Empowering frail older adults: multicomponent elastic-band exercises and BCAA supplementation unleash physical health and preserve haematological biomarkers.

The effectiveness of Branched Chain Amino Acids (BCAAs) supplementation on enhancing exercise performance in both young and older adults remains a topic of debate. Recent research suggests that BCAAs combined with regular exercise might have an impact on human erythropoiesis, blood dynamics, and iron homeostasis. Given the increasing longevity of the global population, it is crucial to investigate the potential benefits of BCAA supplementation and regular exercise as non-pharmacological interventions for improving the overall health of frail older adults. To assess the influence of a 40-week multicomponent exercise intervention (MEP) combined BCCA supplementation on the haematological indicators of frail older adults (83-93 years old) residing in nursing homes. A prospective, naturalistic, controlled clinical trial employing an intervention-washout-intervention was conducted for this purpose. The study included four experimental groups: MEP plus BCAA supplementation (MEP + BCAA, n = 8), MEP only (n = 7), BCAA supplementation only (n = 7), and control group non exercising (CG, n = 13). Fried's physical frailty (PF) protocol was employed to stratify the participants. Additionally, the assessment included the evaluation of nutritional status, comorbidities, and anthropometric measurements. Among the several haematological markers examined, only mean cellular Haemoglobin Concentration (MCH) [F = 4.09; p < 0.03] and Mean Cell haemoglobin Concentration (MCHC) [F = 10, 323; p < 0,0001] showed significant effects of time group. Our findings demonstrate that a long-term intervention with BCAA plus MEP did not lead to significant alterations in the haematological profile. An 8-week withdrawal from interventions did not affect the frailty status in the MEP and MEP + BCAA groups, whereas the control group exhibited an increase in PF status. The findings, demonstrating the potential pro-immune effect and maintenance of MCH and MCHC levels, highlight the relevance of incorporating exercise and nutritional strategies to promote healthy aging. This study contributes to the achievement of the United Nations Sustainable Development Goals 3 (good health and well-being) and 10 (reduced Inequalities) for all.

L-Glutamine Supplementation Enhances Strength and Power of Knee Muscles and Improves Glycemia Control and Plasma Redox Balance in Exercising Elderly Women.

We investigated the effects of oral L-glutamine (Gln) supplementation, associated or not with physical exercises, in control of glycemia, oxidative stress, and strength/power of knee muscles in elderly women. Physically active (n = 21) and sedentary (n = 23) elderly women aged 60 to 80 years were enrolled in the study. Plasma levels of D-fructosamine, insulin, reduced (GSH) and oxidized (GSSG) glutathione, iron, uric acid, and thiobarbituric acid-reactive substances (TBARs) (lipoperoxidation product), as well as knee extensor/flexor muscle torque peak and average power (isokinetic test), were assessed pre- and post-supplementation with Gln or placebo (30 days). Higher plasma D-fructosamine, insulin, and iron levels, and lower strength/power of knee muscles were found pre-supplementation in the NPE group than in the PE group. Post-supplementation, Gln subgroups showed higher levels of GSH, GSSG, and torque peak, besides lower D-fructosamine than pre-supplementation values. Higher muscle average power and plasma uric acid levels were reported in the PE + Gln group, whereas lower insulin levels were found in the NPE + Gln than pre-supplementation values. TBARs levels were diminished post-supplementation in all groups. Gln supplementation, mainly when associated with physical exercises, improves strength and power of knee muscles and glycemia control, besides boosting plasma antioxidant capacity of elderly women.

Concurrent and Construct Validation of a New Scale for Rating Perceived Exertion during Elastic Resistance Training in The Elderly.

The purpose of the study was to examine the concurrent and construct validity of a new perceptual scale to control the exercise intensity using elastic bands (Resistance Intensity Scale for Exercise; RISE) in the elderly. Twenty-six participants underwent two sessions consisting of 4 exercises. The participants performed three sets of 15 repetitions per exercise of either low, medium, or high intensity. The criterion variables were heart rate and applied force (mean and peak). Following the final repetition of each set, active muscle (AM) and overall body (OB) ratings of perceived exertion (RPE) were collected from RISE and the OMNI-Resistance Exercise Scale of perceived exertion with elastic bands (OMNI-RES EB). Construct validity was established by correlating the perceptual score obtained from both scales, RISE and OMNI-RES EB. Significant (p ≤ 0.05) and positive linear relationships between both scales were found (RPE-AM R2 = 0.90; RPE-OB R2 = 0.77). Significant differences in heart rate, applied force, and RISE scores were observed between the sets of the three intensities. For all 4 analyzed exercises, high-intensity sets elicited higher heart rate, applied force, and perceptual scores compared with the medium- and low-intensity sets. Furthermore, the medium-intensity sets produced higher perceptual, physiologic, and performance responses than the low-intensity sets. Intersession reliability was 0.88 for heart rate, 0.94 and 0.95 for applied force, 0.88 for the RPE-AM, and 0.80 for the RPE-OB. Conclusion: The RISE scale can be considered a valid method for assessing the perceived exertion during resistance exercises performed with elastic bands in the elderly.

The Mediating Effect of Different Exercise Programs on the Immune Profile of Frail Older Women with Cognitive Impairment.

BACKGROUND: Frail individuals experience an accelerated immunosenescence, and exercise has been identified as a therapy to promote a better inflammatory environment. OBJECTIVE: To analyze the effects of 28-weeks of two different exercise protocols on the functional fitness and immune profiles of institutionalized pre-frail and frail women with mild cognitive impairment. METHODS: Participants residing in care homes (n=60, 81±7.84 years old) were randomized into three groups: a chair elastic band muscle-strength exercise (CSE, n=21; 81±4.79), a chair multimodal exercise (CME, n=20; 80±8.19), and a control non-exercise (CGne, n=19; 80±10.01). Both CME and CSE groups performed progressive circuit-training exercise sessions. The controls did not change their usual lifestyle. The Fried protocol and the Mini-Mental State Examination questionnaire were used to identify the frail subgroups and the participants with mild cognitive impairment. Data for anti and pro-inflammatory markers and physical fitness were analyzed pre and post-interventions. RESULTS: After the intervention, a significant effect of time and time by group for sIgA and time by group for IL- 10 levels were found (p > 0.05). Within-group analysis showed a significant moderate decrease in the TNF-α to IL-10 ratio for the CME group and an increase in the controls (p > 0.05) and a slight reduction in the IL-6 and IL- 1ß concentrations. The controls showed a negative trend towards a decrease in physical fitness and a trend for increased levels in the pro-inflammatory markers IL-6 and IL-1ß. CONCLUSION: The evidence regarding the use of systematic and moderate long-term exercise as therapy for promoting a better balance between pro- and anti-inflammatory environments and a decrease in the inflammatory index for the CME group were the most promising results from this study.

Strength Training Decreases Inflammation and Increases Cognition and Physical Fitness in Older Women with Cognitive Impairment.

Introduction: Cognitive impairment that affects older adults is commonly associated with an inflammatory imbalance, resulting in decreased physical fitness. Exercise has been pointed to mitigate immunosenescence and cognitive impairment associated with aging, while increase in physical fitness. However, few studies explored the relationship between changes in cytokine concentration and improvement on cognition due to elastic band strength training. The aim of this study was to investigate the effects of strength training on pro-and anti-inflammatory cytokines, hematological markers and physical fitness of older women with cognitive impairment. Methods: Thirty-three women (82.7 ± 5.7 years old) participated in the study and were divided in two groups: strength exercise training group (ST; n = 16) and Control Group (CG; n = 17) and were evaluated before and after 28 weeks of the exercise program. The CG did not undergo any type of exercise programs. Data for IL-10, TNF-α, IFN-γ, C-Reactive Protein (CRP), white blood counts (WBC), red blood counts (RBC), Mini Mental State Examination (MMSE) and physical fitness tests were analyzed in both moments. Results: IL-10 increased in the ST group without changes in CG. TNF-α and CRP increased in the control group while no changes were observed for IFN-γ in both groups. Strength training decreased leukocyte and lymphocyte counts and increase hemoglobin, mean cell volume and mean cell hemoglobin concentration. The MMSE score increased in strength training group but remained unchanged in the control group. A correlation between the variation of granulocyte counts and the MMSE scores was also observed within the total sample. An improvement in physical fitness was observed with strength training. Conclusion: Resistance exercise promoted better anti-inflammatory balance and physical performance simultaneously with an increase in cognitive profile in older women with cognitive impairment.

Dor, qualidade de vida, autopercepção de saúde e depressão de pacientes com fibromialgia, tratados com hidrocinesioterapia / Pain, quality of life, self perception of health and depression in patients with fibromyalgia, submited to hydrocinesiotherapy

OBJETIVOS: Analisar os efeitos do tratamento hidrocinesioterapêutico na qualidade de vida, percepção de dor e gravidade de episódios depressivos em um grupo de pacientes com fibromialgia. MATERIAIS E MÉTODOS: Foram avaliados 64 indivíduos do sexo feminino, separados em dois grupos: hidrocinesioterapia (n = 33; 58,2 ± 10,6 anos) e grupo controle (n = 31; 59,6 ± 9,4 anos), com diagnóstico de fibromialgia. Os indivíduos foram avaliados através da Escala Analógica Visual de Dor (EVA), o Fibromyalgia Impact Questionnaire (FIQ), e o Inventário de Beck. Os participantes foram submetidos a um tratamento hidrocinesioterápico numa piscina aquecida a 33ºC com duas sessões de 45 minutos por semana, ao longo 15 semanas, num total de 30 sessões. Os exercícios subaquáticos foram: de condicionamento cardiovascular, de força, de mobilidade, de coordenação, de equilíbrio, de alongamento e de relaxamento muscular. Utilizou-se a ANOVA 2×2 e Kruskal-Wallis para análise estatística. RESULTADOS: Foram observadas melhorias estatisticamente significativas na percepção da intensidade da dor (Δ% = -28,2%, p < 0,01), na qualidade de vida (Δ% = -32,4%, p < 0,05) e nos sintomas de depressão (Δ% = -35,4%, p < 0,05) favoráveis ao grupo hidrocinesioterapia comparado ao grupo controle. CONCLUSÕES: O estudo sugere que a hidrocinesioterapia mostrou-se eficaz como terapia alternativa da fibromialgia. No entanto, recomenda novos estudos que testem as associações existentes entre as variáveis analisadas e os programas de intervenção, utilizando as atividades aquáticas, bem como a modificabilidade dos parâmetros de saúde física e psíquica quando estes indivíduos são submetidos a programas de curta, média e longa duração.

OBJECTIVES: The aim of this study was to analyze the effects of treatment by hydrotherapy on quality of life, perception of pain and the severity of depression in a group of patients with fibromyalgia. MATERIALS AND METHODS: We evaluated 64 females divided into two groups: hydrocinesiotherapy (n = 33, 58.2 ± 10.6 years) and control group (n = 31 with 59.6 ± 9.4 years) with clinical diagnosis of fibromyalgia. Individuals were assessed by Visual Analog Scale of Pain (VAS), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory. Participants underwent a treatment in a hydrotherapy pool heated to 33ºC over a period of 15 weeks, two sessions per week of 45 minutes, a total of 30 sessions. The exercises were underwater: cardiovascular conditioning, strength training, mobility, coordination, balance and still, stretching exercises and muscle relaxation. The ANOVA 2×2 and Kruskall-Wallis was used for statistical analysis RESULTS: There were statistically significant improvements in the perception of pain intensity (Δ% = -28.2%, p < 0, 01), quality of life (Δ% = -32.4%, p < 0, 05) and depression symptoms (Δ% = -35.4%, p < 0, 05) in favor of the Hydrotherapy group compared to the control group. CONCLUSIONS: The study suggests that hydrocinesiotherapy was effective as an alternative therapy for fibromyalgia, however further studies are recommended to test the associations between the variables and intervention programs and using the water activities, and the modifiability of the parameters of physical and mental health when these individuals undergo programs of short, medium and long duration.

Pain, quality of life, self perception of health and depression in patients with fibromyalgia, submited to hydrokinesiotherapy.

OBJECTIVES: The aim of this study was to analyze the effects of treatment by hydrotherapy on quality of life, perception of pain and the severity of depression in a group of patients with fibromyalgia. MATERIALS AND METHODS: We evaluated 64 females divided into two groups: hydrocinesiotherapy (n = 33, 58.2 ± 10.6 years) and control group (n = 31 with 59.6 ± 9.4 years) with clinical diagnosis of fibromyalgia. Individuals were assessed by Visual Analog Scale of Pain (VAS), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory. Participants underwent a treatment in a hydrotherapy pool heated to 33ºC over a period of 15 weeks, two sessions per week of 45 minutes, a total of 30 sessions. The exercises were underwater: cardiovascular conditioning, strength training, mobility, coordination, balance and still, stretching exercises and muscle relaxation. The ANOVA 2 × 2 and Kruskall-Wallis was used for statistical analysis RESULTS: There were statistically significant improvements in the perception of pain intensity (Δ% = -28.2%, p < 0, 01), quality of life (Δ% = -32.4%, p < 0, 05) and depression symptoms (Δ% = -35.4%, p < 0, 05) in favor of the Hydrotherapy group compared to the control group. CONCLUSIONS: The study suggests that hydrocinesiotherapy was effective as an alternative therapy for fibromyalgia, however further studies are recommended to test the associations between the variables and intervention programs and using the water activities, and the modifiability of the parameters of physical and mental health when these individuals undergo programs of short, medium and long duration.