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多组分训练和去训练对衰弱前期老年人的衰弱状态、身体活动水平、久坐行为模式及身体机能的影响:一项随机对照试验

Effects of a multicomponent training and detraining on frailty status, physical activity level, sedentary behavior patterns and physical performance of pre-frail older adults: a randomized controlled trial.

作者信息

Carnavale Bianca Ferdin, da Silva Santos Vinícius Ramon, Farche Ana Claudia Silva, Rossi Paulo Giusti, Fiogbé Elie, de Souza Buto Marcele Stephanie, de Vassimon-Barroso Verena, de Medeiros Takahashi Anielle Cristhine

机构信息

Department of Physical Therapy, UFSCar Federal University of São Carlos, Road Washington Luiz, Km 235, São Carlos, SP, 13565-905, Brazil.

Research Laboratory of Older Adults' Health (LaPeSI), Federal University of São Carlos, São Carlos, Brazil.

出版信息

Eur Geriatr Med. 2024 Dec;15(6):1701-1712. doi: 10.1007/s41999-024-01052-4. Epub 2024 Sep 11.

Abstract

PURPOSE

To evaluate the effects of a multicomponent training protocol and detraining on frailty status, physical activity level, sedentary behavior patterns, and physical performance in pre-frail older adults.

METHODS

A randomized controlled blinded trial was conducted with pre-frail older adults (74.8 ± 6.4 years, 70.4% female), who were allocated to receive a multicomponent training (MulTI = 16) or control group (CG = 11), which received guidance to maintain their daily living habits. Assessments of the frailty phenotype, physical activity levels measured by accelerometer, and physical performance (gait speed, timed up and go, short physical performance battery) were conducted at pre-intervention, post-intervention (16 weeks), and follow-up (6 weeks). The effect of the intervention was analyzed using the marginal homogeneity test and the two-way ANOVA with repeated measures.

RESULTS

All older adults who received the MulTI reversed their frailty status to non-frail (p < 0.001), and after follow-up, 87.5% remained non-frail. In the CG, one older adult reversed their frailty status to non-frail and another became frail (p > 0.05), maintaining this status after the follow-up period. Furthermore, only the older adults in the MulTI showed an improvement in gait speed post-intervention, which was maintained through follow-up (p = 0.008). No changes were observed in the other variables.

CONCLUSION

The MulTI was efficient to reverse the process of frailty and improving gait speed in pre-frail older adults. However, receiving only the MulTI was not sufficient to increase physical activity levels and reduce sedentary behavior patterns, necessitating the implementation of behavioral change strategies.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03110419.

摘要

目的

评估多组分训练方案及停训对衰弱前期老年人衰弱状态、身体活动水平、久坐行为模式和身体机能的影响。

方法

对衰弱前期老年人(74.8±6.4岁,女性占70.4%)进行了一项随机对照双盲试验,将其分为接受多组分训练组(MulTI=16人)或对照组(CG=11人),对照组接受维持日常生活习惯的指导。在干预前、干预后(16周)和随访(6周)时,对衰弱表型、通过加速度计测量的身体活动水平以及身体机能(步速、定时起立行走测试、简短身体机能测试)进行评估。使用边际齐性检验和重复测量的双向方差分析来分析干预效果。

结果

所有接受多组分训练的老年人衰弱状态均逆转至非衰弱(p<0.001),随访后,87.5%仍保持非衰弱状态。在对照组中,一名老年人衰弱状态逆转至非衰弱而另一名老年人变得衰弱(p>0.05),随访期后维持此状态。此外,只有多组分训练组的老年人干预后步速有所改善,并在随访期保持(p=0.008)。其他变量未观察到变化。

结论

多组分训练方案能有效逆转衰弱前期老年人的衰弱进程并提高步速。然而,仅接受多组分训练不足以提高身体活动水平和减少久坐行为模式,需要实施行为改变策略。

试验注册

ClinicalTrials.gov NCT031104

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