Multicomponent Exercise Program Research Articles

Effects of a Clinical Exercise Program on Health-Related Fitness and Quality of Life in Spanish Cancer Patients Receiving Adjuvant Therapy.

To report the feasibility and effectiveness of a newly developed clinical exercise program for improving maximal cardiorespiratory fitness in Spanish cancer patients receiving adjuvant chemotherapy or radiation. We also examined the effectiveness of the exercise program for improving maximal muscular strength, body composition, fatigue, and quality of life, and explored if the effectiveness varied based on selected patient characteristics. The study was a single group implementation feasibility study using a pre-posttest design. Participants performed a 12-week, twice-weekly, supervised, multi-component exercise program during adjuvant therapy. Paired t-tests were used to assess pre-post changes, and analyses of covariance were used to compare effectiveness based on selected patient characteristics. We had 100 cancer patients referred to the clinical exercise program of which 85 (85%) initiated the exercise program and 76 (89%) completed the post-intervention fitness assessment. Exercise significantly improved VO2max by 4.8 mL/kg/minutes (P < .001, d = 0.74). Exercise also significantly improved chest strength (P < .001, d = 0.82), leg strength (P < .001, d = 1.27), lean body mass (P < .001, d = 0.11), skeletal muscle mass (P < .001; d = 0.09), fat mass (P < .001; d = 0.10), % body fat (P < .001; d = 0.17), quality of life (P = .0017; d = 0.41), and fatigue (P = .007; d = 0.46). Treatment modality, cancer type, and age affected some exercise responses, especially related to body composition changes. A 12-week, supervised, multi-component exercise program was effective for improving health-related fitness and quality of life in Spanish cancer patients receiving adjuvant therapy. Our results show the benefits of incorporating clinical exercise programming into the supportive care of cancer patients receiving treatments. The study protocol is registered at ClinicalTrials.gov (NCT05078216).

Analysis of postural control and muscle function performance of older adults participating in a multicomponent exercise program in primary health care

Objectives: This cross-sectional study aimed to investigate (1) postural control performance in different postural tasks and (2) muscle strength and power of the hip, knee, and ankle of active vs inactive older adults. Methods: The sample consisted of 61 healthy community-dwelling older adults, classified into 2 groups: active, consisting of participants of a multicomponent exercise program offered through the Exercise Orientation Service; and inactive. Participants were considered physically active/inactive in the past 3 months. Postural control was assessed using a force plate in 8 postural tasks. Muscle function was evaluated using an isokinetic dynamometer. T-tests were used to compare clinical characteristics between the groups. ANCOVA and MANCOVA were used to compare differences in variables of postural control and muscle function. Results: Active participants had higher levels of physical activity, clinical balance, and quality of life than inactive participants. The active group had lower values for area (center of pressure) than the inactive group under the following conditions: bipedal stance on an unstable surface with eyes open and with eyes closed, and semi-tandem stance on an unstable surface with eyes open. The active group showed greater muscle power, with higher mean power values for hip abduction and adduction, knee extension, and knee flexion and shorter time to peak torque for hip adduction and ankle dorsiflexion than the inactive group. Conclusions: Multicomponent exercise programs delivered in primary health care settings contributed to improving postural control and muscle power in this sample of older adults, which can potentially help prevent falls and improve quality of life.

Impact of Tailored Multicomponent Exercise for Preventing Weakness and Falls on Nursing Home Residents' Functional Capacity.

We aimed to determine whether the benefits of long (24weeks) and short (4weeks) training programs persisted after short (6weeks) and long (14weeks) periods of inactivity in older adult nursing home residents with sarcopenia. Multicenter randomized trial. The Vivifrail tailored, multicomponent exercise program (http://vivifrail.com) was conducted to individually prescribe exercise for frail older adults, depending on their functional capacity. The training included 4 levels combining strength and power, balance, flexibility, and cardiovascular endurance exercises. Twenty-four institutionalized older adults (87.1 ± 7.1years, 58.3% women) diagnosed with sarcopenia were allocated into 2 groups: the Long Training-Short Detraining (LT-SD) group completed 24weeks of supervised Vivifrail training followed by 6weeks of detraining; the Short Training-Long Detraining (ST-LD) group completed 4weeks of training and 14weeks of detraining. Changes in functional capacity and strength were evaluated at baseline, and after short and long training and detraining periods. Benefits after short and long exercise interventions persisted when compared with baseline. Vivifrail training was highly effective in the short term (4weeks) in increasing functional and strength performance (effect size= 0.32-1.44, P < .044) with the exception of handgrip strength. Continued training during 24weeks produced 10% to 20% additional improvements (P < .036). Frailty status was reversed in 36% of participants, with 59% achieving high self-autonomy. Detraining resulted in a 10% to 25% loss of strength and functional capacity even after 24weeks of training (effects size= 0.24-0.92, P < .039). Intermittent strategies such as 4weeks of supervised exercise 3 times yearly with no more than 14weeks of inactivity between exercise periods appears as an efficient solution to the global challenge of maintaining functional capacity and can even reverse frailty in vulnerable institutionalized older adults.

Effect of a 40-weeks multicomponent exercise program and branched chain amino acids supplementation on functional fitness and mental health in frail older persons.

The ageing process implies several physiological and psychological changes that hence affect the general health, mood states, and quality of life of older persons. Exercise and adequate nutrition are renowned non-pharmacological strategies that significantly delay and alleviate the adverse consequences of the ageing process. This study aimed to evaluate the effects of branched-chain amino acid (BCAA) supplementation and a multicomponent exercise program (ME) on the physical frailty and mood states of older persons. 35 participants (women and men; 83±3years old) from residential care homes were submitted to a 40-week exercise-washout-retraining intervention (16weeks of the elastic band based exercise and/or supplementation, 8weeks of washout, and 16weeks of multicomponent exercise and/or resupplementing), with or without BCAA supplementation. The experimental groups were: (i) ME plus BCAA supplementation (ME+BCAA); (ii) ME; (iii) BCAA supplementation (BCAA), and (iv) control group (CG). Fried's phenotype was used to assess frailty prevalence. Geriatric Depression Scale (GDS), Profile of Mood State (POMS), Mini-Mental State Examination (MMSE), were used to access mental health and cognition. The Short Physical Performance Battery (SPPB) was used to access functional capacity. Salivary testosterone levels (ST) were also determined to access the anabolic effects of the intervention. Exercise was effective in improving functional capacity and prevented the increase in frailty that occurred in the non-exercising CG, where the frailty scores increased over time (p<0.01). BCAAs supplement alone had no impact on functional fitness, but in a short time (16weeks) contributed to diminishing frailty and combined with exercise may have the potential to reduce the effect of a detraining period on functional capacity. Salivary testosterone levels correlated with handgrip strength and could be a useful indicator of susceptibility to frailty. No effects were found for mood states, cognition, and depression. This study showed that a long-term exercise program, independent of being multicomponent or strength elastic band-based, was effective in improving functional capacity and prevented an increase in frailty in frail and pre-frail older persons living in residential care homes.

Personalized multicomponent exercise programs using smartphone technology among older people: protocol for a randomized controlled trial

BackgroundOptimal application of the recently updated World Health Organization (WHO) guidelines for exercise in advanced age necessitates an accurate adjustment for the age-related increasing variability in biological age and fitness levels, alongside detailed recommendations across a range of motor fitness components, including balance, strength, and flexibility. We previously developed and validated a novel tool, designed to both remotely assess these fitness components, and subsequently deliver a personalized exercise program via smartphone.We describe the design of a prospective randomized control trial, comparing the effectiveness of the remotely delivered personalized multicomponent exercise program to either WHO exercise guidelines or no intervention.MethodsParticipants (n = 300) are community dwelling, healthy, functionally independent, cognitively intact volunteers aged ≥65 at low risk for serious fall injuries, assigned using permuted block randomization (age/gender) to intervention, active-control, or control group. The intervention is an 8-week program including individually tailored exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular); active-controls receive exercising counselling according to WHO guidelines; controls receive no guidance. Primary outcome is participant fitness level, operationalized as 42 digital markers generated from 10 motor fitness measures (balance, strength, flexibility); measured at baseline, mid-trial (4-weeks), trial-end (8-weeks), and follow-up (12-weeks). Target sample size is 300 participants to provide 99% power for moderate and high effect sizes (Cohen’s f = 0.25, 0.40 respectively).DiscussionThe study will help understand the value of individualized motor fitness assessment used to generate personalized multicomponent exercise programs, delivered remotely among older adults.Trial registrationClinicalTrials.gov Identifier: NCT04181983

Multicomponent Exercise Program for Improvement of Functional Capacity and Lipidic Profile of Older Women with High Cholesterol and High Triglycerides.

Background: Physical inactivity is a primary cause of most chronic diseases. In addition, the negative effects of aging, physical inactivity and dyslipidemia are risk factors for cardiovascular diseases of older women. Exercise is considered fundamental for the treatment and prevention due to the benefits in the health of this population, but detraining periods after exercise can reverse them. Multicomponent exercise (ME) is a combined method of aerobic and resistance training that can improve the lipidic profile of older women with high cholesterol and triglycerides. Methods: Seventeen older women (EG: 65.3 ± 4.7 years, 1.52 ± 4.12 m) followed a supervised ME program of nine months and three months of detraining (DT), and fifteen older women (CG: 66.4 ± 5.2 years, 1.54 ± 5.58 cm) continued their daily routine, without exercise. Total cholesterol (TC), triglycerides (TG), blood glucose (GL) and functional capacity (FC) were evaluated at the beginning and at the end of the program and after three months of DT. Results: ME program improved (p < 0.05) lipidic profile: GL (−15.6%), TC (−15.3%), TG (−19.3%) and FC: agility (−13.3%), lower body strength (27.78%), upper body strength (26.3%), cardiorespiratory capacity (11.2%), lower body flexibility (66.67%) and upper body flexibility (85.72%). DT declined the lipidic profile and FC (p < 0.05). Conclusion: Lipidic profile and functional capacity can be improved with nine months of ME. Besides the negative effects of DT, three months were not enough to reverse the benefits of exercise in older women with high values of TG and TC.

Safer cycling in older age (SiFAr): a protocol of a randomized controlled trial

BackgroundCycling has positive effects on health and the proportion of older cyclists is rising. However, the risk for older adults to be injured or killed by a bicycle accident increases. The aim of the ongoing project “Safer Cycling in Older Age (SiFAr)” is to promote safer cycling in community-dwelling older adults with a structured, multi-component exercise training.MethodsSiFAr is a randomized, controlled trial with a duration of 3 months for the intervention and a 6–9 months follow-up. We address community-dwelling persons aged 65 years and older living in the area Nürnberg-Fürth-Erlangen (Germany) who are either 1) beginners with the e-bike or 2) feeling self-reported unsteadiness when cycling or 3) uptaking cycling after a longer break. Long-term, experienced cyclists without subjectively reported limitations or worries when cycling are excluded. Participants are either randomized 1:1 to an intervention group (IG; receiving multi-component exercise program related to cycling, MEPC) or an active control group (aCG; receiving health and bicycle-related presentations, HRP). The purpose of this study is to investigate if the cycling competence of the IG will improve compared to the aCG. The cycling competence as primary outcome is tested not blinded in a standardized cycle course prior and after the intervention period, which consists of variant tasks requiring motor and cognitive skills related to traffic situations in daily life. Additional assessments such as physical functioning, quality of life, fear of falling, questionnaires regarding cycling behavior are obtained.To investigate the primary objective, regression analyses with difference of errors in the cycling course as independent variable and group as dichotomous dependent variable adjusted for covariates (sex, bicycle type) will be performed.The trial design is described in the present manuscript, using the extended CONSORT checklist for reporting pragmatic trials.DiscussionSince there is a lack of cycling-related interventions for older people, SiFAr aims to evaluate a standardized intervention to enhance cycling safety. The results of the SiFAr trial could contribute to the implementation of an evaluated cycling course concept promoting mobility and independence of older adults.Trial registrationThis study was registered with clinicaltrials.gov: NCT04362514 on April 27, 2020

Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program.

COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018–Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019–Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.

Does a Multicomponent Exercise Program Improve Physical Fitness in Older Adults? Findings From a 5-Year Longitudinal Study

The objective was to assess the physical fitness of older adults participating in a 5-year multicomponent exercise program. The sample consisted of 138 older adults aged 60-93years (70.4 ± 7.8years) evaluated with the Senior Fitness Test (muscle strength, flexibility, balance, and cardiorespiratory fitness). The multicomponent program was carried out between the months of March and November of each year. Data were analyzed using generalized estimating equations (factor year: Year 1, Year 2, Year 3, Year 4, and Year 5; factor time: pretest and posttest) with Bonferroni's post hoc test. Participation in the multicomponent exercise program for 5years (baseline pretest Year 1 and follow-up Year 5) improved lower and upper limb strength, lower limb flexibility, and balance and cardiorespiratory fitness, while upper limb flexibility was maintained. Year-by-year analysis revealed variable patterns for each fitness parameter. The results of this study show the potential benefits of implementing a long-term community-based exercise program.

Application of a Multicomponent Exercise Program on Functional Capacity in Hip Fractures in Hospitalized Older Adults

Background: To evaluate the effects of multicomponent exercise program (Vivifrail) in patients with hip fracture after surgery over the gait pattern, balance, and muscle strength in the lower body. Methods: Thirty-seven patients operated of hip fracture were enrolled between 2017 and 2018. Results: There were significant improvements (P &lt; .05) in the Short Physical Performance Battery, Tinetti balance, and gait scales, improving the independence measured with the Barthel Index and reducing the risk of falls. Conclusions: The multicomponent exercise improved with minimally obnoxious changes and the ability to balance and walk in older people who have undergone surgery for hip fracture, and also the number of responders who meet the minimally detectable changes is 70.27%.

Effectiveness of a 3-month antifalling program in the mobility, balance confidence, and muscle performance of older adults.

This study determined the effectiveness of a 3-month group-based multicomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, upper limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Significant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicomponent exercise program benefited the physical functions of older adults at low- or high risk of falls.

DOES THREE MONTHS OF DETRAINING PROMOTE DIFFERENT CHANGES IN OLDER ADULTS WITH OR WITHOUT HYPERTENSION AND HIGH CHOLESTEROL?

Cardiovascular deceases are the leading cause of death worldwide in older adults and exercise is one method that can bring benefits against their risk factors, such hypertension and high cholesterol. Exercise can be applied in older adults through different methods, like multicomponent training and can promote lifestyle changes. PURPOSE: Can multicomponent training (MT) and detraining (DT) promote different effects in blood pressure (BP), total cholesterol (TCHOL) and cardiorespiratory capacity of older women with or without hypertension and high cholesterol (HT and HCHOL)? METHODS: Sixteen older women without HT and HCHOL (CG: n = 16, 65.4 ± 1.8 years), and fifteen older women with HT and HCHOL (EG: n = 15, 67.7 ± 4.2 years) followed a six-month multicomponent exercise program before a three-month detraining period. Cardiorespiratory capacity was assessed through 6-min walk test(6MWT), Systolic (SBP) and diastolic (DBP) blood pressure through a Omron Digital Blood Pressure Monitor HEM-907, and total cholesterol (TCHOL) blood sample were assessed in accordance with the procedures of Diabetes Atlas Committee. All assessments were conducted before and after the exercise program and after three months of detraining. RESULTS: MT resulted in declines in SBP (EG: -4.00%, p < 0.01; CG: -2.38%, p < 0.01), DBP (EG: -7.07%, p < 0.01; CG: -7.73%, p < 0.01), TCHOL (EG: -13,29%, p < 0.01; CG: -5.26%, p < 0.01) and improvements in 6MWT (EG: 7.49%, p < 0.01; CG: 4.49%, p < 0.01). DT led to negative effects in SBP (EG: 2.69%, p < 0.01; CG: 3.04%, p < 0.01), DBP (EG: 7,54%, p < 0.01; CG: 7.46%, p < 0.01), TCHOL (EG: 6,26%, p < 0.01; CG: -3.16%, p < 0.01) and 6MWT (EG: -8.70%, p < 0.01; CG: -3.19%, p < 0.01). CONCLUSIONS: Besides the benefits of MT the DT period was enough to reverse the benefits of exercise in BP, TCHOL and cardiorespiratory fitness of booth groups. MT in older adults with hypertension and HCHOL group promoted greater improvements in HCHOL and cardiorespiratory fitness than in the CG.

Effects of multicomponent exercise training intervention on hemodynamic and physical function in older residents of long-term care facilities: A multicenter randomized clinical controlled trial

To assess hemodynamic and physical function responses during a two-month multicomponent group exercise program (MCEP) in residents of long-term care facilities. 40 older long-term care residents were randomly allocated equally to an intervention (IG; n=20; 80±7 years) and control group (CG; n=20; 79±7 years); they all submitted to hemodynamic (blood pressure and heart rate) and functional assessments before and after the MCEP. The IG performed a twice-weekly, two-months multicomponent exercise program composed of functional mobility, balance, muscle strength, and flexibility exercises; while the CG did not perform any exercise intervention. There was a statistically significant decrease in systolic blood pressure (7.25±14.64mmHg; t=2.2; effect size=0.34; p<0.05) following a two-month MCEP as compared with baseline. In all functional measurements (balance, mobility) were significantly improved after the MCEP (p<0.05). These data indicate that a two-month MCEP can improve systolic blood pressure and functionality in older residents of long-term care facilities.

24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting.

Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. After 24months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24months.

Perspectives on Sarcopenia and Protein Intake in Aged and Diabetic Patients

Perspectives on Sarcopenia and Protein Intake in Aged and Diabetic Patients

Home-based exercise for people living with frailty and chronic kidney disease: A mixed-methods pilot randomised controlled trial.

Frailty is associated with adverse health outcomes in people with chronic kidney disease (CKD). Evidence supporting targeted interventions is needed. This pilot randomised controlled trial (RCT) aimed to inform the design of a definitive RCT evaluating the effectiveness of a home-based exercise intervention for pre-frail and frail older adults with CKD. Participants were recruited from nephrology outpatient clinics to this two-arm parallel group mixed-methods pilot RCT. Inclusion criteria were: ≥65 years old; CKD G3b-5; and Clinical Frailty Scale score ≥4. Participants categorised as pre-frail or frail using the Frailty Phenotype were randomised to a 12-week progressive multi-component home-based exercise programme or usual care. Primary outcome measures included eligibility, recruitment, adherence, outcome measure completion and participant attrition rate. Semi-structured interviews were conducted with participants to explore trial and intervention acceptability. Six hundred and sixty-five patients had an eligibility assessment with 217 (33%; 95% CI 29, 36) eligible. Thirty-five (16%; 95% CI 12, 22) participants were recruited. Six were categorised as robust and withdrawn prior to randomisation. Fifteen participants were randomised to exercise and 14 to usual care. Eleven (73%; 95% CI 45, 91) participants completed ≥2 exercise sessions/week. Retained participants completed all outcome measures (n = 21; 100%; 95% CI 81, 100). Eight (28%; 95% CI 13, 47) participants were withdrawn. Fifteen participated in interviews. Decision to participate/withdraw was influenced by perceived risk of exercise worsening symptoms. Participant perceived benefits included improved fitness, balance, strength, well-being, energy levels and confidence. This pilot RCT demonstrates that progression to definitive RCT is possible provided recruitment and retention challenges are addressed. It has also provided preliminary evidence that home-based exercise may be beneficial for people living with frailty and CKD. ISRCTN87708989; https://clinicaltrials.gov/.

The Relation between Functional Performance, Falls and Previous Falls Among Participants in the Otago Programme: A Secondary Data Analysis.

Fall prevention is a key priority in healthcare policies. Multicomponent exercises reduce the risk of falls. The purpose of this study is to describe the relationship between functional performance and falls after following the Otago multicomponent exercise programme and previous falls. A prospective multi-centre intervention study was performed on 498 patients aged over 65 in primary care, with or without a history of previous falls. Sociodemographic, anthropometric and functionality data were collected. The primary outcome was the occurrence of falls; functional performance was measured using the Tinetti, Short Physical Performance Battery and Timed Up and Go tests. Among the patients, 29.7% referred to previous falls. There was a statistically significant (p < 0.001) increase in falls at 6 months (10.1%) and at 12 months (7.6%) among participants with previous falls in the baseline assessment compared to those without. In addition, the existence of previous falls could be considered a risk factor at 6 and 12 months (OR =2.37, p = 0.002, and OR = 1.76, p = 0.046, respectively). With regard to balance and gait, differences between the groups were observed at 6 months in the Tinetti score (p < 0.001) and in the baseline assessment Timed Up and Go score (p < 0.044). Multicomponent exercises improve the fall rate, balance and gait in older people, although this improvement is less in people with previous falls. Earlier intervention and tailoring of exercises in patients with previous falls could help improve outcomes.

Breathing exercises in older adults with asthma: a blinded, randomized, placebo-controlled trial

Objective Breathing exercises have been found to benefit patients with some respiratory disorders, but can take a significant amount of time to complete. The effects of a breathing exercise program are unknown. The aim of this study was to evaluate the effectiveness of a short multi-component exercise program for older adults with asthma. Methods To be included, subjects were age 65 years or older with persistent asthma. 90 subjects with predominantly moderate to severe asthma were randomized, 45 each, into either the exercise or control groups. After in person training at the initial visit, those in the exercise group performed a short three-part exercise program twice per day at home for one month. Those in the control group performed 2 breaths with the incentive spirometer twice per day. At the initial visit patients completed baseline questionnaires assessing demographic information, asthma control (Asthma Control Test – ACT) and quality of life (mini-Asthma Quality of Life Questionnaire – mini-AQLQ) as well as spirometry. After the one-month period at the follow-up visit the ACT, mini-AQLQ, and spirometry were repeated. Results Subjects in the intervention felt that breathing exercises were helpful, and 87% would recommend them to a friend. Although both groups had improvement in ACT and mini-AQLQ, there were no differences between groups. FEV1 was lower in both groups. Conclusion Although a short breathing exercise program was acceptable for older adults with asthma, it did not produce meaningful improvements in asthma outcomes. A longer program may be necessary.

Effects of multicomponent exercise program with progressive phases on functional capacity, fitness, quality of life, dual-task and physiological variables in older adults: Randomized controlled trial protocol

IntroductionThe multicomponent exercise program must be carried out in phases, due to the low tolerance of the old adults to prolonged efforts, since their functional reserve is reduced.The aim of study is investigate the effects of Multicomponent on Progressive Phases Program on functional capacity, fitness, quality of life, dual-task and physiological variables in the elderly. MethodsThis is a randomized controlled trial protocol with blind examiners. The protocol was registered at clinictrials.gov (protocol number: NCT04118478). The experimental group will participate in a progressive multi-component program of 27 weeks divided into 3 phases of 9 weeks each of them. Primary outcomes will be determined by evaluating functional capacity using the Short Physical Performance Battery (SPPB), gait speed, and Time up and Go test. Fitness will be determined by the handgrip, 2-min step test, chair sit and reach test, and back scratch test. Quality of life will appear with the SF-36 questionnaire and dual-task with the walking-while-talking test. The physiological variables evaluated will be heart rate and blood pressure at rest, autonomic balance and forced spirometry. Secondary outcomes are determined by measuring the level of physical activity, motivation for exercise, and anthropometric variables. DiscussionThe results derived from this research will increase the knowledge about the effects of a program of this type. The possible discoveries could serve as a guide to encourage future researchers to develop similar protocols. The purpose of the program is to serve as a practical and viable tool for the benefit of older people.Clinical trial registry protocol: NCT04118478.

Effects of a Multicomponent Exercise Program on Groups of Community-Dwelling Older Adults with Low Schooling: A Pilot Study.

The aim of this study was to analyze the effects of a multicomponent exercise program on the physical and hemodynamic functions of community-dwelling older adults with low schooling levels in relation to simple multicomponent group exercises. Twenty-one older people were randomly assigned to two groups: G1 (n = 11) and G2 (n = 10); sixteen of whom completed the sixteen sessions over a six-week period, three times a week. During eight sessions, G1 performed adapted dual-task multicomponent exercises (strengthening, balance, and cognition) and G2 simple multicomponent exercises (strengthening and balance), and both groups engaged in eight additional sessions of simple multicomponent exercises. The dual-task multicomponent exercises exhibited similar effects to those of their simple multicomponent counterparts. The older adults from both groups improved mobility, frailty, static postural control, balance, and hemodynamic stability. The adapted program was beneficial to the community-dwelling older people with low schooling in the group intervention.