The Functional Effects of Physical Exercise Training in Frail Older People

Department of Public and Occupational Health, VU University Medical Center, Amsterdam, the Netherlands.
Sports Medicine (Impact Factor: 5.32). 02/2008; 38(9):781-93. DOI: 10.2165/00007256-200838090-00006
Source: PubMed

ABSTRACT This systematic review describes the effect of exercise training on physical performance in frail older people. Randomized controlled trials were identified from searches in PubMed, EMBASE and CENTRAL from January 1995 through August 2007. Two reviewers independently screened the trials for eligibility, rated their quality, and extracted data. Randomized controlled trials that examined the effects on performance-based measures of physical function among frail older adults were included. The systematic search identified 20 studies, examining 23 different exercise programmes. The methodological quality score (0-9) of the trials ranged from 2 to 7 points. Sixteen of the studies were scored as high quality. There was a large variety in the studies concerning sample size, degree of frailty, types of interventions and types of assessments. The majority of the programmes were facility-based, group-exercise programmes that were performed three times a week for 45-60 minutes. The intervention programmes comprised resistance training (n = 9), Tai Chi training (n = 2), or multi-component training (n = 12). Six of the total selected 20 studies did not find a beneficial exercise effect on functional performance. This systematic review suggests that older adults with different levels of abilities can improve their functional performance by regular exercise training. To determine the most appropriate design of the exercise programme (type, intensity, frequency and duration of exercise) for functional improvement or prevention of loss of function, more high-quality trials are needed in which different training protocols are compared.

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    • "Benefits were overall equivalent in frail and nonfrail participants . Improvement in physical capacity replicates past findings with frails seniors ( Chin et al . , 2008 ) , although some stud - ies did not report such benefits ( Faber , Bosscher , Chin , & van Wieringen , 2006 ) . Positive results report here might be related to individualize adapted training , which might have maximized training effects . Although past studies reported exercise - induced improvement in cognition in healthy older adult"
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    ABSTRACT: Objectives.Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented.Method.A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life. RESULTS: Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants.Discussion.Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 08/2012; 68(3). DOI:10.1093/geronb/gbs069 · 2.85 Impact Factor
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    • "In accordance with the Cochrane library if there is substantial clinical diversity a qualitative approach combining studies is appropriate. Previous systematic reviews on exercise and frailty [16] [17] did not conduct a meta-analysis for similar reasons. Subgroup analysis was done to examine factors that may explain the variability of these results. "
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    ABSTRACT: This systematic review examines the effectiveness of current exercise interventions for the management of frailty. Eight electronic databases were searched for randomized controlled trials that identified their participants as "frail" either in the title, abstract, and/or text and included exercise as an independent component of the intervention. Three of the 47 included studies utilized a validated definition of frailty to categorize participants. Emerging evidence suggests that exercise has a positive impact on some physical determinants and on all functional ability outcomes reported in this systematic review. Exercise programs that optimize the health of frail older adults seem to be different from those recommended for healthy older adults. There was a paucity of evidence to characterize the most beneficial exercise program for this population. However, multicomponent training interventions, of long duration (≥5 months), performed three times per week, for 30-45 minutes per session, generally had superior outcomes than other exercise programs. In conclusion, structured exercise training seems to have a positive impact on frail older adults and may be used for the management of frailty.
    Journal of aging research 04/2011; 2011:569194. DOI:10.4061/2011/569194
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    • "The benefits of physical activity to prevent disability and/or functional performance derive not only from observational studies. Several randomized clinical trials have demonstrated the positive effects of specific physical activity programs in diseased or frail older adults (Ettinger et al. 1997; Chin et al. 2008; Daniels et al. 2008; Binder et al. 2005; Messier et al. 2000). For example, in FAST study (Ettinger et al. 1997), a randomized trial conducted among 439 community dwelling older adults with knee osteoarthritis, selfreported physical function was significantly improved among those participating in an 18-months aerobic exercise training or resistance exercise training program , as opposed to those participating in a health Table 1 Data from clinical trials on the benefits and potential risks of different types of exercise aimed at preventing frailty in older persons Endurance training (also called cardiovascular or aerobic training) Resistance training (also called strength training or weight lifting) General principles (Elsawy and Higgins 2010) Use of large muscle groups Many repetitions At low resistance Contraction of various muscle groups Few times against a moderate or high resistance Specific recommendations (Carnethon et al. 2009) Choose a low impact of aerobic exercise. "
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    ABSTRACT: Frailty is a common condition in older persons and has been described as a geriatric syndrome resulting from age-related cumulative declines across multiple physiologic systems, with impaired homeostatic reserve and a reduced capacity of the organism to resist stress. Therefore, frailty is considered as a state of high vulnerability for adverse health outcomes, such as disability, falls, hospitalization, institutionalization, and mortality. Regular physical activity has been shown to protect against diverse components of the frailty syndrome in men and women of all ages and frailty is not a contra-indication to physical activity, rather it may be one of the most important reasons to prescribe physical exercise. It has been recognized that physical activity can have an impact on different components of the frailty syndrome. This review will address the role of physical activity on the most relevant components of frailty syndrome, with specific reference to: (i) sarcopenia, as a condition which frequently overlaps with frailty; (ii) functional impairment, considering the role of physical inactivity as one of the strongest predictors of physical disability in elders; (iii) cognitive performance, including evidence on how exercise and physical activity decrease the risk of early cognitive decline and poor cognition in late life; and (iv) depression by reviewing the effect of exercise on improving mood and increasing positive well-being.
    Biogerontology 10/2010; 11(5):537-45. DOI:10.1007/s10522-010-9296-1 · 3.01 Impact Factor
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