[Effects of cardiac rehabilitation on the physical capacity of individuals with heart failure].

PURPOSE: Limited information is available on the effects of cardiac rehabilitation (CR) on individuals with heart failure (HF) in Iceland. The aim of this study was to analyze whether CR yielded increased physical capacity (PC) (w/kg) as measured by maximum exercise test at the end of the training period. MATERIALS AND METHODS: This is a retrospective data study from January 2010 to June 2018. Participants were patients with HF and also patients with ejection fraction (EF) 45% or less. Age and other diagnoses did not limit participation. Information about EF and exercise test at the beginning and end of the training period had to be recorded. Relative change in PC on these tests was evaluated by general linear models for repeated measurements. During the study period, 112 participants were enrolled, 27 did not finish the training period and 9 had incomplete data. Data from 76 participants aged 36-83 were analyzed. RESULTS: Participants' PC increased on average by 16% (p<0.001; confidence interval 13-18%). On average, those who attended training more than twice a week improved their PC by 18% which is -significantly more than those who trained twice or less who improved by 6%. The age group 65-83 improved by 19%, which is significantly more compared to the age group 36-64, which added 12%. No significant difference was in improvement between groups with EF under 40% or 40% and more. CONCLUSION: Focused CR for individuals with HF and individuals with impaired EF resulted in increased PC.

Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: a randomized-controlled cross-over design.

BACKGROUND: Older adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults. METHODS: For this study, 117 participants, 71 to 90 years old, were randomized in immediate intervention group and a control group (delayed intervention group). The intervention consisted of daily endurance and twice-a-week strength training. The method was based on a randomized-controlled cross-over design. Short Physical Performance Battery (SPPB), 8 foot up-and-go test, strength performance, six min walking test (6 MW), physical activity, BMI and quality of life were obtained at baseline, after a 6-month intervention- and control phase, again after 6-month crossover- and delayed intervention phase, and after anadditional 6-month follow-up. RESULTS: After 6 months of MTI, the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery (SPPB) score (mean diff = 0.6, 95 % CI: 0.1, 1.0) and 8-foot up-and-go test (mean diff = -1.0 s, 95 % CI: -1.5, -0.6), and in endurance performance via 6-minute walking test (6 MW) (mean diff = 44.2 meters, 95 % CI: 17.1, 71.2). In strength performance via knee extension the intervention group improved while control group declined (mean diff = 55.0 Newton, 95 % CI: 28.4, 81.7), and also in PA (mean diff = 125.9 cpm, 95 % CI: 96.0, 155.8). Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4: SPPB (1.1 points, 95 % CI: 0.8, 1.4); 8-foot up-and-go (-0.9 s, 95 % CI: -1.2, -0.6); 6 MW (18.7 m, 95 % CI: 6.5, 31.0); knee extension (4.2 Newton, 95 % CI: -10.0, 18.3); hand grip (6.7 Newton, 95 % CI: -4.4, 17.8); PA (-4.0 cpm, 95 % CI: -33.9, 26.0); BMI (-0.6 kg/m2, 95 % CI: -0.9, -0.3) and Icelandic quality of life (0.3 points, 95 % CI: -0.7, 1.4). CONCLUSIONS: Our results suggest that regular MTI can improve and prevent decline in functional fitness in older individuals, influence their lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care. TRIAL REGISTRATION: This study was approved by the National Bioethics Committee in Iceland, VSNb20080300114/03-1.

[The effects of 6 months' multimodal training on functional performance, strength, endurance, and body mass index of older individuals. Are the benefits of training similar among women and men?]. / Áhrif 6 mánaða fjölþættrar þjálfunar á hreyfigetu, vöðvakraft, þol og líkamsþyngdar stuðul eldri einstaklinga. Eru áhrif þjálfunar sambærileg hjá konum og körlum?

INTRODUCTION: Good functional performance in elderly people greatly improves their changes of independence and well-being. Conversely, bad functional performance can impair their capability of managing the activities of daily life.. The main goal of this study was to investigate the effects of a 6-months' multimodal training intervention on the physical performance of males and females, possible gender differences and the outcome 6 and 12 months after its completion. MATERIAL AND METHODS: This study examined 71-90 year old healthy seniors (n=117) participating in the AGES Reykjavik Study. It was a randomized and controlled cross-over trial, conducted in three 6-months' phases (time-points). After enrollment and baseline assessments, the study group was divided in two. Group 1 received 6-months' training while group 2 served as a control. In the second 6 months' phase, group 1 received no formal training while group 2 did. In the third phase, neither group received training. The groups' physical conditions were assessed after each phase. RESULTS: After 6-months' training, 32% improvement was seen in physical activity among males (p<0.001) and 39% among females (p<0.001). In physical performance, 5% improvement was seen for males (p<0.01) and 7% for females (p<0.001). Strength increased by 8% for males (p<0.001) and 13% for females (p<0.001). For both sexes, about 10% increase was seen in dynamic balance in the 8-foot up-and-go test (p<0.001) and 5-6% in walking distance for both sexes in the six minutes walking test (p<0.001). For both sexes, body mass index decreased by about 2% (p<0.001). No difference was seen between the sexes.in the training results. Both sexes retained long-term effects of the training on physical performance and dynamic balance for at least 12 months. CONCLUSIONS: Multimodal training intervention has positive effects on physical performance in older individuals, the sexes respond similarly to the training and retain achieved improvement for at least 12 months. The research indicates that moderate and systemic training for this age group could be a part of conventional health service for this age group.