Muscle strength training program in nonagenarians – a randomized controlled trial

Carral, José Maria Cancela; Rodríguez, Adriana López; Cardalda, Irimia Mollinedo; Bezerra, José Pedro Arieiro Gonçalves

doi:10.1590/1806-9282.65.6.851

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Original Article • Rev. Assoc. Med. Bras. 65 (6) • June 2019 • https://doi.org/10.1590/1806-9282.65.6.851 copy

Muscle strength training program in nonagenarians – a randomized controlled trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVES:

The study aims to improve the functional capacity and quality of life (QOL) of nonagenarian women by implementing an individualized muscle strength training program in a geriatric residential care home.

STUDY DESIGN:

A randomized controlled trial

METHODS:

Twenty-six elderly women were randomized into a control group (CG) and an intervention group (SG). The SG carried out a strength program with TheraBands® for 12 weeks, with two weekly sessions. The assessment tools that we used pre- and post-intervention were the Barthel index of daily living activities, the five times sit-to-stand test (FTSTS) and timed up and go (TUG) test with wiva® sensors.

RESULTS:

The SG maintained the Barthel index scores for activities of daily living and improved in the FTSTS; the CG showed a significant decrease on both tests. The dynamic balance test showed significant differences between groups for the variables sit to stand, peak angular velocity, anterior-posterior range, turning, stand to sit, total time, and speed.

CONCLUSIONS:

Individualized muscle strength training programs may help promote healthy lifestyles in such populations by maintaining autonomy, improving function and balance.

KEYWORDS:
Exercise Therapy; Exercise; Frailty; Postural Balance; Quality of Life; Aged

Week	1-2		3-5		6-7		8-10		11		12
Session	Type A	Type B	Type C	Type D	Type E	Type F	Type E	Type F	Type E	Type F	Type E	Type F
Methodology	2 exercises 10 reps x 2 series x exercise Pause: 40s/10reps; 60s/exercise		2+1 exercises 15 reps x 3 series x exercise Pause: 40s/15reps; 60s/exercise		3 +1 exercises 15 reps x 3 series x exercise Pause: 40s/15reps; 60s/exercise		3 +1 exercises 15 reps x 3 series x exercise Pause: 35s/15reps; 55s/exercise		3 +1 exercises 15 reps x 3 series x exercise Pause: 30s/15reps; 45s/exercise		3 +1 exercises 15 reps x 3 series x exercise Pause: 0s/exercise
Warm-up	Foot Abduction and adduction./ Heel movements. /Circumduction with the foot. / Plantar flexors with ankle extension.
Principal Phase	Ankle extension. Ankle abduction and adduction. with hip rotation	Knee flexion/extension. Hip flexion	Knee flexion/extension Hip flexion Hip flexion and abduction	Ankle extension. Ankle abduction and adduction. with hip rotation Hip flexion and abduction	Knee flexion/extension Hip flexion Hip flexion and abduction Plantar flexion	Ankle extension. Ankle abduction and adduction. with hip rotation Knee flexion Hip abduction	Knee flexion/extension Hip flexion Hip flexion and abduction Plantar flexion	Ankle extension. Ankle abduction and adduction. with hip rotation Knee flexion Hip abduction	Knee flexion/extension Hip flexion Hip flexion and abduction Plantar flexion	Ankle extension. Ankle abduction and adduction. with hip rotation Knee flexion Hip abduction	Knee flexion/extension Hip flexion Hip flexion and abduction Plantar flexion	Ankle extension. Ankle abduction and adduction. with hip rotation Knee flexion Hip abduction
Calm down	Hip abduction without TheraBands®, both legs simultaneously. Foot crossing.

		Total (n = 24)		Strength Training Group (n = 11)		Control Group (n = 13)
		Mean	SD	Mean	SD	Mean	SD
Age, y		90.63	4.43	90.18	4.02	91.00	4.88
Height, cm		151.35	7.10	151.20	7.40	151.50	6.80
Weight, kg		59.48	10.06	60.95	8.47	58.23	11.42
Cognition mini-exam⁹9. Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population. Med Clin (Barc). 1999;112(20):767-74.		14.30	6.38	13.36	6.86	15.17	6.07
Educational background, %	No studies	54.20		54.50		53.80
	Primary	29.20		27.30		30.8
	Secondary	8.30		9.10		7.70
	University	8.30		9.10		7.70

		Strength Training Group (n = 11)				Control Group (n = 13)
		Pre-test		Post-test		Pre-test		Post-test
		Mean	SD	Mean	SD	Mean	SD	Mean	SD
BMI, kg/m²		30.82	2.93	27.18	4.25^* * p < 0.05,	30.66	2.31	30.60	5.20^$ $ p < 0.05,
FTSTS, s		16.53	4.86	12.74	3.12^ p<0.005 significant differences intra-group,	16.17	3.77	17.70	4.88^* * p < 0.05, ^$ $ p < 0.05,
Barthel Index		65.91	24.68	66.87	25.34	66.92	20.67	51.67	21.65^* * p < 0.05, ^$ $ p < 0.05,
Dynamic balance
TUG: Sit to Stand
	Sit to stand, s	4.40	2.43	4.58	3.02	4.22	1.66	6.16	8.67^* * p < 0.05, ^$ $ p < 0.05,
	Peak Angular Velocity, º/s	9.60	2.94	9.24	4.62	8.77	3.25	5.71	3.64^* * p < 0.05, ^$ $ p < 0.05,
	AP Range, m/s²2. Walston J, Fried LP. Frailty and the older man. Med Clin North Am. 1999;83(5):1173-94.	5.08	1.93	5.72	2.06	5.42	1.90	4.19	2.04^* * p < 0.05, ^$ $ p < 0.05,
	PD Range, m/s²2. Walston J, Fried LP. Frailty and the older man. Med Clin North Am. 1999;83(5):1173-94.	1.73	0.80	2.64	1.37	2.69	0.75	2.29	0.99
	ML Range, m/s²2. Walston J, Fried LP. Frailty and the older man. Med Clin North Am. 1999;83(5):1173-94.	2.43	1.26	2.66	1.31	2.19	0.29	1.48	0.69
TUG: Go
	Gait go, s	8.05	3.56	7.53	6.12	9.06	4.65	9.87	4.78
TUG: Turning
	Turning, s	4.58	2.22	5.45	3.29^* * p < 0.05,	7.66	4.42	8.09	5.28^$ $ p < 0.05,
TUG: Return
	Gait return, s	7.98	3.10	7.01	2.54	9.82	4.86	9.53	0.78
TUG: Stand to Sit
	Stand to sit, s	3.04	2.60	3.16	1.94	4.36	1.28	4.97	0.75^* * p < 0.05, ^$ $ p < 0.05,
	Peak Angular Velocity, º/s	129.42	124.12	127.03	76.34	99.98	42.13	98.00	39.15
TUG: total
	Total Time, s	28.05	9.99	27.73	11.62	35.12	11.59	38.62	15.44^* * p < 0.05, ^$ $ p < 0.05,
	Speed, m/s	0.21	0.08	0.22	0.09	0.17	0.06	0.15	0.06^* * p < 0.05, ^$ $ p < 0.05,

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[1] CORRESPONDING AUTHOR: José M. Cancela Carral, Campus A Xunqueria s/n E-36005, Faculty of Education Science and Sports, Pontevedra, Spain Tel: 0034 986801799, Fax: 0034 986801701 E-mail: chemacc@uvigo.es