Exercise-Based Interventions as a Management of Frailty Syndrome in Older Populations: Design, Strategy, and Planning

Abstract

Exercise-based interventions emerged as the best alternative for treating frailty syndrome (FS). Recognized as a complex phenotype, the FS is a multifaceted aging expression determined by biologic, environment, and behaviors factors. The biological theories of human development perceive aging process as an accumulation of harmful biochemical changes, whose occurrence attends the course of life. The progressive losses of functional reserves that occur in the body systems are a hallmark of this negative process. Despite the biological effects of physical and cognitive decline, more contemporary studies have identified that the environmental and behavior factors such as malnutrition and negative psychological adjustment across the life span also contribute to the early appearance of FS. Notwithstanding the latest findings that consistently demonstrate an overall positive benefit of long-term-based exercise in the decrease and/or reversal of the FS with a substantial impact on their correlated outcomes, the focus of this chapter is to present strategies for designing exercise programs for this type of population, taking into account their practical application in the field.

Effects of resistance bands exercise for frail older adults: A systematic review and meta‐analysis of randomised controlled studies

“…Finally, 15 sources were included for the systematic review and quantitative synthesis (meta‐analysis) (Bandinelli et al., 2006; Bong & Song, 2020; Chen et al., 2020; Furtado, Caldo, et al., 2020; Furtado, Carvalho, et al., 2020; Hsieh et al., 2019; Huang et al., 2020; Mollinedo Cardalda et al., 2019; Nagai et al., 2018; Rezola‐Pardo et al., 2019; Saeterbakken et al., 2018; Sahin et al., 2018; Seino et al., 2017; Tarazona‐Santabalbina et al., 2016; Tieland et al., 2015; Yoon et al., 2018). The selection of studies is presented in Figure 1 through a PRISMA flow diagram.…”

“…The pooled SMD values for five studies were calculated for the intervention group and control group using the frailty phenotype score (Furtado, Caldo, et al., 2020; Furtado, Carvalho, et al., 2020; Hsieh et al., 2019; Seino et al., 2017; Tarazona‐Santabalbina et al., 2016; Yoon et al., 2018) to measure frailty. The random‐effects‐weighted SMD was −0.29 (95% CI: −0.55 to −0.03), and a significant difference in frailty scores was observed between the intervention and control groups ( p = .03).…”

“…In this review, most of the included studies implemented resistance band exercises for 12 weeks, 2–3 times per week, performed for 60 min with high intensity (≥75% RM), in 2–3 sets of 10–15 repetitions. Resistance band exercises are recommended for frail older adults to preserve and enhance muscle strength, endurance and ADL, and exercises are suggested to be performed at least twice a week, using 10–20 repetitions for 45–60 min per training (Furtado, Caldo, et al., 2020; Furtado, Carvalho, et al., 2020). A previous systematic review reported mixed results concerning the benefits of resistance training on physical outcomes, although a resistance training frequency of 2–3 sets consisting of 6–15 repetitions performed with high intensity was shown to promote significant improvements in muscle strength, functional outcomes and decreased frailty scores among frail older adults (Lopez et al., 2018).…”

“…For instance, an 8‐week randomised controlled study suggested that resistance exercise using elastic bands reduced the frailty score ( p < .001) and depression ( p < .001) and increased muscle strength ( p < .001), and quality of life ( p <.001) (Sahin et al., 2018). Another 14‐week randomised study suggested that elastic band exercises significantly improved the ability of frail older adults to perform activities of daily living (ADL, p = .005) (Furtado, Caldo, et al., 2020; Furtado, Carvalho, et al., 2020). However, an 8‐week randomised controlled trial (RCT) found insignificant effects for resistance band exercises on depression ( p = .43) and muscle strength ( p = .94) (Bandinelli et al., 2006).…”

Physical activity and patients with frailty syndrome

“…Each of these forms impro- ves various aspects of physical functioning, so it is recommended to combine them depending on the needs as a multicomponent intervention, always bearing in mind that the therapy should be tailored to the individual capabilities and needs of the patient [16,21]. When planning physical activity, one should take into account age, functional capacity, comorbidities, lifestyle, and the patient's previous experience and preferences in exercising [22,23].…”