ABSTRACT
INTRODUCTION: Concurrent training has been shown to be a beneficial approach to improve overall health status in older adults. However, little is known about the adaptations of this type of training in the long term (i.e., after cessation of exercise), even less in older people affected by frailty syndrome. Therefore, this study aimed (i) to assess the effects of a 6-week concurrent training program composed of power-oriented resistance training and fast walking interval training on physical function, muscle power, disability in activities of daily living and frailty in pre-frail and frail older people, and (ii) to assess the effects of a 6-month detraining period on these outcomes. METHODS: A total of 59 pre-frail and frail older adults (>75 years old; Frailty Phenotype >1) were allocated into intervention (INT; n = 32; 81.8 years; 21 women) or control (CON; n = 27; 82.5 years; 19 women) groups. Primary outcomes of this study were Short Physical Performance Battery (SPPB), relative sit-to-stand (STS) power, Barthel index, Lawton scale and Frailty Phenotype. Assessments were performed at baseline (PRE), after the concurrent training programme (POST) and after 6 months of follow-up (DET) in both groups. Mixed model repeated measures ANOVA with Bonferroni's post hoc tests was used. RESULTS: Immediately after the intervention (∆ = POST-PRE), INT improved SPPB (∆ = 3.0 points; p < 0.001), relative STS power (∆ = 0.87 W·kg-1; p < 0.001) and reduced their frailty levels (∆ = -1.42 criteria; p < 0.001), while no changes were observed in CON. After 6 months of detraining (∆ = DET-PRE), INT showed higher SPPB (∆ = 2.2 points; p < 0.001), higher relative STS power (∆ = 0.73 W·kg-1; p < 0.001) and lower frailty (∆ = -1.24 criteria; p < 0.001) values than those reported at baseline, which were significantly different than those reported by CON. Both, Barthel index and Lawton scale values were not modified during the study in either group. CONCLUSIONS: The 6-week concurrent training program improved physical function, muscle power and reduced frailty in pre-frail and frail older people and these improvements were maintained above baseline levels after 6 months of detraining. However, due to the individual variability found, future studies of long-term responders versus non-responders in frail populations are required.
ABSTRACT
OBJECTIVES: This study aimed i) to compare relative sit-to-stand power (STSrel) values yielded by the different equations reported in the literature; ii) to examine the associations between STSrel, derived from the equations, and age, sex, frailty and habitual gait speed (HGS); and iii) to compare the ability of the different STSrel equations to detect frailty and low HGS in older adults. METHODS: 1568 participants (>65 years) were included. STSrel was calculated according to four validated equations. Frailty was assessed using the Frailty Trait Scale and HGS as the time to complete 3 m. ANOVA tests, regression analyses and receiver operator characteristic curves were used. RESULTS: There were significant differences among the STSrel values yielded by all the equations, which were higher in men compared to women and negatively associated with age (r = -0.21 to -0.37). STSrel was positively and negative associated to HGS and frailty, respectively, in both men (r = 0.29 to 0.36 and r = -0.18 to -0.45) and women (r = 0.23 to 0.45 and r = -0.09 to -0.57) regardless of the equation used. Area under the curve values varied between 0.68 and 0.80 for Alcazar's, 0.67-0.80 for Ruiz-Cárdenas's, 0.51-0.65 for Smith's, and 0.68-0.80 for Takai's equations. Low STSrel indicated an increased probability of having both low HGS and frailty (OR [95%CI] = 1.6 to 4.5 [1.21 to 5.79]) for all equations with the exception of Smith's equations for frailty in women. CONCLUSIONS: All the equations presented adequate criterion validity, however, the Alcazar's equation showed the highest level of clinical relevance according to its ability to identify older people with frailty and low HGS.
