A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial

Tarazona-Santabalbina, Francisco José; Gómez-Cabrera, Mari Carmen; Pérez‐Ros, Pilar; Martínez-Arnau, Francisco Miguel; Cabo, Helena; Tsaparas, Konstantina; Salvador‐Pascual, Andrea; Rodríguez‐Mañas, Leocadio; Viña, José

doi:10.1016/j.jamda.2016.01.019

Cited by 385 publications

(389 citation statements)

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“…7 Whereas many group programs emphasize lower extremity muscle strengthening, flexibility, and general conditioning because of the association of related impairments with walking difficulties, 12 they have failed to focus on the ability to walk or the timing and coordination of movement that is critical to walking. [7][8][9]11 Previously, therapeutic, individually supervised exercise led by physical therapists that includes timing and coordination components has been shown to improve walking in older adults. [13][14][15][16] Therefore, timing and coordination exercises could be an important addition to community-based health promotion group exercise programs to improve walking.…”

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confidence: 99%

Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults

et al. 2017

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IMPORTANCE Timing and coordination exercises may be an important addition to community-based health promotion exercise programs to improve walking in older adults.OBJECTIVE To compare the effectiveness of the On the Move group exercise program, which focuses on the timing and coordination of movement, with a seated strength, endurance, and flexibility program (usual care) at improving function, disability, and walking ability of older adults.DESIGN, SETTING, AND PARTICIPANTS Cluster-randomized, single-blind intervention trial. Thirty-two independent living facilities, senior apartment buildings, and senior community centers were randomized to On the Move (16 sites; 152 participants) or usual care (16 sites; 146 participants). Participants were 65 years or older, able to ambulate independently with a gait speed of at least 0.60 m/s, able to follow 2-step commands, and were medically stable. INTERVENTIONS Exercise classes were 50 minutes, twice a week for 12 weeks and had 10 or fewer participants per class. On the Move consisted of warm-up, timing and coordination (stepping and walking patterns), strengthening, and stretching exercises. The usual-care program consisted of warm-up, strength, endurance, and stretching exercises. MAIN OUTCOMES AND MEASURES The primary outcomes were self-report of function and disability (Late Life Function and Disability Instrument) and mobility (6-minute walk distance and gait speed) assessed by blinded individuals. RESULTS Participants (mean [SD] age, 80.0 [8.1] years) were mostly female (251 [84.2%]) and white (249 [83.6%]) and had a mean (SD) of 2.8 (1.4) chronic conditions. Intervention groups were similar on baseline characteristics. Postintervention, 142 (93.4%) participants in On the Move and 139 (95.2%) participants in usual care completed testing. On the Move had greater mean (SD) improvements than the usual-care group in gait speed (0.05 [0.13] vs −0.01 [0.11] m/s; adjusted difference = 0.05 [0.02] m/s; P = .002) and 6-minute walk distance (20.6 [57.1] vs 4.1 [55.6] m; adjusted difference = 16.7 [7.4] m; P = .03). Attendance was greater in the usual-care program compared with On the Move (95 [65.1%] vs 76[50.0%] attended Ն20 classes; P = .03). There were no significant differences in any of the other primary or secondary outcomes. CONCLUSIONS AND RELEVANCEThe On the Move group exercise program was more effective at improving mobility than a usual-care exercise program, despite lower attendance. Additional research examining the impact of the intervention on long-term disability outcomes is needed before recommending routine implementation into clinical practice.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01986647

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Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults

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“…Studies have suggested that exercise and nutrition interventions can improve outcomes in frail older persons (72)(73)(74)(75). A rapid screen -the FRAIL -can be utilized both in hospitals (76,77) and in the outpatient setting (78)(79)(80)(81).…”

Section: Modern Geriatric Giantsmentioning

confidence: 99%

Geriatrics in the 21st century

Vellas

Morley

2018

The Journal of nutrition, health and aging

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“…Both aerobic and resistance training attenuates the loss of lean body mass, increases muscle strength and ameliorates frailty in older adults [42][43][44]. Numerous dietary interventions have been extensively investigated, though most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns [45][46][47][48][49].…”

Section: Introductionmentioning

confidence: 99%

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

McClure

Villani

2017

JCSM Clinical Reports

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Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti-inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well-designed, longer-term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.

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A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial

Abstract: ClinicalTrials.gov. Identifier: NCT02331459.

Cited by 385 publications

References 46 publications

Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults

Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults

Geriatrics in the 21st century

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

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