Influence of two different exercise programs on physical fitness and cognitive performance in active older adults: functional resistance-band exercises vs. recreational oriented exercises.

Author:Ponce-Bravo, Hernan
Position:Research article - Report
 
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Introduction

According to estimates by the World Health Organization, elderly persons make up the most rapidly growing section of the population worldwide. It is forecast that by 2050, around 2000 million people -or one in four- will be older than 60 years of age.

The physical and cognitive decline that occurs during aging translates to an inability to carry out daily living tasks with consequent impacts on social relationships and quality of life. This has prompted the design of programs for this population sector targeted at improving functional health and promoting the independence of the elderly in their environment. In this context, routine physical exercise plays a major role in the life quality and expectancy of older adults (Blain et al., 2000; Katula et al., 2008; Poon and Fung, 2008; Vogel et al. 2009).

A lack of agility and dynamic balance (gross motor abilities) is a significant risk factor for loss of independence and increases the risk of falls. Balance also affects daily living activities such as standing, bending, climbing stairs, walking or responding to external stimuli (Sturnieks et al., 2008). The reason for this is the progressive deterioration in neurophysical skills that occurs with age, impairing sensory-motor functions and producing deficiencies in perception, muscle and cognitive function, and thus affecting balance and the risk of falling (Sturnieks et al., 2008). Regularly practicing some form of physical exercise reduces the risk of falls (Howe et al., 2007), essentially because of improved muscular strength, agility, dynamic balance and coordination (Blain et al., 2000; Karinkanta et al., 2009; Orr et al., 2008) and also helps preserve cognitive skills (Angevaren et al., 2008; Blain et al., 2000; Brisswalter et al., 2002; Colcombe and Kramer, 2003; Liu-Ambrose and Donaldson., 2009; Williamson et al. 2009). Indeed, different exercise programs seem to achieve proportional changes in physical condition and cognition in older adults (Berryman et al, 2014). However, the physiological pathway of these results displays a large variety of mechanisms liked with their cognitive impact, which nowadays should be clarified (Berryman et al., 2014; Voelcker-Rehage et al., 2010).

The available data indicates a direct link between improved cognitive performance and training programs designed to improve cardiovascular fitness (Colcombe & Kramer, 2003), strength and balance (Araya, 2011). However, there is no general consensus regarding the details of the most appropriate fitness training program (including the best intervention type, length of exercise program, session duration, etc.) or of its effects on indicators of cognitive function. Some of these indicators are simple reaction time (S-RT) (Dustman et al. 1984), choice reaction time (C-RT) (Van Boxtel et al., 1997), or visualspatial tasks (Shay and Roth, 1992), which are considered as key markers of the functional independence of the elderly (Colcombe and Kramer, 2003). Training programs for older adults have been mostly based on exercises designed to improve cardiovascular fitness and muscular strength (de Vreede et al., 2005; Kalapotarakos et al., 2006; Katula, et al. 2008; Liu-Ambrose and Donaldson, 2009; Van Boxtel et al., 1997). However, it has not always been possible to correlate such improvements with a capacity to better carry out daily living tasks. Some authors propose the inclusion of functional exercises (multijoint motor tasks that involve several body parts) in inter ventions planned for older adults (de Bruin and Murer, 2007; de Vreede et al. 2005) though their effects on cognitive performance and general fitness have not yet been established.

This study was designed to determine the impact of a program of functional exercises using elastic bands versus a recreational activity program on fitness and cognitive performance in active elderly participants older than 60 years of age.

Methods

Participants

Fifty-four participants were recruited from the community among older adults attending regular physical activity classes organized by the town hall (age 70.57 [+ or -] 5.46 years; weight 72.96 [+ or -] 10.54 kg; height 1.56 [+ or -] 0.09 m; 6 men, 48 women). Exclusion criteria were: A diagnosis of a progressive somatic or psychiatric disease, or any illness preventing participation in physical activities. The study protocol adhered to the tenets of the Declaration of Helsinki and received institutional review board approval. Written informed consent was obtained from each participant.

The participants enrolled were assigned to two groups matched in terms of their baseline reaction times and physical fitness, as well as the compatibility training schedule : an experimental group (EG; n = 22) and a control group (CG; n = 32). Participants in each group completed a 4-week training program consisting of 5 weekly sessions of 50 min each. Before and after the training intervention, fitness and cognitive performance were assessed in each participant.

Study design

In a longitudinal-experimental study, pre- and post-intervention data were compared in an experimental (functional training with resistance elastic-bands; EG) and control (recreational training; CG) group. The effects of both training programs on physical fitness and cognitive performance (simple and choice reaction times) were determined by intra- and intergroup comparisons of means. Sampling was performed via an intentional non-probabilistic convenience procedure.

Both types of training included a multidimensional activity program (endurance, strength, balance, gross motor, and flexibility training), which is considered optimal for health and functional benefits in older people (Cress et al., 2005). Differences between training groups came from the nature of the exercises (multi-joint vs analytical) and the focus towards which they were directed (physical condition improvement or ludic orientation): 1) Resistance-band functional training sessions combined several objectives simultaneously by means of exercise that incorporated multi-joint motor tasks that involved several body parts (functional exercises; de Bruin and Murer, 2007; de Vreede et al., 2005). These exercises were executed with low-resistance elastic-bands in order to highlight the strength content in each session (Cress et al., 2005); 2) Recreational training also combined several objectives simultaneously but used more analytical low-load exercises applied in a ludic form.

The variables used as indicators of physical fitness were: leg strength (LS) using the Chair-stand test; right/left arm strength (R/L AS) using the Arm curl test; and gross motor abilities (AG; 8-Foot up-and-go). For all tests, we followed the...

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