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.

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.

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.

Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study.

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Prevalence of Metabolic Syndrome and Association with Physical Activity and Frailty Status in Spanish Older Adults with Decreased Functional Capacity: A Cross-Sectional Study.

Metabolic syndrome (MetS) is a cluster of medical conditions associated with several health disorders. MetS and frailty can be related to prolonged physical deconditioning. There is a need to know whether there is concordance between the different ways of diagnosing it and to know their prevalence in Spanish older adults. Thus, the aims of this study were to describe the prevalence of MetS; to analyse the concordance between different definitions to diagnose MetS; and to study the associations between MetS, frailty status, and physical activity (PA) in older adults with decreased functional capacity. This report is a cross-sectional study involving 110 Spanish older adults of ages ≥65 years with decreased functional capacity. Clinical criteria to diagnose MetS was defined by different expert groups. Anthropometric measurements, blood biochemical analysis, frailty status, functional capacity, and PA were assessed. The Kappa statistic was used to determine the agreement between the five MetS definitions used. Student's t-test and the Pearson chi-square test were used to examine differences between sex, frailty, and PA groups. The sex-adjusted prevalence of MetS assessed by the National Cholesterol Education Program-Third Adult Treatment Panel was 39.4% in men and 32.5% in women. The International Diabetes Federation and the Harmonized definitions had the best agreement (k = 1.000). The highest odds ratios (ORs) of cardiometabolic risk factors to develop MetS were elevated triglycerides (37.5) and reduced high-density lipoprotein cholesterol (27.3). Central obesity and hypertension prevalence were significantly higher in the non-active group (70.7% and 26.8%, respectively), compared to the active group (50.0% and 7.7%, respectively). Moreover, the active group (OR = 0.85, 95% CI = 0.35, 2.04) and active women group (OR = 0.77, 95% CI = 0.27, 2.20) appeared to show a lower risk of developing this syndrome. MetS is highly prevalent in this sample and changes according to the definition used. It seems that sex and frailty do not influence the development of MetS. However, PA appears to decrease central obesity, hypertension, and the risk of developing MetS.

Functional Frailty, Dietary Intake, and Risk of Malnutrition. Are Nutrients Involved in Muscle Synthesis the Key for Frailty Prevention?

Frailty is a reversible condition, which is strongly related to physical function and nutritional status. Different scales are used to screened older adults and their risk of being frail, however, Short Physical Performance Battery (SPPB) may be more adequate than others to measure physical function in exercise interventions and has been less studied. Thus, the main aims of our study were: (1) to describe differences in nutritional intakes by SPPB groups (robust, pre-frail and frail); (2) to study the relationship between being at risk of malnourishment and frailty; and (3) to describe differences in nutrient intake between those at risk of malnourishment and those without risk in the no-frail individuals. One hundred one participants (80.4 ± 6.0 year old) were included in this cross-sectional study. A validated semi-quantitative food frequency questionnaire was used to determine food intake and Mini Nutritional Assessment to determine malnutrition. Results revealed differences for the intake of carbohydrates, n-3 fatty acids (n3), and saturated fatty acids for frail, pre-frail, and robust individuals and differences in vitamin D intake between frail and robust (all p < 0.05). Those at risk of malnutrition were approximately 8 times more likely to be frail than those with no risk. Significant differences in nutrient intake were found between those at risk of malnourishment and those without risk, specifically in: protein, PUFA n-3, retinol, ascorbic acid, niacin equivalents, folic acid, magnesium, and potassium, respectively. Moreover, differences in alcohol were also observed showing higher intake for those at risk of malnourishment (all p < 0.05). In conclusion, nutrients related to muscle metabolism showed to have different intakes across SPPB physical function groups. The intake of these specific nutrients related with risk of malnourishment need to be promoted in order to prevent frailty.

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study.

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

Statistical Differences in Set Analysis in Badminton at the RIO 2016 Olympic Games.

The aim of the present study was to determine statistical differences in a set of badminton competition matches in five different modalities with regard to competition level (Group Phase vs. Eliminatory Phase). Data from 453 sets (125 in men's singles; 108 sets in women's singles; 77 sets in men's doubles; 73 in women's doubles and 70 in mixed doubles) from the RIO 2016 Olympics Games were recorded and classified in two groups of variables to analyze variables related to match (5) and set (15). A descriptive analysis and univariate test (Mann-Whitney U) for non-parametric data were conducted. The results show in men's and women's singles all the variables related to match were higher in the Elimination Phase than in the Group Phase (p < 0.01). In Sets 1 and 3, the longest set duration, rally and average rally were found in the Elimination Phase than Group Stage (p < 0.05). In women's singles, these differences were also recorded in Set 2. For doubles, the results are more stable among groups. Men's doubles had a longer duration of the match and set (sets 1 and set 2) (p < 0.01), and also scored highest for average rally strokes (sets 1 3) (p < 0.05) and shuttles used in the Elimination Phase vs. the Group Phase along the match (p < 0.01). In women's doubles, more shuttles were used in a match in the Elimination than in the Group Phase. Moreover, the same results are established for Set 2, including for average rally. Mixed doubles saw no match going to three sets. However, the greatest differences showed a longer rally and average rally being registered in the Elimination than in the Group Phase. In conclusion, the timing factors of the badminton singles and doubles games were different in the Elimination and Group Phases. This information may help players and coaches prepare and administer different types of workouts or, more specifically, competition schedules adapted to the characteristics of modern badminton.

Design and Validation of an Observational Instrument for the Technical-Tactical Actions in Singles Tennis.

The competitive performance in tennis practice is determined by the effectiveness of technical tactical action. The main objective of the present study was to design and validate an observational instrument with the aim of analysing the technical-tactical in singles tennis. The instrument uses the stroke as a unit of measure, so that each time a player hits a ball, a total of 23 variables are analyzed. The variables collect information about: (a) matching context; (b) result; and (c) technical-tactical information of the stroke (five variables: sequences of the stroke of the point, kind of technical and tactical stroke, bounce area, hitting, and effectiveness area). The design and validation of the instrument consisted on five different stages: (a) review of the scientific literature and variables definition by experts, (b) pilot observation study, (c) qualitative and quantitative assessment of the instrument by experts, (d) review and confirmation of the instrument by experts (content validity), and (e) observation training and reliability evaluation. From 23 expert judges, divided into three panels, and four observers the instrument went from being composed of 38 variables (eight contextual, seven related to the result and 23 related to the game) to 23 (eight contextual variables, 10 of result and five of game), with minimum Aikens's V values of 0.94 and reliability of 0.81. The results show that the designed instrument allows obtaining valid and objective information about the technical-tactical actions of the players and their performance in singles tennis.

Differences in game statistics between winning and losing for male wheelchair tennis players in Paralympics Games

Aims: The aim of the present study was to analyze the differences in wheelchair tennis game statistics between winning and losing sets. Methods: Data were collected from the 139 sets of 64 matches played by 64 males' players in the 2012 Paralympics Games. The variables studied were grouped in four groups: variables related to serve, to return, to winners and errors, and to net point. Data was collected from official website of the Paralympics Games. A univariate (Wilcoxon test) and multivariate (discriminant) analysis of data was done to the study the four groups of variable in relation to the result of the set (win or lose). Results: The result showed that winning players commit fewer errors and achieved more winning shots than losing players. Conclusion: The values presented could be used as a reference for practice and competition in wheelchair tennis players.(AU)