Agility-based exercise training compared to traditional strength and balance training in older adults: a pilot randomized trial

Abstract

Background In addition to generally high levels of physical activity, multi-component exercise training is recommended for the maintenance of health and fitness in older adults, including the prevention of falls and frailty. This training often encompasses serial sequencing of balance, strength, endurance and other types of exercise. Exercise training featuring integrative training of these components (i.e. agility training) has been proposed, as it more likely reflects real life challenges like stop-and-go patterns, cutting manoeuvers, turns and decision-making. In this study, we compared the efficacy of an agility-based training to the traditional strength and balance training approach with regard to selected risk factors for falls and frailty. Methods We trained twenty-seven community-dwelling healthy seniors (16♂; 11♀; age: 69.5 ± 5.3 y; BMI: 26.4 ± 3.7 kg/m2) for 8 weeks in a group setting with 3 sessions per week, each lasting 50 minutes. Participants were randomized into either the agility group (AGI; n = 12), that used the integrative multi-component training, or the traditional strength and balance group (TSB; n = 15). TSB performed balance and strength exercises separately, albeit within the same session. The training of both groups progressively increased in difficulty. Outcomes were static and dynamic balance (single leg eyes open stand, Y-balance test, reactive balance), lower limb (plantar flexion and dorsal extension) and trunk flexion and extension maximum strength and rate of torque development (RTD). In addition, we tested endurance by the six-minute walk test (6MWT). We calculated linear mixed effects models for between-groups comparisons as well as effect sizes (ES) with 95 % confidence intervals. Results Small ES in favor of AGI were found for plantar flexion strength (ES > 0.18[−0.27;0.89]) and RTD (ES > 0.43[−0.19;1.36]) as well as trunk extension RTD (ES = 0.35[−0.05;0.75]). No other parameters showed notable between group differences. Compliance was high in both groups (AGI: 90 ± 8% of sessions; TSB: 91 ± 7% of sessions). Discussion Agility-based exercise training seems at least as efficacious as traditional strength and balance training in affecting selected physical performance indicators among community-dwelling healthy seniors. In particular, lower limb and trunk extension explosive strength seem to benefit from the agility training.

Aerobic Exercise Combination Intervention to Improve Physical Performance Among the Elderly: A Systematic Review

“…Earlier data has shown that yoga, Pilates, dance, Tai Chi and stretching can improve the flexibility of the elderly (Saravanakumar et al, 2018). On the contrary, multi-component training of 50 min, three times a week for eight weeks did not affect static balance (Lichtenstein et al, 2020). Balance training is considered task specific (Kümmel et al, 2016) and programs to improve balance suggest 90-120 min of balance training per week for 11-12 weeks (Lesinski et al, 2015).…”

“…Moreover, there were very few studies comparing single training and combined training. Most of these combination exercises training had a greater effect on physical performance in older adults than single exercise training (Fatouros et al, 2002;Karinkanta et al, 2007;Cancela Carral and Ayán Pérez, 2008;Carvalho et al, 2010;Sousa et al, 2013aSousa et al, ,b, 2017Lee et al, 2015;Haripriya et al, 2018;Timmons et al, 2018;Lichtenstein et al, 2020). This was because the combination exercises involve more elements that engage in physical performance, so they produce more comprehensive and effective results than single exercises (U.S. Department of Health and Human Services, 2021).…”

“…It also advocates the combination of various exercise components to comprehensively promote the physical health of the elderly and prevents injuries caused by the imbalances between the enhancement of one component and neglecting the other ( Woo et al, 2007 ; Timmons et al, 2018 ). Moreover, there are many combinations of aerobic exercises that have shown more benefits from the combination of multiple exercise components than from one component alone ( Rogers et al, 2002 ; Deley et al, 2007 ; Zhuang et al, 2014 ; Lee et al, 2015 ; Lacroix et al, 2016 ; Haripriya et al, 2018 ; Jia et al, 2018 ; Timmons et al, 2018 ), and the effect of the combination of multiple exercise components is greater than the effect of one component exercise ( Cancela Carral and Ayán Pérez, 2008 ; Sousa et al, 2013a , 2017 ; Lee et al, 2015 ; Timmons et al, 2018 ; Lichtenstein et al, 2020 ). The effects of combination workouts vary with the type, duration, and frequency of exercise.…”

Effects of multimodal agility-like exercise training compared to inactive controls and alternative training on physical performance in older adults: a systematic review and meta-analysis

“…Comprehensive multimodal agility training concepts bring the advantage of reproducing real-life conditions and therefor offer more opportunity for transfer; however, this must be investigated more. With this in mind, the results of a first pilot-study [53] are promising and the evaluation of an innovative agility training approach within an RCT study [54] could provide further insights about the effects of agility training in older adults. Thus, the present meta-analysis highlights the importance of MAT for older adults and provides important insights for future training conceptualization.…”

“…However, the perceptual aspects of agility training and the characteristics of an original definition by Sheppard and Young [52]: "a rapid whole-body movement with change of velocity or direction in response to a stimulus", comprising a perceptual decision-making process and its outcome, a change of direction or velocity task is often missing in recent studies. A recently published pilot study [53] specifically included agility-based exercises being based upon the agility approach by Donath et al [12]. In addition, Morat et al [54] published the protocol of their planned RCT evaluating agility training for older adults.…”