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J.E. Pompeu1, F. Cassales Tosi1, G.C. Vieira Gomes1, I.M. Macedo Santos2, C. Quirino Dias2, D. Brancolini de Oliveira2, G. Carvalho Raimundi2, F. Grazielli Mendes2, S. Mori Lin2, N. Kondo Nakagawa1, W. Jacob Filho3
1School of Medicine/University of Sao Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Sao Paulo, Brazil, 2Clinics Hospital/School of Medicine/University of Sao Paulo, Department of Physical Therapy, Sao Paulo, Brazil, 3School of Medicine/University of Sao Paulo, Department of Geriatrics, Sao Paulo, Brazil
Background: Frail older adults spend 80% of the wakefulness in sitting and lying posture, with low energy expenditure. Sedentary behavior (SB) leads to several negative health outcomes and an increased risk of mortality.
Purpose: To evaluate the effects of an in-home exercise program performed in standing position on the SB, postural control, mobility and number of steps.
Methods: Older people, 60 years or older, classified with frailty syndrome, were randomly divided into Exercise Group (EG) and Control Group (CG). Individuals unable to remain in a standing position were excluded. EG protocol consisted of 5 simple execution exercises on standing position, performed 5 times a week for 16 weeks. CG received verbal orientation about the importance of avoiding a sedentary lifestyle. The SB was analyzed by both total and accumulated sedentary time for at least 10 consecutive minutes (min) and by the time and number of sedentary episodes, measured objectively by an accelerometer positioned on the hip (model GT3x; ACTIGRAPH), considering as valid data a minimum of 600 min/day for 4 days, excluding sleep time. Secondary outcomes were:
(1) postural control, assessed by the Short Physical Performance Battery scale;
(2) mobility, assessed by the Life-Space Assessment scale;
(3) number of steps assessed by accelerometer.
(1) postural control, assessed by the Short Physical Performance Battery scale;
(2) mobility, assessed by the Life-Space Assessment scale;
(3) number of steps assessed by accelerometer.
Results: We recruited 43 older adults, 86% women, mean pre-intervention SB time of 11h/day. After the intervention, EG showed a significant reduction in both total and accumulated sedentary time for at least 10 consecutive min that is equivalent to 35.53 min/day (p=0.008) and 48.86 min/day (p = 0.016) respectively, but without significant maintenance 30 days after the intervention. Adhesion to the protocol was satisfactory, reaching 78.4% of the target between the 1st and 8th weeks, falling down to 61% between the 9th and 16th. Postural control, mobility, and number of steps did not change significantly in any of the groups (all p> 0.05).
Conclusion(s): The in-home exercise protocol based on standing position reduced SB on frail older people without a significant impact on physical performance.
Implications: A low cost, very simple in-home exercise protocol can decrease SB and potentially reduce its negative impact.
Funding, acknowledgements: This study was funded by the São Paulo Research Foundation, process number 2018/19618-8.
Keywords: frailty, sedentary behavior, standing position
Topic: Older people
Did this work require ethics approval? Yes
Institution: University of Sao Paulo
Committee: School of Medicine of the University of Sao Paulo
Ethics number: 65494617.8.0000.0068
All authors, affiliations and abstracts have been published as submitted.
