Low-volume cycling training improves body composition and functionality in older people with multimorbidity: a randomized controlled trial

Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions and their informal carers: a scoping review and stakeholder consultation

INTRODUCTION

This scoping review mapped evidence on physical activity (including structured exercise) and sedentary behaviour interventions (interventions to reduce sedentary behaviour) in people living with both frailty and multiple long-term conditions (MLTCs) and their informal carers.

METHODS

Ten databases and grey literature were searched from 2000 to October 2023. Two reviewers screened studies and one extracted data. Results were shared with three stakeholder groups (n = 21) in a consultation phase.

RESULTS

After screening, 155 papers from 144 studies (1 ongoing) were retained. The majority were randomised controlled trials (86, 55%). Participants' mean age was 73 ± 12 years, and 73% were of White ethnicity. MLTC and frailty measurement varied widely. Most participants were pre-to-moderately frail. Physical health conditions predominated over mental health conditions.Interventions focused on structured exercise (83 studies, 60%) or combined interventions (55 studies, 39%). Two (1%) and one (0.7%) focused solely on habitual physical activity or sedentary behaviour. Adherence was 81% (interquartile range 62%-89%) with goal setting, monitoring and support important to adherence. Carers were only involved in 15 (11%) studies. Most interventions reported positive outcomes, primarily focusing on body functions and structures.

CONCLUSIONS

A modest volume of evidence exists on multicomponent structured exercise interventions, with less focus on habitual physical activity and sedentary behaviour. Interventions report largely positive effects, but an updated systematic review is required. The field could be advanced by more rigorous characterisation of MLTCs, socioeconomic status and ethnicity, increased informal carer involvement and further evaluation of habitual physical activity and sedentary behaviour interventions.

Evaluation of an exercise program incorporating an international cycling competition: a multimodal intervention model for physical, psychological, and social wellbeing in residential aged care

BACKGROUND

The transition into residential aged care is frequently associated with a reduction in physical activity, social engagement, and emotional wellbeing. Our aim was to evaluate the impact of a 26-day international cycling competition (Road Worlds Competition for Seniors), incorporating elements of exercise, audiovisual cycling footage, social engagement, and gamification, on the physical, psychological, and social well-being of aged care residents. We aimed to use findings to inform the development of a multi-modal intervention model to maximise wellbeing for older adults.

METHODS

Residents (N = 32) participated in a mixed-methods single-group intervention pilot study that compared pre-and post-competition measures for the following wellbeing domains; physical, psychological, and social. In addition, interviews were conducted with residents (n = 27) and staff (n = 6) to explore their experiences.

RESULTS

Measures identified significant improvements across multiple wellbeing domains, including functional fitness, depression, self-efficacy, and social network sizes. Findings from the interview data indicated that the multimodal components involved in the program delivery were valued by staff and residents who enjoyed the gamification, audiovisual cycling footage, social engagement, opportunities for reminiscence, and camaraderie between peers, staff, and volunteers.

CONCLUSIONS

Findings highlight a constellation of benefits across physical, psychological, and social domains of wellbeing and inform a model for innovative multidimensional programs in residential aged care. The benefits for residents with varying physical and cognitive abilities support the use of creative strategies that maximise inclusion and engagement for residents.

Effect of Resistance Training Programs With Equated Power on Older Adults' Functionality and Strength: A Randomized Controlled Trial

ABSTRACT

Fraga-Germade, E, Carballeira, E, and Iglesias-Soler, E. Effect of resistance training programs with equated power on older adults' functionality and strength: a randomized controlled trial. J Strength Cond Res 38(1): 153-163, 2024-This study aimed to compare the effect of 2 training programs of equated power but differing in load intensity on older adults' functionality, strength, performance, and body composition. Forty-four active (23 female) older adults (66.3 ± 4.5 years) were randomly assigned to low-load high-velocity (LL-HV), high-load low-velocity (HL-LV), and control (CON) groups. Low-load high-velocity and HL-LV performed, twice weekly for 5 weeks, a resistance training program at 95% of their individual peak power (PP) but with different load intensities for 3 exercises: chest press (CHP), leg press (LP), and seated row (SR). Before and after the intervention, body composition, functional performance, maximal voluntary isokinetic force (MVF), PP, and a relative load-power profile (L-PP) were evaluated for every exercise. PP similarly improved in the experimental groups for SR and LP (p < 0.05). Both groups increased their MVF for the 3 exercises (p < 0.05). Positive effects on L-PP were observed in LL-HV for SR (p = 0.009) and HL-LV for LP (p < 0.001). CON decreased its global power performance in SR (p = 0.009) and CHP (p = 0.031) compared with the baseline. Both experimental groups improved Timed Up and Go performance (p < 0.05), but only HL-LV increased 6-minute walking performance (pre: 514.3 ± 89.0 m, post: 552.6 ± 65.4 m; p < 0.05). In conclusion, adding short-term power training (i.e., 10 sessions throughout 5 weeks) with loads slightly above the optimal load to nonsupervised multicomponent training might improve active older adults' functional performance and cardiovascular endurance.

Exploring the Associations between Functional Capacity, Cognitive Function and Well-Being in Older Adults

Background: The present study aimed to explore the associations between functional capacity and global cognition, executive function and well-being in older adults. Methods: Ninety-seven older adults (age 80.6 ± 8.2 years) were examined for global cognitive function (Mini-Mental State Examination), executive function (symbol cancellation test), functional capacity (sit-to-stand tests, 6 min walk test, timed up-and-go test and handgrip strength test) and well-being (quality of life, fatigue levels, sleep quality and daily sleepiness). Adjusted partial correlations were computed to examine the associations between variables. Mediation analyses were conducted to evaluate whether functional capacity would mediate the relationships between age and cognitive or executive function. Results: Greater levels of functional capacity were associated with better performance in cognitive and executive function tests (p < 0.05). Mediation analyses revealed that functional capacity partially mediated the effects of age on global cognition and executive function (indirect effect: β = −0.11, 95% CI = −0.20 to −0.03; β = 0.34, 95% CI = 0.13 to 0.57, respectively). Increased levels of functional capacity were also associated with higher quality of life (p < 0.05, r = 0.32 to 0.41), lower fatigue levels (p < 0.05, r = 0.23 to 0.37), and better sleep quality (p < 0.05, r = 0.23 to 0.24). Conclusions: Functional capacity can mediate the effects of age on global cognition and executive function in older adults and greater levels of functional capacity are associated with improved quality of life, better sleep quality, and lower fatigue levels.