Pre‐Frail Multicomponent Training Intervention project for complexity of biological signals, functional capacity and cognition improvement in pre‐frail older adults: A blinded randomized controlled study protocol

Abstract

Aim Frailty syndrome is related to decreased physiological complexity, functional capacity and cognition. Physical exercise has been suggested to slow down and reverse this syndrome. However, evidence of its effectiveness is not as straightforward as conventionally admitted, as there is a lack of trials with rigorous methodology. The purpose of this study was to describe the Pre‐Frail Multicomponent Training Intervention protocol. Methods Cardiovascular, motor control and neuromuscular systems of pre‐frail older adults will be assessed by measuring the complexity of the output of these systems. Functional capacity and cognition will be assessed by specific tools. A 16‐week training protocol will be carried out on three alternate days, with 60‐min sessions, and combining aerobic, muscle strength, flexibility and balance exercises. The objective of this intervention is to improve the cardiovascular, motor control and neuromuscular systems, as well as functional capacity and cognition of pre‐frail older adults. The assessment of these systems will be carried out using gold standard devices. Results The results of the present study might allow clinical and functional support for the evaluation of the variables analyzed. Conclusion This protocol is easily reproducible and requires low‐cost materials, thus the Pre‐Frail Multicomponent Training Intervention could be a therapeutic strategy for pre‐frail older adults. Geriatr Gerontol Int 2019; 19: 684–689.

Items analysis of the Frailty Index (FI-35): Insight in the contribution of each item to the level of frailty

“…Several previous studies have shown the relationship between frailty and cognition. Prefrailty is a risk factor for cognitive dysfunction, and cognition tends to decline as frailty increases [ 24 – 27 ]. A meta-analysis from Bu [ 28 ] summarized that cognitive frailty was found to be a predictor of dementia in older adults living in communities.…”

Home‐based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol

“…When necessary, manual support will be provided, which will be diminished gradually. The choice, design, components, and parameters of physical exercise were based on the Otago Exercise Programme (Campbell, Robertson, Gardner, Norton, & Buchner, 1999), Weightbearing Exercise for Better Balance (Sherrington, Lord, & Herbert, 2004), and previous randomized trials from our research group (Ansai et al., 2016; Buto et al., 2019).…”

“…This is a strategy to minimize losses in assessments and to monitor health status. All questions were developed by the authors and carried out according to the purpose of this study and the experiences of previous longitudinal studies from our research group (Andrade et al., 2013; Ansai, Aurichio, Gonçalves, & Rebelatto, 2016; Buto et al., 2019; Santos et al., 2013).…”

“…Considering the primary outcomes (functional performance and capacity), study design related (two-way repeated-measures ANOVA), a 5% type I error (α = 0.05), 80% statistical power (1−β = 0.80) and a size effect of 0.25 (Buto et al, 2019), a minimum of 28 people would be needed for the total sample. This number was increased to 40 people to compensate for a possible 40% dropout rate according to Steinberg et al (2009) (dropout, illness, institutionalization, death).…”

Multicomponent exercise training in cardiovascular complexity in prefrail older adults: a randomized blinded clinical pilot study

“…The sessions were composed by: a) 10 min of warm-up (light walk); b) 20 min of aerobic exercises; c) 10 min of balance exercise; d) 15 min of resistance exercises; and e) 5 min of cool-down. Details concerning exercise type, intensity, and progression are described in a previous study (27).…”