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      El ejercicio físico multicomponente como herramienta de mejora de la fragilidad en personas mayores Translated title: Multi-component physical exercise as a tool to improve frailty in older people

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          Abstract

          RESUMEN Introducción: La fragilidad, entendida como un estado de vulnerabilidad y prediscapacidad en el paciente geriátrico, lleva asociada un aumento significativo del riesgo de morbimortalidad y, con ello, un impacto importante en la calidad de vida y la funcionalidad de las personas mayores con enfermedades crónicas y/o degenerativas. En este sentido, se ha constatado como el ejercicio físico aparece como una herramienta óptima no farmacológica para preservar y/o mejorar la calidad de vida de las personas mayores. Objetivos: Analizar la influencia de la práctica de ejercicio físico multicomponente en la mejora del estado de fragilidad de las personas mayores inscritas en clases de gimnasia de mantenimiento. Metodología: Estudio transversal y analítico que evaluó (pre- y posprograma) el nivel de fragilidad, la condición física y las constantes vitales de 118 personas mayores. Todos los participantes recibieron un entrenamiento de ejercicio físico multicomponente durante 12 semanas con una frecuencia de 3 días por semana con 1 h de duración. Resultados: Los datos muestran mejora en la condición física tras el programa de intervención con independencia del nivel físico de partida. Por otro lado, se observó una disminución del número de personas prefrágiles tras el programa. Conclusiones: los programas de ejercicio físico multicomponente optimizan la calidad de vida, mejoran la salud, y previenen la fragilidad de las personas mayores.

          Translated abstract

          ABSTRACT Introduction: Frailty, understood as a state of vulnerability and prediscapability in the geriatric patient, is associated with a significant increase in the risk of morbidity and mortality, and with it an important impact on the quality of life and functionality of elderly with chronic diseases and/or degenerative. In this sense, it has been verified how physical exercise appears as an optimal non-pharmacological tool to preserve and / or improve the quality of life of the elderly. Objectives: To analyze the influence of the practice of multicomponent physical exercise in improving the frailty state of the elderly enrolled in maintenance gym classes. Methods: Crosssectional and analytical study that evaluated (pre- and postprogram) the level of frailty, physical condition and vital signs of 118 elderly people. All participants received 12-week multicomponent physical exercise training 3 hours a week, lasting one hour. Results: Data show improvement in physical condition after the intervention program regardless of the starting physical level. On the other hand, a decrease in the number of pre-fragile people was observed after the program. Conclusions: Multicomponent physical exercise programs optimize quality of life, improve health, and prevent frailty in the elderly.

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          Most cited references21

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          Resistance training and executive functions: a 12-month randomized controlled trial.

          Cognitive decline among seniors is a pressing health care issue. Specific exercise training may combat cognitive decline. We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women. In this single-blinded randomized trial, 155 community-dwelling women aged 65 to 75 years living in Vancouver were randomly allocated to once-weekly (n = 54) or twice-weekly (n = 52) resistance training or twice-weekly balance and tone training (control group) (n = 49). The primary outcome measure was performance on the Stroop test, an executive cognitive test of selective attention and conflict resolution. Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests (parts A and B) and working memory as assessed by verbal digit span forward and backward tests. Gait speed, muscular function, and whole-brain volume were also secondary outcome measures. Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group (P < or = .03). Task performance improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups, respectively; it deteriorated by 0.5% in the balance and tone group. Enhanced selective attention and conflict resolution was significantly associated with increased gait speed. Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study (P < or = .03). Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women. clinicaltrials.gov Identifier: NCT00426881.
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            Transitions between frailty states among community-living older persons.

            Little is known about the natural course of frailty. We performed a prospective study to determine the transition rates between frailty states and to evaluate the effect of the preceding frailty state on subsequent frailty transitions. We studied 754 community-living persons, aged 70 years or older, who were nondisabled in 4 essential activities of daily living. Frailty, assessed every 18 months for 54 months, was defined on the basis of weight loss, exhaustion, low physical activity, muscle weakness, and slow walking speed. Participants were classified as frail if they met 3 or more of these criteria, as prefrail if they met 1 or 2 of the criteria, and as nonfrail if they met none of the criteria. Of the 754 participants, 434 (57.6%) had at least 1 transition between any 2 of the 3 frailty states during 54 months. The rates were 36.8%, 21.5%, and 9.2% for 1, 2, and 3 transitions, respectively. During the 18-month intervals, transitions to states of greater frailty were more common (rates up to 43.3%) than transitions to states of lesser frailty (rates up to 23.0%), and the probability of transitioning from being frail to nonfrail was very low (rates, 0%-0.9%), even during an extended period. The likelihood of transitioning between frailty states was highly dependent on one's preceding frailty state. Frailty among older persons is a dynamic process, characterized by frequent transitions between frailty states over time. Our findings suggest ample opportunity for the prevention and remediation of frailty.
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              Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis.

              To determine the effect of exercise on the physical function, activities of daily living (ADLs), and quality of life (QOL) of the frail older adults. Relevant articles published between 2001 and June 2010 were searched in PubMed, MEDLINE, EMBASE, the Chinese Electronic Periodical Service, CINAHL, and the Cochrane Library databases. The participants were selected based on the predetermined frailty criteria and randomly assigned to either an exercise or control group. The intervention for the exercise group was a single or comprehensive exercise training program, whereas usual care was provided to the control group. The characteristics and outcome measures of the included studies were identified independently by 2 investigators. The effect sizes of physical function assessed by the timed up and go test, gait speed, the Berg Balance Scale (BBS), the ADL questionnaires, and QOL measured by the Medical Outcomes Study 36-Item Short-Form Health Survey were calculated, using a weighted mean difference (WMD) and a 95% confidence interval (CI) to represent the results. Compared with the control group, the exercise group increased their gait speed by .07 m/s (95% CI .02-.11), increased their BBS score (WMD=1.69; 95% CI .56-2.82), and improved their performance in ADLs (WMD=5.33; 95% CI 1.01-9.64). The exercise intervention had no significant effects on the Timed Up & Go test performance and the QOL between the groups. Exercise is beneficial to increase gait speed, improve balance, and improve performance in ADLs in the frail older adults. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2022
                : 33
                : 1
                : 16-20
                Affiliations
                [3] León orgnameHospital Universitario de León España
                [1] León orgnameComplejo Asistencial Universitario de León orgdiv1Servicio de urgencias España
                [4] León Castilla y León orgnameUniversidad de León Spain
                [2] León Castilla y León orgnameUniversidad de León orgdiv1Psicología Spain
                Article
                S1134-928X2022000100005 S1134-928X(22)03300100005
                d1915a23-0447-4c88-b07e-f61a6abfeb2e

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 05 May 2020
                : 22 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 5
                Product

                SciELO Spain

                Categories
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                Elderly,Personas mayores,fragilidad,ejercicio físico,ejercicio físico multicomponente,fragility,physical exercise,multicomponent physical exercise

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