ABSTRACT
BACKGROUND: The periodization of physical exercise to optimize objectives is common in competitive sports. However, physical exercise programs for older adults only sometimes present periodization in their programming. Therefore, this article aims to research the results of applying the sports periodized method to older adults. METHODS: A total of 137 participants over 60 years old performed a physical exercise program; 71 participated in a multi-component non-periodized program as the Control Group (CG), and 66 participated in a program periodized in blocks as the Experimental Group (EG). The block periodization program was oriented to the development of strength and was carried out in 86 sessions thrice weekly for eight months. Anthropometric assessments were made using weight, height, Body Mass Index, and electrical bioimpedance; and functional evaluations were made through standardized tests: Short Performance Physical Battery (SPPB), Timed Up & Go (TUG), handgrip, and a two-minute stair test. RESULTS: After the intervention, the EG significantly improved TUG, weight, and BMI. On the other hand, the CG showed significant improvements in fat weight, BMI, and the 2 min stair test. The SPPB did not show changes after the intervention. CONCLUSION: The periodization of physical exercise for older adults does not significantly impact functional capacity in this population group.
ABSTRACT
BACKGROUND: Ageing entails changes in complex cognitive functions that lead to a decrease in autonomy and quality of life. Everyday cognition is the ability to solve cognitively complex problems in the everyday world, enabling instrumental activities of life. Benefits have been found in studies using everyday cognition-based assessment and intervention, as the results predict improvements in everyday performance, not just in specific cognitive functions. A study protocol is presented based on assessment and training in everyday cognition versus traditional cognitive stimulation for the improvement of functionality, emotional state, frailty and cognitive function. METHODS: A parallel randomised controlled clinical trial with two arms will be conducted. It will be carried out by the University of Salamanca (Spain) in eleven centres and associations for the elderly of the City Council of Salamanca. People aged 60 years or older without cognitive impairment will be recruited. Participants will be randomly distributed into two groups: the experimental group will undergo a training programme in everyday cognition and the control group a programme of traditional cognitive stimulation, completing 25 sessions over 7 months. All participants will be assessed at the beginning and at the end of the intervention, where socio-demographic data and the following scales will be collected: The Medical Outcomes Study (MOS), Questionnaire ARMS-e, Everyday Cognition Test (PECC), Scale Yesavage, Test Montreal Cognitive Assessment (MoCA), The Functional Independence Measure (FIM), Fragility Index and Lawton y Brody Scale. DISCUSSION: The present study aims to improve conventional clinical practice on cognitive function training by proposing a specific assessment and intervention of everyday cognition based on the importance of actual cognitive functioning during the resolution of complex tasks of daily life, giving priority to the improvement of autonomy. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT05688163. Registered on: January 18, 2023.
Subject(s)
Cognitive Dysfunction , Frailty , Aged , Humans , Quality of Life , Activities of Daily Living , Cognition , Cognitive Dysfunction/rehabilitation , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Inspiratory muscle training (IMT) has been applied to different populations, but evidence in elderly women and maintenance of improvements achieved during training is scarce. The objective of the study was to evaluate the effectiveness of IMT 6 months after finishing the training period in elderly women. METHODS: A controlled, randomized, double-blind trial was conducted, with allocation concealment performed on 26 institutionalized elderly women distributed into 2 groups: high loads and low loads. Over an 8-week period, an IMT protocol was followed; later, elderly women continued for 6 months with their daily normal activities. Inspiratory strength, expiratory strength, and functional capacity were measured pre-IMT, post-IMT, and 6 months after intervention. RESULTS: After an 8-week training, respiratory strength and functional capacity increased in both groups. Six months after finishing the intervention, these benefits were lost. Inspiratory strength decreased in the high-loads group but was 32% higher than initial values (p = 0.007); in the low-loads group, patients lost 41% (p = 0.015). Improvements were higher in the high-loads group after training (p = 0.000) and follow-up (p = 0.002). Functional capacity was similar to initial values in both groups. CONCLUSION: The improvements achieved with IMT in elderly women disappeared 6 months after the end of training. High loads were more effective to keep inspiratory strength than low loads.
Subject(s)
Breathing Exercises , Respiratory Muscles , Humans , Female , Aged , Breathing Exercises/methods , Muscle Strength/physiologyABSTRACT
BACKGROUND: Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is presented as a possible solution to attenuate the loss of respiratory function in the elderly. The objective of the study was to evaluate and compare the efficacy of 2 protocols with inspiratory muscle training (IMT), low loads and high loads, to improve respiratory strength, functional capacity and dyspnea in institutionalized elderly women, over 65 years. METHODS: The study was a controlled, randomized, double-blind trial and with allocation concealment performed on 26 institutionalized elderly women distributed in 2 groups, the high-intensity group (HIG) and low-intensity group (LIG). Over an 8-week period an IMT protocol was followed 5 days/week, 15 min/day. The HIG trained with a load of 40% of the maximum inspiratory pressure (MIP) and the LIG with 20%. MIP, maximum expiratory pressure (MEP), functional capacity and dyspnea were evaluated. RESULTS: After training, in the HIG MIP, MEP and functional capacity increased 52, 16 and 7%, respectively (p = 0.000, p = 0.001, p = 0.001) and in the LIG 30, 18 and 9%, respectively (p = 0.002, p = 0.014, p = 0.001). The improvement in MIP was significantly higher in the HIG than in the LIG (p = 0.042). CONCLUSION: IMT with low and high loads improves respiratory muscle strength and functional capacity in institutionalized elderly women. In addition, high loads were significantly more effective to improve MIP.
Subject(s)
Aging/physiology , Breathing Exercises/methods , Dyspnea/therapy , Respiratory Insufficiency , Respiratory Muscles/physiopathology , Aged , Clinical Protocols , Double-Blind Method , Dyspnea/physiopathology , Female , Humans , Male , Muscle Strength/physiology , Outcome Assessment, Health Care , Respiratory Function Tests , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/etiology , Respiratory Insufficiency/physiopathologyABSTRACT
INTRODUCTION: Reduced bone mineral density and increased risk of falls are related with Alzheimer disease, and these increase likelihood of bone osteoporotic fractures causing serious complications such as disability, fear of falling, loss autonomy, decreased quality of life, and anticipated mortality in elderly patients. Gait and balance disturb are 2 factors to favor falls in elderly, and in patients with cognitive impairment, the risk of falls increases to double. Exercise and Mediterranean diet produce beneficial effects for aging, cognitive decline, and are widely recommended to reduce the effects of osteoporosis, fall risk, and related fragility fractures. The primary objective of this study is to evaluate the short and medium-term effects during 6 months, of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, fall risk, balance, and gait by a controlled clinical trial in patients with Alzheimer disease. METHODS: The study is a 6-month, randomized controlled parallel-group, single-blinded clinical trial. Institutionalized patients with Alzheimer disease will be included. The intervention group will perform a multicomponent physical exercise program in reduced groups, with a frequency of 3 sessions per week, associated with a Mediterranean diet. This program includes strength, balance, and aerobic resistance exercises, and in the main part of the session, also ludic exercises to improve agility, coordination, and balance. The control group will receive usual care. The outcomes to assess are the change of physical functions, such as gait and balance, and the change of bone mineral density by calcaneal quantitative ultrasound, during the study follow-up at 1, 3, and 6 months. This clinical trial will generate more and new evidence on the effects of a multicomponent physical exercise program and Mediterranean diet in patients with Alzheimer disease on risk of falls and osteoporotic fractures, the relation of these with bone mineral density, gait and balance, and the correlations between them. ETHICS AND DISSEMINATION: This study protocol has been approved by the Ethics Committee of the University of Salamanca. The results will be published in peer-reviewed journals and disseminated in national and international conferences, to the participants and their families, and the general public through the associations of people with AD. TRIAL REGISTRATION ID: ClínicalTrials.gov ID: NCT04439097.
Subject(s)
Alzheimer Disease/therapy , Bone Density , Diet, Mediterranean , Exercise Therapy/methods , Accidental Falls/prevention & control , Female , Gait , Humans , Male , Postural Balance , Randomized Controlled Trials as TopicABSTRACT
La cognición cotidiana consiste en la aplicación de las habilidades cognitivas básicas y el conocimiento del dominio específico para la resolución de problemas que se integran dentro de los dominios instrumentales de funcionamiento. Para valorar la cognición cotidiana, existen evaluaciones que presentan problemas cotidianos cognitivamente desafiantes, pertenecientes a actividades instrumentales, cuyo objetivo es evaluar el funcionamiento cognitivo dentro de estos dominios en el mundo real. Objetivo principal: Analizar la diferencia existente entre la realización de programas de estimulación cognitiva tradicionales y programas de intervención directa en cognición cotidiana. Metodología: Estudio experimental, aleatorizado, estratificado, prospectivo, longitudinal mediante un esquema de asignación fija con grupo experimental y grupo control. La población a estudio fueron adultos mayores sanos de la ciudad de Salamanca que participaron en los programas de terapia ocupacional. La intervención constó de un programa específico de estimulación en cognición cotidiana. Para la evaluación se utilizó la ERFC (evaluación rápida de las funciones cognitivas) para medir la función cognitiva global y la ECB (Everyday Cognition Battery) para medir la cognición cotidiana. Resultados: Muestra total de pacientes (n = 147) compuesta por 19 hombres y 128 mujeres, con una edad media de 75 años. Se observaron diferencias estadísticamente significativas (p < 0,001) en la variable ECB, así como diferencias estadísticamente significativas (p < 0,05) en los ítems "total", "cálculo", "razonamiento", "comprensión" y "reconocimiento visual". Conclusiones: La utilización combinada de estimulación cognitiva tradicional y entrenamiento en cognición cotidiana presenta mayores beneficios en términos de cognición cotidiana que la utilización exclusiva de estimulación cognitiva en adultos mayores
Everyday cognition consists in the application of basic cognitive skills and the knowledge about a specific domain in problem solving which are integrated within the functional instrumental domains. In order to assess everyday cognition, there are assessments which include challenging cognitive tasks which are categorized as instrumental domains. The aim of these assessments is to assess cognition in the real world. Main objective: To analyze the difference among the implementation conventional of cognitive stimulation programs and the implementation of everyday cognition programs. Methods: Longitudinal prospective stratified randomized control trial. The population study will be older adults living in Salamanca who will participate in occupational therapy programs. The intervention will consist of a specific everyday cognition stimulation program. For the evaluation we used the ERFC (rapid assessment of cognitive functions) to measure global cognitive function and the ECB (everyday cognition battery) to measure daily cognition. Results: Sample size (n=147) composed of 19 males and 128 females with an average age of 75. Statistically significant difference is observed (p<0.001) in ECB variable (Everyday Cognition Battery), and in "total", "calculation", "reasoning", "comprehension" and "visual recognition" items as well (p<0.05). Conclusions: The combination of conventional cognitive stimulation and everyday cognition training has more benefits in terms of everyday cognition than the administration of cognitive stimulation by itself in older adults
Subject(s)
Humans , Male , Female , Aged , Cognitive Behavioral Therapy/methods , Cognitive Remediation/methods , Cognitive Dysfunction/therapy , Activities of Daily Living/psychology , Evaluation of Results of Therapeutic Interventions/methods , Occupational Therapy/methodsABSTRACT
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