 min group session, three times a week, on non-consecutive days. Body composition and physical fitness variables were assessed through dual X-ray absorptiometry, anthropometric measurements, and senior fitness tests. Repeated measures ANOVA, with terms for group, time, and interaction, was performed. Results: Our results showed that a combined intervention significantly lowered BMI and total fat. Also, significant differences between assessments in all physical fitness tests, except for aerobic endurance, were observed. Adjusted models show significant differences in BMI (p = 0.049) and WHR (p = 0.037) between groups and in total fat (p = 0.030) for the interaction term. Body strength (p < 0.001), balance tests (p < 0.001), and aerobic endurance (p = 0.005) had significant differences amongst groups. Considering the interaction term, differences were observed for upper body strength (p = 0.046) and flexibility tests (p = 0.004 sit and reach, p = 0.048 back scratch). Conclusions: Our intervention study demonstrates the potential of implementing healthy lifestyle and sustainable models to promote healthy and active aging.

Effects of Neuromuscular Training on Postural Balance and Physical Performance in Older Women: Randomized Controlled Trial.

Background: Aging causes morphological and physiological changes, especially in the musculoskeletal and somatosensory systems, leading to sarcopenia and reduced postural balance, increasing the risk of falls and loss of independence. This study aimed to analyze the effects of a neuromuscular training program on postural balance, physical performance, and muscle strength in older Chilean women. Methods: The double-blind randomized controlled trial included 48 participants aged 65-80 who were divided into three groups: a control group (CG), a multicomponent training group (MCG), and a neuromuscular training group (NMG). Postural balance was assessed using a force platform with open eyes (OE) and closed eyes (CE) conditions, measuring ML velocity, AP velocity, mean radius, and area. Physical performance was evaluated with the Short Physical Performance Battery (SPPB), including static balance, 4-m walking speed, and 5× sit-to-stand chair test. Muscle strength was measured using a hydraulic hand dynamometer to record maximum grip force. Results: Significant time × group interactions in the CE condition were found for mean radius (F = 0.984; p = 0.017; ηp2 = 0.184), AP velocity (F = 10.01; p = 0.001; ηp2 = 0.312), and ML velocity (F = 4.30; p = 0.027; ηp2 = 0.163). Significant pre-post differences in the NMG for mean radius (p < 0.001), AP velocity (p < 0.001), and ML velocity (p = 0.029) were observed, with no significant changes in CG. Significant time × group interactions were also found in the SPPB test score (F = 11.49; p < 0.001; ηp2 = 0.343), gait speed (F = 5.513; p = 0.012; ηp2 = 0.198), and sit-to-stand test (F = 5.731; p = 0.010; ηp2 = 0.206), but not in the balance score (F = 2.099; p = 0.148). Handgrip strength showed no significant interactions (F = 3.216; p = 0.061; ηp2 = 0.127). Conclusions: These findings suggest that neuromuscular training is a promising intervention to mitigate the decline in balance and physical function associated with aging, offering a targeted approach to improve the quality of life in the elderly.

Synchronous and asynchronous tele-exercise for older adults: study protocol for a randomized clinical trial

Objective: Multicomponent physical training, carried out via tele-exercise, can contribute to a healthier lifestyle in the elderly. The objective is to present the intervention protocol of the “Idoso Ativo” (Active Older Adult) program via tele-exercise, synchronously and asynchronously. Method: This is a randomized clinical trial with two groups performing tele-exercise. Participant recruitment will be done via digital platforms, social media pages and printed leaflets distributed in the different regions of Distrito Federal. Both groups will perform exercises three times a week, lasting 50 min, and the intervention period will be 12 weeks. Discussion: The hypothesis is that the multicomponent exercise program offered online will provide improvements in muscular strength, balance and mobility in both groups. A higher adherence rate is expected in relation to the asynchronous group, and it is believed that the positive effects on physical health, minimizing the negative outcomes caused by inactivity, are present in participants in both groups.

Impact of Multicomponent Training Frequency on Health and Fitness Parameters in Postmenopausal Women: A Comparative Study.

Menopause induces physiological changes in women, including increased risks of obesity, cardiovascular diseases, and muscle loss, which can be mitigated by physical exercise. This study aimed to evaluate the effects of a 12-week multicomponent exercise programme, performed 2 or 3 days per week, on health and fitness parameters in postmenopausal women. Eighty-three postmenopausal women (aged 50-65 years) were randomly assigned to three groups: control group (CG, n = 27), 2 days/week exercise group (EG2, n = 28), and 3 days/week exercise group (EG3, n = 28). The intervention included strength, balance, aerobic, and flexibility exercises. Anthropometric measurements (body weight, BMI, waist-to-hip ratio, lean body mass, body fat percentage), lipid profile, and isometric strength were assessed pre- and post-intervention. Data were analysed using a repeated-measures ANOVA, with p < 0.05 considered significant. Significant reductions in body weight, BMI, and waist-to-hip ratio were observed in EG2 and EG3 compared to CG. Lean body mass increased significantly in both EG2 (p < 0.001, ES = 1.37) and EG3 (p < 0.001, ES = 1.50). EG3 showed a greater reduction in body fat percentage than EG2 (p = 0.049). Strength and balance improved significantly in both experimental groups compared to CG, with no significant differences between EG2 and EG3. EG3 also showed superior improvements in lipid profile compared to EG2 and CG. A multicomponent exercise programme, particularly with higher frequency (3 days per week), improves body composition, strength, balance, and lipid profile in postmenopausal women.

Investigating the Effect of a Multicomponent Exercise Program on Adropin, Endothelial Function, Insulin Resistance, and Sleep Quality in Overweight Older Adults (a Link With Physiological Indexes and Sleep Quality): Results of a Randomized Controlled Study.

The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8weeks, 3days a week. Study variables were measured 48hr before and after the intervention. After 8weeks of multicomponent training, adropin (p = .01), nitric oxide (p = .01), and maximal oxygen uptake (VO2max; p = .002) increased, and glucose (p = .001), insulin (p = .001), insulin resistance (p = .01), systolic blood pressure (p = .01), and sleep disorders (p = .01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p = .01 and r = -.55) and glucose (p = .01 and r = -.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults.

Multicomponent training: the effect of a strenght training program on physical and functional fitness in older women

Ageing is a natural, irreversible and progressive phenomenon. It is strongly associated with decreased physical abilities and motor skills, thus facilitating the appearance of degenerative diseases, being aggravated by factors such as a sedentary lifestyle. Multicomponent training applied in to the Third Age, namely, physically active elderly women, could constitute a valid mechanism in the development of anthropometric parameters and motor abilities. The objective of the present study was to evaluate the effect of a multicomponent training program on the anthropometric parameters and physical and functional fitness in elderly women. The study was conducted with fifteen volunteer elderly women, ages sixty-five and ninety-four, who performed daily living activities independently and autonomously. We used the Functional Physical Fitness Protocol Test Battery developed by Rikli &amp; Jones (1999) (Pre and post-test). For the statistical data analysis, we used SPSS software version 25.0, for Windows. For comparison, between the study groups, at the two moments of evaluation, we used the t-test for paired samples. For the association between the variables under study, at the second moment of evaluation, we used Spearman's correlation coefficient (r). The level of significance was set at p ≤ 0.05. We concluded that multicomponent training provided benefits in functional physical fitness and body composition of the elderly women under study. It seems fundamental to include physical exercise for the development of motor skills, in its entirety, through multicomponent training exercises, to promote performance capacity in daily life activities, as well as in tasks with a higher level of demand.

A 10-week multicomponent outdoor exercise program improves hemodynamic parameters and physical fitness in cardiovascular disease adult and elderly patients

AbstractThis study aimed to assess the effects of a 10-week multicomponent outdoor exercise program on hemodynamic, physical fitness and psychological variables in subjects with CVDs. Twenty participants (12 M and 8 F; age 68.5 ± 8.6 years; BMI 28.49 ± 4.98 kg/m2) suffering from CVDs participated in this randomized controlled study and were allocated into two groups: an experimental group (EG; 6 M, 5 F) who underwent a multicomponent training (i.e., cardiorespiratory, resistance, mobility and breathing exercises; 60’, 2d·wk-1), or a wait-list control group (CG; 6 M, 3 F) who did not engage in any PA. Hemodynamic parameters were assessed through resting heart rate (RHR) and peripheral blood pressure (P-SBP/P-DBP). Physical fitness was assessed via a 30″ chair stand test (30CST), timed up and go (TUG) test, handgrip strength (HGS) test, and 2’ step test (TMST). The health status and quality of life (QoL) were evaluated with short form-12 (SF-12) and World Health Organization QoL (WHOQoL-bref), respectively. After the intervention, EG showed significant reduction in hemodynamic parameters (RHR p &lt; 0.001, ES = 0.98; P-SBP p &lt; 0.001, ES = 0.53; P-DBP: p &lt; 0.001, ES = 0.78), physical fitness (30CST p &lt; 0.001, ES = 0.92; TUG p = 0.001, ES = 0.67; TMST p &lt; 0.05, ES = 0.79) and physical component of SF-12 (PSC-12 p &lt; 0.05, ES = 0.42) compared to CG; no significant changes were observed in HGS, QoL and mental health component of the SF-12 (p &gt; 0.05). The findings showed significant improvements in hemodynamic parameters and physical fitness suggesting the effectiveness of the multicomponent outdoor exercise program in adults and elderly with stabilized CVDs.

Effects of a multicomponent training and detraining on frailty status, physical activity level, sedentary behavior patterns and physical performance of pre-frail older adults: a randomized controlled trial.

To evaluate the effects of a multicomponent training protocol and detraining on frailty status, physical activity level, sedentary behavior patterns, and physical performance in pre-frail older adults. A randomized controlled blinded trial was conducted with pre-frail older adults (74.8 ± 6.4years, 70.4% female), who were allocated to receive a multicomponent training (MulTI = 16) or control group (CG = 11), which received guidance to maintain their daily living habits. Assessments of the frailty phenotype, physical activity levels measured by accelerometer, and physical performance (gait speed, timed up and go, short physical performance battery) were conducted at pre-intervention, post-intervention (16weeks), and follow-up (6weeks). The effect of the intervention was analyzed using the marginal homogeneity test and the two-way ANOVA with repeated measures. All older adults who received the MulTI reversed their frailty status to non-frail (p < 0.001), and after follow-up, 87.5% remained non-frail. In the CG, one older adult reversed their frailty status to non-frail and another became frail (p > 0.05), maintaining this status after the follow-up period. Furthermore, only the older adults in the MulTI showed an improvement in gait speed post-intervention, which was maintained through follow-up (p = 0.008). No changes were observed in the other variables. The MulTI was efficient to reverse the process of frailty and improving gait speed in pre-frail older adults. However, receiving only the MulTI was not sufficient to increase physical activity levels and reduce sedentary behavior patterns, necessitating the implementation of behavioral change strategies. ClinicalTrials.gov NCT03110419.

THE EFFECTS OF MULTICOMPONENT EXERCISE ON MILD COGNITIVE IMPAIRMENT IN ELDERLY POPULATION: A RANDOMIZED CONTROL TRIAL

Objective: To determine the effectiveness of multicomponent exercise on mild cognitive impairment in older adults. Materials and Methods: This randomized control trial was conducted at the Department of Rehabilitation at Pakistan Railway General Hospital, Rawalpindi. Fifty-eight older persons with mild cognition impairment were allocated randomly into 2 groups. The participants of the experimental group (n=29) performed multicomponent exercises two times a week for 55-60 minutes. In the control group (n=29), participants performed 20 minutes of treadmill walking thrice a week. Both groups performed these exercises for 6 weeks. Pre and post assessment was carried out at baseline and after 6 weeks of intervention for the following test: Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail-making test A (TMT-A) and Trail making test-B (TMT-B). Data was analyzed using SPSS 21. Results: The overall mean age of study participants was 62.74±74 years. Within-group analysis for MMSE, MoCA, TMT-A, and TMT-B significantly improved (p &lt;0.05) in the experimental group in comparison to the control group. Between-group analysis showed that all parameters were significantly improved (P &lt;0.05) at post-intervention assessment. Conclusion: Multicomponent exercise training was found to be effective in the elderly with mild cognitive impairment. A combination of exercise can enhance cognitive function, help in the prevention of the decline in cognitive function, and reduce the risk for dementia. Keywords: Mild Cognitive Impairment, Cognition, Trail Making Test, Dementia Trial Registration number: NCT03938051

Postoperative physical rehabilitation in the elderly patient after emergency surgery. Influence on functional, cognitive and quality of live recovery: study protocol for a randomized clinical trial

BackgroundThe progressive aging of the population has meant the increase in elderly patients requiring an urgent surgery. Older adults, especially those with frailty, have a higher risk for complications, functional and cognitive decline after urgent surgery. These patients have their functional and physiological reserve reduced which makes them more vulnerable to the effects of being bedridden. The consequences are at multiple levels emphasizing the functional loss or cognitive impairment, longer stays, mortality and institutionalization, delirium, poor quality of life and increased use of resources related to health.We aim to determine whether postoperative physical rehabilitation can prevent functional and cognitive decline and modify the posterior trajectory.Methods/designThis study is a randomized clinical trial, simple blinded, conducted in the Department of Surgery of a tertiary public hospital in Navarra (Hospital Universitario de Navarra), Spain. Patients > = 70 years old undergoing urgent abdominal surgery who meet inclusion criteria will be randomly assigned to the intervention or control group. The intervention will consist of a multicomponent physical training programme, which will include progressive and supervised endurance, resistance and balance training for 4 weeks, twice weekly sessions with a total of 8 sessions, and the group control will receive the usual care. The primary outcome measure is the change in functional (SPPB) and cognitive status (Mini-Mental State Examination) and the change of quality of life (EuroQol-5D-VAS) during the study period. The secondary outcomes are postoperative complications, length of stay, delirium, mortality, use of health resources, functional status (Barthel Index and handgrip strength tests), cost per quality-adjusted life year and mininutritional assessment. The data for both the intervention group and the control group will be obtained at four different times: the initial visit during hospital admission and at months 1, 3 and 6 months after hospital discharge.DiscussionIf our hypothesis is correct, this project could show that individualized and progressive exercise programme provides effective therapy for improving the functional capacity and achieve a better functional, cognitive and quality of life recovery. This measure, without entailing a significant expense for the administration, probably has an important repercussion both in the short- and long-term recovery, improving care and functional parameters and could determine a lower subsequent need for health resources. To verify this, we will carry out a cost-effectiveness study.The clinical impact of this trial can be significant if we help to modify the traditional management of the elderly patients from an illness model to a more person-centred and functionally oriented perspective. Moreover, the prescription of individualized exercise can be routinely included in the clinical practice of these patients.Trial registrationClinicalTrials.gov Identifier: NCT05290532. Version 1. Registered on March 13, 2022.

Feasibility of a Culture-Based Multicomponent Cognitive Training Program for Older Adults With Dementia.

To understand whether a culture-based multicomponent cognitive training program is feasible and tolerable for persons with dementia (PWD) in day care centers in Taiwan, and to examine the effectiveness of a 16-week program in preventing declines in cognitive function and self-care, as well as the development of depressed mood and behavioral problems. This study was a 4-month cluster randomized controlled trial. PWD (N = 56) who met sample selection criteria were recruited from five day care centers and assigned to the experimental or comparison group. Participants in the experimental group received a series of culture-based multicomponent cognitive training activities via research assistants and day care center caregivers for 16 weeks. Participants in the comparison group received usual daily activities. Time attending activities and degree of participation were used as criteria for determining feasibility and tolerability of the program. Results confirmed the feasibility of culture-based multicomponent cognitive training activities if the activities were guided by caregivers. Results also showed participants in the experimental group had statistically significant improvements in cognitive function. Activities of daily living performance, depressed mood, and behavioral problems showed non-significant improvements. The current study suggests that this program can assist PWD in preventing declines in self-care and the development of behavioral and psychological problems, and improve their cognitive function. Further research with a larger sample size and staff training should be considered to test the effectiveness of this program. [Research in Gerontological Nursing, 17(5), 257-264.].

Effects of a 6-month dual-task, power-based exercise program on cognitive function, neurological and inflammatory markers in older adults: secondary analysis of a cluster randomised controlled trial.

Functional power-based exercise training can improve physical performance in older adults and cognitive training can improve measures of cognition, but their combined effects on cognition and related risk factors (neurological and inflammatory markers) remains uncertain. This 6-month cluster randomised controlled trial evaluated the effectiveness of dual-task functional power training (DT-FPT) on cognition and circulating neurological and inflammatory markers in older adults at increased falls risk, and whether intervention responses varied by apolipoprotein-E (ApoE) and brain derived neurotrophic factor (BDNF) polymorphisms. Three hundred residents aged ≥ 65 years at increased falls risk residing in 22 independent-living retirement communities, were randomised by village, to DT-FPT (n = 156, 11 villages) involving a multi-component power-based training program performed simultaneously with cognitive and/or motor tasks (45-60 min, 2/week), or a usual care control (CON) group (n = 144, 11 villages). Cognition (computerized CogState battery), inflammatory cytokines, BDNF, insulin-like growth factor-1, vascular endothelial growth factor, amyloid β (1-40) and (1-42) were assessed at baseline and 6-months. Overall, 233 (78%) participants completed the intervention and adherence averaged 50.1%. DT-FPT led to a net 0.18-0.20 SD benefit versus CON in psychomotor ability/attention and reaction time/attention (both P < 0.05). There were no significant intervention effects on circulating markers, except for a net 10.5% benefit in amyloid β (1-40) in DT-FPT versus CON (P < 0.05). Responses were not influenced by APOE or BDNF genotype. In conclusion, DT-FPT in older adults at increased falls risk can provide some cognitive benefits, but these were not related to corresponding changes in inflammatory or neurological markers or influenced by genotype. Australian New Zealand Clinical Trials Registry (ACTRN12613001161718). http://www.anzctr.org.au/ This project was funded by a grant from the National Health and Medical Research Council (NHMRC) Project (APP1046267).

Multicomponent versus aerobic exercise intervention: Effects on hemodynamic, physical fitness and quality of life in adult and elderly cardiovascular disease patients: A randomized controlled study

ObjectiveCardiovascular diseases (CVDs) remain a leading cause of mortality globally, emphasizing the need for effective preventive measures. This study aimed to investigate the effects of a multicomponent compared to an aerobic training program on the hemodynamic parameters, physical fitness, psychophysical health status and quality of life (QoL) of adults and elderly with stabilized CVDs. MethodsThirty-three subjects (19M and 14F; age 69.5 ± 4.9 years; BMI 27.34 ± 4.95 kg/m2) suffering from CVDs voluntarily participated in this 10-week randomized controlled study and were allocated into three groups: multicomponent training group (MTG; 6M, 6F; cardiorespiratory, resistance, flexibility and breathing exercises; 60′, 2d·wk-1), aerobic training group (ATG; 7M, 5F; aerobic-only training; 60′, 2d·wk-1) or a wait-list control group (CG; 6M, 3F; no PA). Hemodynamic parameters were assessed through resting hearth rate (RHR) and peripheral-systolic and diastolic blood pressure (P-SBP/P-DBP). Physical fitness was assessed via a 30” chair stand test (30CST), timed up and go (TUG) test, handgrip strength (HGS) test, and 2’ step test (TMST). The health status, QoL and enjoyment were evaluated with short form-12 (SF-12), world health organization quality of life-bref (WHOQoL-bref) and physical activity enjoyment scale (PACES), respectively. ResultsAfter the intervention, MTG showed significant improvements in hemodynamic parameters (95 % CI, RHR: 2.76 to 9.07; P-SBP: 3.28 to 13.71; P-DBP: 3.56 to 8.94; p < 0.001), physical fitness (95 % CI, 30CST: 4.42 to −1.90; TUG: 0.56 to 1.58; TMST: 35.24 to −18.58; Dominant HGS: 4.00 to −1.65; Undominant HGS: 2.87 to −0.79, p < 0.001) and enjoyment (PACES: 15.18 to −5.48, p < 0.001) compared to CG; ATG showed significant improvement in hemodynamic parameters (95 % CI, RHR: 1.76 to 8.07; P-SBP: 3.19 to 13.63; P-DBP: 4.47 to 9.85, p < 0.001), physical fitness (95 % CI, 30CST: 2.59 to −0.07; TUG: 0.03 to 1.05; Dominant HGS: 2.42 to −0.07, p < 0.05; TMST: 36.08 to −19.41, p < 0.001) and enjoyment (PACES: 14.68 to −4.98, p < 0.001) compared to CG. No significant changes were observed in QoL and SF-12 (p > 0.05). Significant differences between MTG and ATG were only found in physical fitness variables (95 % CI, 30CST: 3.21 to −0.45, p < 0.01; Dominant HGS: 0.00 to 3.00, p < 0.05). ConclusionsFindings showed significant improvements in hemodynamic parameters and physical fitness suggesting the effectiveness of the multicomponent exercise program, similar to aerobic-only training, and greater efficacy for lower limb strength and dominant hand grip strength in adults and elderly with stabilized CVDs. Both exercise groups showed similar levels of enjoyment.

Trends in Multicomponent Training Research in the Aged Population: A Bibliometric Analysis.

The proportion of aged populations is increasing worldwide. Exercise has a palliating effect on some adverse implications of aging. Multicomponent training (MCT) is a recommended form of exercise for the aged population. The aims of this research were to (1) study the number of publications regarding MCT in the aged population following an exponential growth rate; (2) identify the journals, authors, and countries that stand out the most in this area; and (3) describe the most common themes and used keywords in this field. The analysis was performed through the traditional laws of bibliometrics, including, Price's, Lotka's, Bradford's, and Zipf's law. All documents published in journals indexed in the Web of Science (WoS) Core Collection from 2001 to November 2023 that met the inclusion criteria were included. The 485 documents included in this review revealed that the number of annual publications experienced an exponential growth phase, 15 journals with six or more publications formed the core journals on this topic, and the author Mikel Izquierdo and his collaborative network topped the lists of prominent and prolific co-authors. Spain was the leading country in number of publications. Various thematic lines and keywords regarding strength, sarcopenia, quality of life, falls, balance, dual-task exercise, and cognitive and physical functioning were identified. In conclusion, this work confirmed that research on this topic is going through an exponential growth phase and provided detailed information about the journals, authors, and countries involved in the subject, as well as the keywords most frequently used in the subject matter.

Combined mediterranean diet-based sustainable healthy diet and multicomponent training intervention impact on plasma biomarkers and metabolome in older adults

Background and AimsHealthy dietary patterns and exercise practices have been associated with improved metabolic and inflammatory profiles. However, studies regarding the combined effect of these interventions on plasma biomarkers and metabolome in older adults are sparser. The primary aim of this study was to investigate the impact of a combined Mediterranean Diet-based Sustainable Healthy Diet (SHD) and Multicomponent Training (MT) intervention on the plasma biomarkers and metabolome and how dietary intake and exercise could modulate these effects. MethodsSHD intervention included a weekly supply of Mediterranean Diet-based SHD food and four nutrition sessions involving a Mediterranean-Diet culinary workshop, and the exercise program included 50-minute MT group sessions, held three times a week, lasting both 12 weeks. Plasma biomarkers were obtained through standard biochemical analysis. A proton (1H) nuclear magnetic resonance (NMR) spectroscopy-based metabolomics approach was used to study the metabolome in blood plasma. Repeated measures ANOVA were performed and adjusted for confounders. ResultsSHD+MT intervention significantly decreased HDL-C and calcium. SHD+MT showed some changes in common with the SHD and MT group, namely a significant decrease in citrate levels (p=0.009 for SHD+MT; p=0.037 for SHDT) and an increase in pyruvate (p<0.001 for MT and SHD+MT). The SHD+MT group also revealed specific changes in the levels of some amino acids (decrease in alanine, glutamine and lysine: p=0.026; p<0.001; p=0.038, respectively). Formate (p=0.025) and unsaturated lipids (p=0.011) increase are consistent with changes in energy, amino acid and lipoprotein metabolism. ConclusionOur data show that a combined lifestyle intervention program, including a Mediterranean Diet-based SHD and MT, could modulate biomarker and metabolome and there seems to be a metabolic path associated to these interventions in older adults. Due to its wide-ranging relevance, it is pertinent to assess to what extent combined SHD and MT can contribute to better clinical profiles.

Is It Possible to Improve the Perceived Quality of Life of Overweight or Obese Older People through a Multicomponent Physical Exercise Program?

Multicomponent exercise is a physical exercise modality in which various physical qualities (strength, cardiorespiratory endurance, flexibility, and balance) are developed with an equal distribution of volume in the same session (approximately 60 min) and that has been little explored in improving the quality of life of older adults. The aim of this study was to verify the effect of multicomponent training on self-perceived quality of life in Chilean overweight or obese older people. To this end, a quasi-experimental study with a control group was designed to evaluate self-perceived Quality of Life using the World Health Organization Quality of Life, brief version [Overall Quality of Life (OQOL); Overall Health (OH); Physical Health (PH); Psychological Health (PsH); Social Relations (SR); Environment (E)]. Seventy overweight or obese people aged between 60 and 86 years participated (M = 73.15; SD = 5.94) and were randomized into a control group (CG, n = 35) and an experimental group (EG, n = 35). The results in the EG (pre vs. post-intervention) indicated that there were statistically significant differences in OQOL (p = 0.005), OH (p = 0.014), PH (p < 0.001), PsH (p < 0.001), E (p = 0.015), and SR (p < 0.001) which were not found in the CG in any of the variables (p > 0.050) except in SR (p < 0.001). Regarding sex, post-intervention differences were only found between CG and EG in women in OQOL (p = 0.002), PH (p < 0.001), PsH (p = 0.003), and SR (p < 0.001), but not in OH or E (p > 0.050). These differences were not found among men in any of the variables (p > 0.050). As a conclusion, we can say that a multicomponent physical exercise program applied for 6 months significantly improves the perception of OQOL, OH, PH, PsH, SR, and E in overweight or obese older people. This perception is greater in men than in women.

Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial.

Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs. We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users. This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes. We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001). The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia. ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667. RR2-10.3389/fmed.2022.1071409.

Cardiac autonomic modulation and exercise capacity in older adults with intellectual disability: A 6-month randomised control trial.

Despite reported physical and functional improvements with aerobic and sprint interval training (SIT) protocols in individuals with intellectual disability (ID), it is not known if these interventions' effectivity would promote improvements in cardiac autonomic modulation. This study aimed to investigate if a 6-month SIT or a continuous aerobic programme could enhance physical performance and cardiac autonomic modulation at rest, during physical activity (PA) and after it in older adults with an ID. This is a randomised control trial. Participants with ID (age: 50.58±7.25) were allocated to one of three groups [multicomponent aerobic training group (MATG), multicomponent interval sprint training group (MISTG) and control group (CG)]. The programmes lasted 24weeks, with three sessions/week, 75-90min per session. The HRV was analysed at rest and recovery, the delta of heart rate (HR) was analysed during 6MWT, and the HR t-off kinetics was analysed in recovery after 6MWT. There were not found differences between groups, moments, or interaction for cardiac autonomic modulation at rest and recovery. During exercise, only MSITG showed a significant increase of HR between rest and the first 30s of exercise (P<0.05). Physical performance increased only in MSITG (P<0.05), while CG showed a significant reduction (P<0.01). The MSITG improved the physical performance and the vagal withdrawal at the beginning of the submaximal exercise. These findings suggest that high-intensity exercise may positively impact baroreflex function, mitigating the decline in autonomic reflex response capacity associated with aging in individuals with ID.