BackgroundAging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality.MethodsThis was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind.ResultsThe IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p < 0.01) and in all its 7 components of evaluation (p < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01).ConclusionOur results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders.Trial registrationEnsaiosclinicos.gov.br process number: RBR-3cqzfy.

BackgroundElderly people have high rates of functional decline, which compromises independence, self-confidence, and quality of life (QoL). Physical exercise leads to significant improvements in strength, balance, functional mobility, and QoL, but there is still reduced access to this therapeutic strategy due to difficulties in locomotion to training centers or lack of adaptation to the exercise environment.Methods/designThe purpose of this clinical trial will be to verify the effect of a progressive and semi-supervised, home-based exercise program on the functional mobility, and in the QoL of sedentary elderly people. This is a protocol of a consecutive, single-center, single-blind, and randomized controlled trial. The design, conduct, and report follows the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. Sedentary elderly people will be enrolled, and randomly allocated into two groups. The intervention group will perform exercises in their own home and the control group will not perform exercises. The evaluations will occur at study enrollment and after 3 months of intervention, and will be performed using the functional mobility Timed Up & Go (TUG) test and sociodemographic and QoL questionnaires. In the statistical analysis, comparisons of mean and correlation analyses will be performed. The primary expected outcome is the improvement in functional mobility verified through the TUG test and the secondary outcome is the improvement in QoL verified by the WHOQOL-OLD.DiscussionThe lack of scientific evidence demonstrating the benefits of semi-supervised home exercise on functional mobility and QoL in elderly people represents an obstacle to the development of guidelines for clinical practice and for policy-makers. The World Health Organization highlighted the importance of musculoskeletal health programs for elderly people, and the exercise program described in this protocol was designed to be viable, easy to implement, and inexpensive, and could be performed at the home of elderly subjects after receiving only guidelines and follow-up via periodic visits. Based on these facts, we hope that this study will demonstrate that a well-structured, home-based exercise program can be effective in improving functional mobility and QoL of sedentary elderly people, even without constant supervision during exercise.Trial registrationRegistro Brasileiro de Ensaios Clínicos (ReBEC), Identifier: RBR-3cqzfy. Registered on 2 December 2016.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3061-1) contains supplementary material, which is available to authorized users.

Aims: To test the hypothesis of a semi-supervised home physical exercise programme that is likely to improve the functional mobility and quality of life (QOL) of elderly in the community. Methods: This trial included elderly adults (88% female) aged 60 years or older and who were sedentary and without cognitive decline. The participants were randomly assigned to an intervention group (IG, home physical exercise and sleep hygiene) and a control group (CG, sleep hygiene). The International Questionnaire on Physical Activity, mental state mini-exam, World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the Timed Up and Go (TUG) tests were conducted before and after the 12-week intervention period. Results: The study was concluded with 125 elderly participants. Anthropometric data were indicative of pre-obesity, with a mean body mass index of 27.3 ± 4, a low-income socio-economic profile (78% ≤ 2 SM) and low schooling rates (76% ≤ 3 years of study). Most of the elderly (87%) were considered physically active How to cite this article: Brandão GS, Brandão GS, Sampaio AAC, et al. Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORTprospective, randomised controlled clinical trial. Int J Clin

BackgroundThe progressive increase in the elderly population contributes to the fact that studies on human aging have important attention of health professionals and government agents, since they present a great challenge regarding public health. Our objective is to characterize the profile of older people with poor sleep quality and analyze possible associations with excessive daytime somnolence, quality of life and functional mobility.MethodsThis is a cross-sectional descriptive study, involving elderlies of the community, with the questionnaires Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, WHOQOL-OLD and application of the Timed Up and Go test - TUG. Descriptive statistics, Student’s t test for paired samples and Pearson’s correlation coefficient (p ≤ 0.05) were used.ResultsWe recruited 131 elderly people, predominantly female (87%); mean age 68 ± 7 years, low per capita income (84.8% ≤ 2 minimum wage), low education (86.3% ≤ 3 years of study), and mostly staying with relatives (67.9%), married (39.7%) or amassed (35.9%). Seventy-one percent of the sample is above normal weight, 90.1% of women have an abdominal circumference ≥ 80 cm and a high prevalence of chronic and psychosocial diseases was identified in the self-report, and the risk of obstructive sleep apnea in 38.2%. The mean PSQI, Epworth Sleepiness Scale, WHOQOL-OLD and TUG were equal to, respectively, 11.2 ± 3.2; 8.32 ± 2.2; 84.8 ± 10.2 and 8.97 ± 2. An association of sleep quality with excessive daytime somnolence and quality of life, while not with functional mobility, was observed.ConclusionThe results of the present study allowed to identify a sleep quality associated with excessive daytime somnolence and quality of life and also to characterize the profile of elders with poor sleep quality.

Background: Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. Methods: This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scaleA (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. Results: The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p < 0.01) and in all its 7 components of evaluation (p < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). Conclusion: Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders.

Introduction: Low levels of physical activity and functional mobility lead to greater difficulty in performing activities of daily living and are directly proportional to mortality in the elderly. Thus, there are the need to create mechanisms linked to the maintenance of the functional capacity, which assure the elderly autonomy and self-confidence. Objective: To verify the level of physical activity and functional mobility in the elderly and if this functional mobility suffers interference of the age group and physical activity. Methods: The study involved the elderly aged 60 and over, living in Senhor do Bonfim (BA), in the northeastern region of Brazil, from February to July 2015. The evaluation of the subjects occurred in a single session, with physical and general clinical evaluation, as well as the collection of sociodemographic, anthropometric and self-reported morbidities through the application of questionnaires. It was also carried out the Timed Up and Go test (TUG) to verify the levels of functional mobility and level of physical activity with application of the International Questionnaire of Physical Activity (IPAQ) adapted for the elderly. Results: In this study, 127 patients were studied, predominantly female (87%) and mean age of 68 ± 7 years, and the majority of the elderly corresponded to the age group of 60 to 69 years. The elderly belonging to the group considered inactive (IPAQ up to 150 min/weekly) presented the execution time of TUG higher than the elderly in the group considered active (IPAQ > 150 min/weekly), with averaging time for carrying out the test of 10.5±2 minutes and 8.9±2 minutes respectively, with a statistically significant difference of p<0.01. And the execution time of TUG increased proportionally to the increase of the age group. Conclusion: Elderly with lower level of physical activity and belonging to the higher age groups present a higher risk of falls. Strategies should be developed to stimulate increased physical activity level and functional mobility of this population, especially among the older ones, reducing the incidence of falls and providing greater autonomy.

Introduction: The analysis of heart rate variability (HRV) has been used as a resource for the measurement of autonomic nervous system activity in different situations. This analysis is based on identifying the strength of bands of low and high frequencies of the spectral function of the RR intervals in heart rate. Studies have shown that the related high frequency band parasympathetic tone controls the resting state, while exercise is associated with sympathetic activation, linked to lower frequency bands. The autonomic nervous system plays an important role in mediating the cardiovascular responses induced by stress. Objective: To describe a technique for analysis of heart rate variability in the measurement of autonomic nervous system activity. Discussion: To perform HRV analysis the "Nerve-Express" uses an effective and transparent visual representation, known as rhythmography method which reflects the structure of HRV wave and acts as a "fingerprint" of autonomic regulatory mechanisms. The wave RR intervals are recorded sequentially forming a rhythmogram, namely a picture of curved wave-specific variability of RR intervals. Key words: Heart Variability, Nerve-Express, Autonomic Nervous System, Salbutamol, doping. ResumoIntrodução: A análise da variabilidade da freqüência cardíaca tem sido empregada como recurso para a mensuração da atividade do sistema nervoso autônomo em diversas situações. Esta análise baseia-se na identificação da força das bandas de baixas e altas freqüências da função espectral dos intervalos R-R da freqüência cardíaca. Estudos revelaram que o tônus parassimpático relacionado à banda de alta freqüência controla o estado de repouso, enquanto o exercício está associado a uma ativação simpática, ligada às bandas de baixa freqüência. O sistema nervoso autônomo tem um papel importante na mediação das respostas cardiovasculares induzidas pelo estresse. Objetivo: Descrever a técnica de análise da variabilidade da frequência cardíaca na mensuração da atividade do sistema nervoso autônomo. Discussão: Para efetuar a análise da VFC, o "Nerve-Express" utiliza uma representação visual efetiva e transparente, conhecida como Método de Ritmografia, que reflete a estrutura de onda da VFC e atua como uma "impressão digital" dos mecanismos regulatórios autonômicos. Os intervalos de onda R-R são registrados sequencialmente, formando um ritmograma, ou seja, um retrato de onda curvo-específica da variabilidade dos intervalos R-R.

Background: The progressive increase in the elderly population contributes to the fact that studies on human aging have important attention of health professionals and government agents, since they present a great challenge regarding public health. Our objective is to characterize the profile of older people with poor sleep quality and analyze possible associations with excessive daytime somnolence, quality of life and functional mobility. Methods: This is a cross-sectional descriptive study, involving elderlies of the community, with the questionnaires Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, WHOQOL-OLD and application of the Timed Up and Go test - TUG. Descriptive statistics, Student’s t test for paired samples and Pearson’s correlation coefficient (p ≤ 0.05) were used. Results: We recruited 131 elderly people, predominantly female (87%); mean age 68 ± 7 years, low per capita income (84.8% ≤ 2 minimum wage), low education (86.3% ≤ 3 years of study), and mostly staying with relatives (67.9%), married (39.7%) or amassed (35.9%). Seventy-one percent of the sample is above normal weight, 90.1% of women have an abdominal circumference ≥ 80 cm and a high prevalence of chronic and psychosocial diseases was identified in the self-report, and the risk of obstructive sleep apnea in 38.2%. The mean PSQI, Epworth Sleepiness Scale, WHOQOL-OLD and TUG were equal to, respectively, 11.2 ± 3.2; 8.32 ± 2.2; 84.8 ± 10.2 and 8.97 ± 2. An association of sleep quality with excessive daytime somnolence and quality of life, while not with functional mobility, was observed. Conclusion: The results of the present study allowed to identify a sleep quality associated with excessive daytime somnolence and quality of life and also to characterize the profile of elders with poor sleep quality.