Upper versus lower body resistance exercise with elastic bands: effects on cognitive and physical function of institutionalized older adults

Abstract

Purpose To compare the effects of upper versus the lower-body resistance exercise on cognitive and physical functions of institutionalized older people. Methods This was a non-randomized multi-center comparative and crossover study (clincialtrials.gov code NCT03831373). Two experimental groups performed a 12-week intervention of resistance exercises with low-intensity elastic bands, one program focused on exercises of the upper body (n = 20, mean age 87.6 ± 6.4 years, 75% women) and the other on the lower body (n = 29, mean age 81.4 ± 7.7 years, 55% women). Following 12 weeks of detraining, the groups performed the other intervention. After another 12 weeks, a follow-up assessment was carried. The control group (n = 19, mean age 81.3 ± 9.5, 68% women) performed a full body stretching exercise program in both phases. Before and after each period, cognitive and physical function was assessed by standardized test (Mini-Mental State Examination, Trail Making test and Phototest; Timed Up and Go, Back Scratch, Chair Sit and Reach and had grip strength, respectively). Intention-to-treat and per-protocol analyses were carried. Results After the first intervention, significant improvements (p < 0.05) were observed in the cognitive function in both experimental groups, and in the hand grip strength in the group that performed lower-body exercise. After the second phase, all groups showed improvements in lower-body and shoulder flexibility and a significant worsening in hand grip strength. The lower-body exercise group showed a worsening in cognitive function, and the upper-body group in functional mobility and dynamic balance. Conclusions Resistance exercise with elastic bands showed beneficial effects on cognitive function and functional independence in institutionalized older adults. While upper body exercises seemed to be more effective on cognitive function, lower limb exercises showed better results on physical function parameters.

Effects of Exercise Behavior, Social Cohesion, and Social Support on Health Behaviors in Older Adults: Intervention in a Multi-Component Exercise Program

“…There were also significant improvements in "single left leg" and "single right leg" stands, showing improved balance in the older adults. These findings were consistent with those of many other studies [99][100][101][102][103][104], also showing that improved lower extremity strength leads to neurological integrity and reduces the risk of fall in older adults. In addition, from the perspective of older adults' adherence to exercise, after the implementation of the multi-component exercise pro-gram, it was found that the variety of exercises intrinsically motivated older adults to exercise, and the attendance rates of males and females reached 95% and 97%, respectively, demonstrating their exercise adherence [50,51].…”

Effects of elastic band resistance training on the physical and mental health of elderly individuals: A mixed methods systematic review

“…Table 1 presents the key characteristics of the included studies. Most were published between 2013 and 2022, and the majority were quantitative studies, including 7 quantitative non-randomized studies [ 42 , 46 , 48 , 54 , 58 , 65 , 66 ], 1 quantitative descriptive study [ 39 ], and 17 quantitative randomized controlled trials [ 40 , 41 , 43 – 45 , 47 , 49 – 53 , 59 – 64 ]. The subjects were all 60 or older; six of the studies looked specifically at older women [ 41 , 51 , 52 , 60 , 64 , 65 ], and one specifically at older men [ 44 ].…”

“…Twelve of the 25 quantitative studies measured the effects of elastic band resistance training on upper and lower limb flexibility in older adults. Six were randomized controlled trials [ 40 , 44 , 50 , 52 , 53 , 64 ], five were non-randomized controlled trials [ 46 , 48 , 54 , 58 , 66 ], and one was a quantitative descriptive study [ 39 ].…”

“…Nine studies used back scratch tests [ 39 , 40 , 46 , 52 – 54 , 58 , 64 , 66 ], and one used simple reaction and choice tests to assess upper limb flexibility [ 48 ]. Of the ten studies, statistically significant improvement in upper limb flexibility after intervention was noted in seven studies (p<0.05) [ 40 , 46 , 48 , 52 – 54 , 58 ], and a non-significant improvement was noted in three studies [ 39 , 64 , 66 ]. Of the studies measuring lower limb flexibility, eight used the chair sit and reach test [ 39 , 40 , 46 , 52 – 54 , 58 , 64 , 66 ], and two used the sit and reach test [ 44 , 50 ].…”

“…Of the ten studies, statistically significant improvement in upper limb flexibility after intervention was noted in seven studies (p<0.05) [ 40 , 46 , 48 , 52 – 54 , 58 ], and a non-significant improvement was noted in three studies [ 39 , 64 , 66 ]. Of the studies measuring lower limb flexibility, eight used the chair sit and reach test [ 39 , 40 , 46 , 52 – 54 , 58 , 64 , 66 ], and two used the sit and reach test [ 44 , 50 ]. All studies found statistically significant improvement in lower limb flexibility after intervention (p<0.05).…”