Psychosocial factors related to physical activity in frail and prefrail elderly people.

BACKGROUND: Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly. METHODS: A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68-94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants. RESULTS: Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation). CONCLUSION: The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population.

Nonspecific Resistance Training and Swimming Performance: Strength or Power? A Systematic Review.

ABSTRACT: Muniz-Pardos, B, Gomez-Bruton, A, Matute-Llorente, A, Gonzalez-Aguero, A, Gomez-Cabello, A, Gonzalo-Skok, O, Casajus, JA, and Vicente-Rodriguez, G. Nonspecific resistance training and swimming performance: Strength or power? A systematic review. J Strength Cond Res 36(4): 1162-1170, 2022-The purpose of this systematic review was to determine the type of nonspecific resistance intervention that is more effective to enhance swimming performance and to determine the nonspecific strength- or power-related variable that better predicts swimming performance. A search was conducted on PubMed, Cochrane Plus, and SportDiscus up to June 2018. Studies were distributed into 4 categories: dry-land strength (DLS), dry-land power (DLP), combination of training methods, and strength and power in start performance. From 1,844 citations, 33 met the inclusion criteria. Cross-sectional DLS studies showed positive associations between swimming performance and DLS development (especially through upper-body isometric assessments), although the efficacy of DLS training interventions remains unclear. Dry-land power training (principally through plyometrics) was a proficient, nonspecific method to enhance swimming block start performance (SBS; the start phase off the block and during the first 5-15 m), and jump assessment was the best predictor of SBS. Some pioneering nonspecific practices such as the acute exposure to high altitude or the maintenance of a high core temperature during the transition phase before competition seem to improve performance, although more research is required to confirm their efficacy. Further high-quality intervention studies are required to clarify the effect of DLP training on sprint swimming performance.

'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

OBJECTIVES: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults. METHODS: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. RESULTS: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). CONCLUSION: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Swim-Specific Resistance Training: A Systematic Review.

Muniz-Pardos, B, Gomez-Bruton, A, Matute-Llorente, A, Gonzalez-Aguero, A, Gomez-Cabello, A, Gonzalo-Skok, O, Casajus, JA, and Vicente-Rodriguez, G. Swim-specific resistance training: A systematic review. J Strength Cond Res 33(10): 2875-2881, 2019-The purpose of this systematic review was to determine which type of swim-specific training is most beneficial to enhance swimming performance and to determine which specific strength- or power-related tests better predict swimming performance. A search was conducted on PubMed, Cochrane Plus, and SPORTDiscus up to June 2018. Studies were distributed into 2 main categories: swim-specific dry land resistance training (SDLRT) and specific in-water swimming power training (SSWPT). From 1,844 citations, 25 met the inclusion criteria. It was determined that SSWPT was the most appropriate method to improve swimming performance, with tethered swimming protocols being the most studied and effective. In addition, SDLRT was a competent method to enhance swimming performance, and specifically, the inclusion of inertial training might evoke greater improvements in both strength/power capacities and swimming performance, than traditional resistance training. In conclusion, tether forces showed the greatest associations with swimming performance, although the efficacy of tethered swimming as an SSWPT method is yet to be confirmed. Further research should focus on the effects of SDLRT to verify the greater transfer of dry land resistance practices to swimming performance, with inertial training being potentially more beneficial than traditional resistance training.

Soccer helps build strong bones during growth: a systematic review and meta-analysis.

The aim of this study was to analyze the effects of soccer practice on bone in male and female children and adolescents. MEDLINE, PubMed, SPORTDiscus and Web of Science databases were searched for scientific articles published up to and including October 2016. Twenty-seven studies were included in this systematic review (13 in the meta-analysis). The meta-analysis was performed by using OpenMeta[Analyst] software. It is well documented that soccer practice during childhood provides positive effects on bone mineral content (BMC) and density (BMD) compared to sedentary behaviors and other sports, such as tennis, weightlifting, or swimming. Furthermore, soccer players present higher BMC and BMD in most weight-bearing sites such as the whole body, lumbar spine, hip, and legs. Moreover, bone differences were minimized between groups during prepuberty. Therefore, the maturity status should be considered when evaluating bone. According to meta-analysis results, soccer practice was positively associated with whole-body BMD either in males (mean difference 0.061; 95%CI, 0.042-0.079) or in females (mean difference 0.063; 95%CI, 0.026-0.099). CONCLUSION: Soccer may be considered a sport that positively affects bone mass during growth. Pubertal soccer players presented increased bone mass compared to controls or other athletes; however, these bone differences are minimized during the prepubertal stage. What is known: • It has been described that childhood and adolescence are important periods for bone mass and structure. • Previous studies have demonstrated that soccer participation improves bone mass in male and female children and adolescents. What is new: • The differences between soccer players and controls are more marked during puberty than prepuberty. • Weight-bearing sites such as lumbar spine, hip, femoral neck, trochanter, intertrochanteric region and both legs are particularly sensitive to soccer actions.

Swimming and peak bone mineral density: A systematic review and meta-analysis.

This meta-analysis aims to determine the effects of regular swimming on bone mineral density (BMD) in young adults (18-30 years). A systematic search was performed in Pubmed, SPORTDiscus and the Cochrane Library from the earliest possible year to March 2016. Swimmers were compared to non-athletic controls (CG) and to high-impact athletes (HIGH). Effect sizes with the Hedges g in random effects models were developed. Fourteen studies met the inclusion criteria and were included in the meta-analyses. Swimmers presented similar BMD values to CG in whole-body (g = -0.20; P = 0.251), femoral neck (g = -0.05; P = 0.818) and lumbar spine (g = 0.18; P = 0.492); and lower BMD in the whole-body (g = -1.21; P < 0.001), femoral neck (g = -1.51; P < 0.001) and lumbar spine (g = -0.84; P = 0.017) than the HIGH. For the whole-body differences, the higher the latitude the smaller the differences between swimmers and HIGH (B = 0.10; P = 0.001). For the femoral neck differences, age also seemed to reduce the differences between groups (B = 0.19; P = 0.020). Young adult swimmers present similar BMD values than CG and lower values than HIGH.

Bone Structure and Geometric Properties at the Radius and Tibia in Adolescent Endurance-Trained Cyclists.

OBJECTIVE: To describe cortical and trabecular volumetric bone mineral density (vBMD), bone mineral content (BMC), cross-sectional area (CSA), and bone strength indexes (BSIs) in adolescent endurance-trained cyclists (CYC) and compare them with controls (CON). DESIGN: Descriptive cohort study. PARTICIPANTS: Twenty-five male adolescent CYC and 17 CON. ASSESSMENT OF RISK FACTORS: Peripheral quantitative computed tomography was used to evaluate proximal and distal sites of the radius and tibia. MAIN OUTCOME MEASURES: Total, trabecular, and cortical BMC, vBMD, and CSA were measured. Also, cortical thickness, endosteal and periosteal circumferences, and different BSIs were calculated. Unadjusted analysis of variance and body weight-adjusted analysis of covariance tests were applied between cyclist and control groups. RESULTS: Cyclists were almost 12% lighter than CON (P < 0.05). Unadjusted data showed lower distal total vBMD and proximal cortical BMC and vBMD in cyclists compared with CON at the radius (P < 0.05) and lower distal total and trabecular BMC, vBMD and bone area, proximal total and cortical BMC and vBMD, and cortical bone area at the tibia (P < 0.05). Body weight-adjusted data showed the same differences for distal total vBMD at the radius and total and trabecular BMC and vBMD at the tibia, diaphyseal radius cortical vBMD and tibia total vBMD, cortical BMC and area, and also for tibia cortical thickness and BSI. The rest of differences were no longer detectable and bone area at the distal radius become significantly higher in cyclist compared with CON (P < 0.05). CONCLUSIONS: Adolescent CYC in this study showed lower values of BMC and vBMD at determined sites of the radius and tibia than CON, some of these differences were explained in part by their lower body weight. However, even further adjustment, some differences remained, which indicates that further longitudinal studies are needed to better understand if cycling influences these differences.

Longitudinal effects of swimming on bone in adolescents: a pQCT and DXA study.

The aims of the present study were, firstly, to evaluate areal bone mineral density (aBMD), bone strength and structure during a swimming season and compare them to those of normo-active controls (CG), and secondly to ascertain whether practising an additional weight-bearing sport other than swimming might improve bone. Twenty-three swimmers who only swam (SWI-PURE; 14 males, 9 females), 11 swimmers who combined swimming with an additional weight-bearing sport (SWI-SPORT; 8 males, 3 females) and 28 controls (CG; 16 males, 12 females) participated in the present study. aBMD was assessed with dual energy X-ray (DXA). Bone mass, area, structure and strength of the non-dominant tibia and radius were measured with peripheral quantitative computed tomography (pQCT). Measurements were performed at the beginning of the swimming season and 8 months later. The only difference among groups for DXA and pQCT variables was found for arm aBMD, which was higher in the SWI-SPORT than in the CG group at both pre- and post-evaluation. Group by time interactions (GxT) were found for trochanter aBMD when comparing SWI-SPORT to CG and SWI-SPORT to SWI-PURE, favouring in both cases SWI-SPORT. No GxT were found for the radius. For the tibia, GxT were found between SWI-SPORT and CG and between SWI-PURE and CG, in both cases favouring the swimmers. A season of swimming does not confer any additional benefits to aBMD, but may confer minor benefits to structure and mass. Complementing swimming with a weight-bearing activity is beneficial to bone.

Association of regional muscle strength with mortality and hospitalisation in older people.

BACKGROUND: the association between muscular strength, mortality and hospitalisation with ageing can change depending on sex and the body region analysed (e.g. upper and lower limb muscles). OBJECTIVE: to determine the effect of measuring lower and upper extremities muscular strength on the relationship between strength, mortality and hospitalisation risk in elder men and women. DESIGN: a population-based cohort study using data from the Toledo Study for Healthy Aging (TSHA). METHODS: a Spanish population sample of 1,755 elders aged ≥65 years participated in this study. Upper (handgrip and shoulder) and lower limbs (knee and hip) maximal voluntary isometric strength was obtained using standardised techniques and equipment. Cox proportional hazards model was used to examine mortality and hospitalisation over 5.5 and 3 years of follow-up, respectively. RESULTS: after adjustment for potential confounding factors, including co-morbidities and BMI, hazard ratio of death and hospitalisation was significantly lower in the stronger women and men, but showing regional- and sex-specific differences. That is shoulder, knee and hip muscle regions in women and handgrip and shoulder in men (all P < 0.05). There was a cumulative effect of measuring several muscle strengths over the risk of health events (P < 0.05), so that mortality hazard ratio increased by 45% in women and 25% in men per muscular strength (shoulder, grip, knee and hip) in the weaker strength quartile increase (P < 0.01). CONCLUSIONS: regional muscle strength is a predictor of medium-term mortality and hospitalisation in elder men and women. Multiple strength measures including lower and upper body limb muscles are better predictors than a single strength measurement.

Influence of different sports on bone mass in growing girls.

The aim of this study was to analyse whether there are differences in bone mass in girls playing different sports. Two hundred girls (10.6 ± 1.5 years old, Tanner stages I-III) participated in the study and were divided into groups of 40 (swimmers, soccer players, basketball players, handball players and controls). Bone mineral content and bone mineral density (BMD) (whole body and hip) were measured using dual-energy X-ray absorptiometry. The degree of sexual development was determined using Tanner test, and physical activity habits were recorded through a questionnaire designed ad hoc for this research. Girls were divided by pubertal stage and the type of sport. In the prepubertal group, intertrochanteric BMD was significantly higher in both handball and soccer players compared with the control group (P < 0.05). Furthermore, in the pubertal group, total BMD, mean arms BMD, pelvis BMD, femoral neck BMD, intertrochanteric BMD and Ward's triangle BMD were significantly higher in soccer and handball players compared with the control group (P < 0.05), and the swimmers showed significantly higher values in the mean arms BMD compared with the control group (P < 0.01). Our data suggest that sport practice during puberty, especially in activities that support the body weight, may be an important factor in achieving a high peak bone mass and improving bone health in girls.

Influences of physical fitness on bone mass in women with fibromyalgia.

The aim of this study was to provide information about the relationship of bone mineral content (BMC) and density (BMD) with some physical-fitness-related variables in a sample of women with fibromyalgia (FM) and age-matched women without FM. Twenty-eight women clinically diagnosed with FM (age 51.1 ± 8.4 yr, M ± SD) and 22 age-matched controls participated in the study. Whole-body BMC and BMD, lean mass, handgrip strength, quadriceps strength, and cardiovascular fitness were measured in all participants. The association between physical-fitness variables and bone-related variables was tested by linear regression controlling for body weight as a possible confounder. There were no differences in BMC or BMD between groups. Women with FM had lower values of handgrip strength, quadriceps strength, and VO2peak than the control group. Handgrip strength and aerobic capacity were associated with BMC and BMD and quadriceps strength was associated with BMD in women with FM; however, only VO2peak was associated with BMC in the group of women without FM. Bone mass of women with FM may be more susceptible to changes in physical fitness than that of the women without fibromyalgia.

Longitudinal Changes in the Body Composition of Non-Institutionalized Spanish Older Adults after 8 Years of Follow-Up: The Effects of Sex, Age, and Organized Physical Activity.

Aging leads to physiological changes affecting body composition, mediated by lifestyle. However, the effectiveness of organized physical activities (OPAs) in attenuating or delaying these age-related transformations remains an area of limited understanding. The primary objectives of this study were threefold: (I) to comprehensively assess the evolution of body composition in a cohort of Spanish older adults over an 8-year period; (II) to compare this evolution in the different age groups; and (III) to investigate the influence of active engagement in OPAs on these age-related changes. From a sample of 3136 Spanish older adults recruited in 2008, 651 agreed to participate in the 8-year follow-up. Anthropometric and bioelectrical impedance data were included for 507 females (70.3 ± 4.4 years) and 144 males (77.8 ± 4.5 years). Age groups were categorized as follows: youngest (65-69 years), mid (70-74 years), and oldest (≥75 years). The engagement in OPA was recorded before and after the follow-up. A repeated measures ANOVA was performed to evaluate the 8-year changes. Males increased in hip (98.1 ± 9.3 vs. 101.5 ± 10.2 cm) and waist circumferences (101.2 ± 6.6 vs. 103.2 ± 6.1 cm), specifically in the youngest group (p < 0.05). Females decreased in weight (67.6 ± 10.0 vs. 66.6 ± 10.5 kg) and fat mass percentage (39.3 ± 5 vs. 38.8 ± 5.4%) and increased in hip circumference (104.4 ± 9.0 vs. 106.5 ± 9.7 cm); these effects were the most remarkable in the oldest group (all p < 0.05). OPA engagement seemed to slow down fat-free mass loses in males, but not in females (grouped by time, p < 0.05). Body composition changes caused by aging seem to happen earlier in males than in females. Moreover, participating in OPAs does not prevent fat-free mass due to aging.

Effects of a multicomponent training followed by a detraining period on metabolic syndrome profile of older adults.

AIMS: The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity. METHODS: This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups. RESULTS: TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p < 0.05). CONCLUSIONS: Exercise can be a key component in the treatment of the MetS, since MCT seems to be effective to decrease DBP and total fat mass. Nevertheless, 4-months of detraining could cause a drop of total fat mass, but no in DBP. To avoid reversibility of the benefits obtained, it could be beneficial to promote continuing exercise programs. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT03831841.

Decreased levels of physical activity in adolescents with down syndrome are related with low bone mineral density: a cross-sectional study.

BACKGROUND: Down syndrome (DS) has been described as one of the main contributors for low bone mineral density (BMD). Physical activity (PA) is a key factor in skeletal health and thus, PA levels might be associated to the risk of developing osteoporosis. Therefore, the aims were (1) to describe PA patterns in adolescents with DS compared to their counterparts and (2) to determine the relationships between PA and the risk of having low bone mass in adolescents with DS. METHODS: Nineteen adolescents (10 girls) with DS and 14 without disabilities (7 girls) participated in the study. Minutes in different PA intensities were objectively assessed with accelerometers (ActiTrainer). Moreover adolescents with DS were classified into PA tertiles taking into account the amount of total minutes of PA at any intensity, resulting in those performing low, medium or high of PA (lowPA, medPA and highPA). BMD was measured at the whole body, hip and lumbar spine with dual-energy X-ray absorptiometry and the BMD Z-score was calculated for each region taking into account age- and sex-matched reference data. Student's unpaired t-tests and analysis of covariance were used to compare variables between different conditions (DS vs. control) and PA levels (low, medium and high). RESULTS: None of the adolescents with DS achieved the minimum of 60 min of daily moderate to vigorous PA (VPA) intensity recommended by PA guidelines; adolescents with DS group spent less time in sedentary and in VPA and more time in light PA than those without DS (p < 0.05). Adolescents with DS showed lower BMD Z-score values than those without (p < 0.05). Those adolescents with DS allocated in the lowPA tertile showed significant lower BMD Z-score at the hip and a general tendency towards lower BMD Z-score was found at whole body and lumbar spine compared to those in highPA tertile and (p < 0.05). CONCLUSIONS: Adolescents with DS in the highPA tertile showed lower risk of developing future osteoporosis by having higher BMD Z-score at the hip. This data provides an idea regarding the importance of accumulated minutes of PA, and not only moderate or vigorous in the bone health in adolescents with DS.

Effects of Diet-Exercise Interaction on Human Health across a Lifespan.

The world is changing even faster than ever and has modified people's lives [...].

Does nutritional status influence the effects of a multicomponent exercise programme on body composition and physical fitness in older adults with limited physical function?

Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control (n = 45) and intervention (n = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (-1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (-1.0 ± 0.3 kg) and body fat percentage (-1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition.Trial registration: ClinicalTrials.gov identifier: NCT03831841.Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people.Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity.The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.

Design of a Computer Model for the Identification of Adolescent Swimmers at Risk of Low BMD.

This paper aims to elaborate a decision tree for the early detection of adolescent swimmers at risk of presenting low bone mineral density (BMD), based on easily measurable fitness and performance variables. The BMD of 78 adolescent swimmers was determined using dual-energy X-ray absorptiometry (DXA) scans at the hip and subtotal body. The participants also underwent physical fitness (muscular strength, speed, and cardiovascular endurance) and swimming performance assessments. A gradient-boosting machine regression tree was built to predict the BMD of the swimmers and to further develop a simpler individual decision tree. The predicted BMD was strongly correlated with the actual BMD values obtained from the DXA (r = 0.960, p < 0.001; root mean squared error = 0.034 g/cm2). According to a simple decision tree (74% classification accuracy), swimmers with a body mass index (BMI) lower than 17 kg/m2 or a handgrip strength inferior to 43 kg with the sum of both arms could be at a higher risk of having a low BMD. Easily measurable fitness variables (BMI and handgrip strength) could be used for the early detection of adolescent swimmers who are at risk of suffering from low BMD.

Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study.

The aims of this study were (1) to analyse the effects of a 6-month multicomponent training (MCT) on the physical fitness of older adults with or at risk of frailty; (2) to study the consequences of a 4-month detraining period; (3) to analyse the influence of frailty status on the training and detraining adaptations. A total of 102 robust, frail and prefrail older adults (80.1 ± 6.1 y) were divided into an intervention (TRAIN) and control group (CON). The TRAIN performed a 6-month MCT, while the CON continued with their usual lifestyle. Fitness assessment was mainly based on the Senior Fitness Test. Four evaluations were carried out; at baseline, and at 3, 6 and 10 months from baseline. Linear mixed models were performed to analyse group by time interactions and to compare differences in changes within groups between different time points. After 6-month MCT, TRAIN showed greater improvements for all fitness variables (group effects p < 0.05, except for flexibility) when compared to the CON. During the 4-month detraining period, TRAIN significantly decreased their balance, upper-limb flexibility and upper and lower-limb strength (all p < 0.05). CON only decreased upper-limb flexibility. When accounting for frailty status in the TRAIN, the frail-prefrail showed lower adaptations to the training and were more affected by detraining than the robust. The presented MCT is a good strategy to improve fitness in this population, but its positive effects are limited in time. It is, therefore, critical to avoid detraining periods.Trial registration: ClinicalTrials.gov identifier: NCT03831841.HighlightsOur 6-month MCT-program improves the physical fitness of robust, frail and prefrail older adultsA detraining period of four months partially deteriorates the physical fitness of robust, frail and prefrail older adults, so it is recommended to promote ongoing exercise programs or smaller break periodsIt seems that those older adults with a more advanced frailty status may not benefit from exercise to the same degree and will be more affected by detraining. Therefore, trainers may need to individualize training protocols to obtain the greatest exercise benefits.

Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty.

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.

A 21-week bone deposition promoting exercise programme increases bone mass in young people with Down syndrome.

AIM: To determine whether the bone mass of young people with Down syndrome may increase, following a 21-week conditioning training programme including plyometric jumps. METHOD: Twenty-eight participants with Down syndrome (13 females, 15 males) aged 10 to 19 years were divided into exercise (DS-E; n=14; eight females, six males mean age 13y 8mo, SD 2y 6mo) and non-exercise (DS-NE; n=14; five females, nine males mean age 15y 5mo, SD 2y 6mo) groups. Total and regional (hip and lumbar spine [L1-L4]) bone mineral content (BMC) and total lean mass were assessed by dual energy X-ray absorptiometry at baseline and after a 25-minute training session performed twice a week. Repeated-measures analyses of variation were applied to test differences between pre- and posttraining values for BMC and total lean mass. Differences between increments were studied with the Student's t-test. Linear regression models were fitted to test independent relationships. RESULTS: After the intervention, higher increments in total and hip BMC, and total lean mass, were observed in the DS-E group (all p<0.05). A time × exercise interaction was found for total lean mass (p<0.05). The increment in total lean mass, height, and Tanner stage accounted for almost for 60% in the increment in total BMC in the DS-NE group (p<0.05). INTERPRETATION: Twenty-one weeks of training have a positive effect on the acquisition of bone mass in young people with Down syndrome.