Remote Physical and Cognitive Training Effects in Older Adults at Increased Risk of Clinical-functional Vulnerability

Effects of a Remote Physical Training Program Combined With Cognitive Training in Older Adults at Increased Risk of Clinical-functional Vulnerability: a Randomized Clinical Trial

This study is a randomized, single-blind, parallel, controlled, superiority trial. The main objective is to verify the chronic effects of a remote 12-week low-intensity physical training program alone or in combination with cognitive training on functional, cognitive, and occupational capacity, as well as on the self-reported quality of life.

Study Overview

• Status: Completed
• Conditions: Aging; Functional Status
• Intervention / Treatment: Behavioral: Physical training; Behavioral: Cognitive training

Detailed Description

Participants over 60 years of age at increased risk of clinical-functional vulnerability will be recruited in the city of Pelotas/RS, Brazil and randomized to two different arms. The intervention group will receive low-intensity physical training combined with a cognitive training program using neurobic exercises, whereas the active comparator group will only receive the low-intensity physical training program. Participants from both groups will perform their training sessions remotely for a total of 12 weeks. Outcomes of interest include handgrip strength, functional and cognitive capacity, occupational performance, clinical-functional vulnerability level, self-reported quality of life, and depressive symptoms, which will be assessed in a pre-post fashion. The study hypothesis is that remote low-intensity physical training combined with cognitive training will result in additional benefits to those of low-intensity physical training alone in the physical and cognitive capacity outcomes, and as a consequence, improved quality of life, occupational performance, decreased level of clinical-functional vulnerability and symptoms of depression will be observed.

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • RS
    • Pelotas, RS, Brazil, 96055-630
      • Escola Superior de Educação Física

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 60 years of age or older,
• MMSE score equal to or greater than 19 points,
• Elementary school education complete or over,
• Sedentary (no current or previous participation in structured exercise (>1x/week) in the past 6 months),
• Increased risk of clinical-functional vulnerability, as determined by the Clinical-Functional Vulnerability Index-20 (IVCF-20) questionnaire.
• Access to a cell phone or notebook with internet access,
• Resident in the city of Pelotas, Brazil.

Exclusion Criteria:

• Individuals who have been affected by COVID-19,
• Not retired, or those retired individuals who maintained continuous or sporadic work activities,
• Neuromuscular deficits or any medical diagnosis that prevents the individuals from performing physical exercises,
• Individuals with decompensated or untreated blood pressure (> than 140x90 mmHg) and,
• Individuals with visual problems that prevent them from watching the training sessions on their cell phone or notebook screen.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Physical and cognitive exercise group; Participants will be randomized to receive physical and cognitive training for a period of 12 weeks.	Behavioral: Physical training; Older adults assigned to this group will undergo two weekly sessions of remote and supervised physical training at home for 1 hour on non-consecutive days. All synchronous meetings will be held on Google Meet, and supervisors will undergo training to standardize their procedures; Behavioral: Cognitive training; These participants will also perform a weekly remote and supervised cognitive training session with neurobic exercises for 1 hour. In addition to the supervised cognitive training session, participants will also be prescribed asynchronous neurobic exercises to be performed on the remaining days of the week (without supervision). The intervention will last for 12 weeks, and all asynchronous neurobic exercises will be recorded in the following synchronous sessions by the supervisor. All synchronous meetings will be held on Google Meet, and supervisors will undergo training to standardize their procedures
Active Comparator: Physical exercise only group; Participants will be randomized to receive only physical training for a period of 12 weeks.	Behavioral: Physical training; Older adults assigned to this group will undergo two weekly sessions of remote and supervised physical training at home for 1 hour on non-consecutive days. All synchronous meetings will be held on Google Meet, and supervisors will undergo training to standardize their procedures

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Timed Up and Go (TUG) performance	The TUG test will be used to measure possible modifications in the dynamic balance of older adults during the performance of the task.	Baseline (weeks 0) to Post-training (week 13)
Dual-task performance	The TUG test will also be applied with a dual task, in which participants' functional capacity will be assessed while simultaneously performing a verbal task. Specifically, the participants will perform the same procedures explained in the TUG test session, while also pronouncing the maximal number of animal names as possible.	Baseline (weeks 0) to Post-training (week 13)
Mini-Mental State Examination (MMSE) score	The MMSE will be used to assess participants' cognitive function, which will be classified based on the education-adjusted cut-off scores.	Baseline (weeks 0) to Post-training (week 13)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Handgrip strength	The amount of force produced by a maximal isometric contraction of the extrinsic hand muscles of the dominant upper limb will be measured using a hand dynamometer.	Baseline (weeks 0) to Post-training (week 13)
30-s Sit-to-Stand test performance	Lower limb strength will be assessed using the 30-s Sit-to-Stand test, which involves counting the number of times the participant can stand up completely from the sitting position, with arms crossed over the chest.	Baseline (weeks 0) to Post-training (week 13)
World Health Organization Quality of Life-bref (WHOQOL-bref) score	The WHOQOL-bref questionnaire covers four domains of quality of life (physical health, psychological health, social relationships, and environment) and will be used to assess self-reported quality of life.	Baseline (weeks 0) to Post-training (week 13)
Beck's Depression Inventory (BDI) score	The BDI is a self-administered questionnaire covering cognitive, affective, behavioral, and somatic aspects of depression.	Baseline (weeks 0) to Post-training (week 13)
Canadian Occupational Performance Measure (COPM)	The COPM is a semi-structured interview that uses a typical day as a reference to identify issues in self-care, productivity, and leisure based on the self-reported performance capacity and satisfaction of the patient in occupations the participant need, wants, and/or is expected to do.	Baseline (weeks 0) to Post-training (week 13)
Digit Span Test (DST)	The DST will be used to evaluate participants' working memory.	Baseline (weeks 0) to Post-training (week 13)
Verbal fluency test	Participants' verbal fluency will me assessed by asking participants to name as many different animals as they know in one minute.	Baseline (weeks 0) to Post-training (week 13)

Collaborators and Investigators

• Sponsor: Federal University of Pelotas
• Investigators: Principal Investigator: Cristine L Alberton, PhD, Federal University of Pelotas

Study record dates

Study Major Dates

• Study Start (Actual): July 26, 2022
• Primary Completion (Actual): December 31, 2022
• Study Completion (Actual): December 31, 2022

Study Registration Dates

• First Submitted: March 25, 2022
• First Submitted That Met QC Criteria: March 25, 2022
• First Posted (Actual): April 4, 2022

Study Record Updates

• Last Update Posted (Actual): August 8, 2025
• Last Update Submitted That Met QC Criteria: August 4, 2025
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: Exercise; Aging; Frailty; Cognitive training; Occupational performance
• Other Study ID Numbers: 55791522.6.0000.5313

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No