MULTIDIMENSIONAL EXERCISE TRAINING ON HEMODYNAMIC AND PHYSICAL FUNCTION RESPONSES IN OLDER LONG-TERM CARE RESIDENTS: A MULTICENTER RANDOMISED CLINICAL CONTROLLED TRIAL

G. Pepera¹, K. Krinta¹, C. Mpea¹, A. Grigoriadou¹, V. Antoniou¹, A. Peristeropoulos¹, Z. Dimitriadis¹

Background: Age-related adaption in physical function, cognitive capacity, and cardiovascular function are the most typical changes remarked in the older aged population. A few findings have demonstrated that different types of exercise can positively affect hemodynamic parameters in older adults, however, some bias of these exercise training models limit their use in clinical community-based use, due to high cost required for equipment, space, and specialized professionals to prescribe exercise. There is no evidence on how a multidimensional group exercise program (MGEP) based on different factors of exercise like strength, balance, movement amplitude, flexibility in the same session could improve physical and hemodynamic functions in older home care residents.

Purpose: The aim of this study was to assess hemodynamic (heart rate and blood pressure) and physical function (gait ability and balance) responses of third aged residents in long-term care facilities, during a two-month multidimensional group exercise program (MGEP).

Methods: 40 older long-term care residents were randomly allocated equally to an intervention (IG; n=20; 80±7 years) and control group (CG; n=20; 79±7 years); whereas they all submitted to hemodynamic (blood pressure and heart rate) and functional assessments before and after the MGEP. The IG performed a twice-weekly, two-months multicomponent exercise program composed of functional mobility, balance, muscle strength, and flexibility exercises; while the CG did not perform any exercise intervention. A multi-center, single-blind, randomized, parallel group study design (NCT04358653, ClinicalTrials.gov) was used.

Results: There was a statistically significant decrease in systolic blood pressure (7.25±14.64 mmHg; t=2.2; effect size=0.34; p<.05) following a two-month MGEP as compared with baseline. In all functional measurements (balance, mobility) were significantly improved after the MGEP (p<0.05). The results of the multivariate ANOVA showed a significant interaction of time and group, for all physical functional measurement, between the IG and the CG (p<0.05): gait ability (TUG) and balance (BERG). No significant interaction of time and group for hemodynamic measurements was observed.

Conclusion(s): The main findings of this study indicate that MGEP affects positively all physical function factors and enhances the overall physical status of the care home residents. However, hemodynamic parameters showed a selective adjustment to the MGEP implementation, with only the systolic blood pressure of the intervention group developing a significant reduction between pre and post intervention assessment. Further studies need to be carried out to determine results on a larger sample to make safe conclusions for the general population between the older adults and to examine the long-term benefits of that multicomponent exercise intervention.

Implications: MGEP appears to be an ideal choice of massive exercise training of the older population. As it comprises a mix of multiple exercise regimes, it allows its easy adjustment to the different needs of any third aged group target, presenting an alternative way for public health maintenance by managing the blood pressure of the third age citizens. The MGEP described in this study has been proven to be feasible, easy to be implemented and potential for any long-term care facilities, since it does not require any expensive equipment or spacious indoor facilities.

Funding, acknowledgements: No funding to declare

Keywords: blood pressure, Rehabilitation, aging

Topic: Cardiorespiratory

Did this work require ethics approval? Yes

Institution: Physiotherapy Department, University of Thessaly

Committee: Ethics Committee of the University of Thessaly

Ethics number: 118/02-10-2018