Low-volume cycling training improves body composition and functionality in older people with multimorbidity: a randomized controlled trial

Abstract

Physical exercise, when practiced regularly and in adequate doses, is a proven nonpharmacological measure that helps to prevent and reverse noncommunicable diseases, as well as reduce mortality rates from any cause. In general, older adults perform insufficient physical activity and do not meet the doses recommended by the World Health Organization for the improvement of health through physical activity. However, there is little evidence on adequate doses of exercise in older people, especially in those with multimorbidity. Our main aim was to evaluate the effect of a 6-week intervention on health-related outcomes (body composition, hemodynamic and functionality changes) in 24 individuals aged 65 and older with multimorbidity in a randomized controlled trial. The intervention consisted of a very low volume (60 min per week) of low-to-moderate intensity exercise training (perception of effort from 3 to 6 on an 11-point scale). After the intervention, blood pressure was significantly (p = 0.038) reduced in the exercise group (EG), with a higher reduction in men. Furthermore, the EG decreased their waist circumference (p = 0.005), a proxy of abdominal adiposity, and demonstrated an increased likelihood (73%) that a randomly selected change in muscle mass score from the EG would be greater than a randomly selected change score from the control group. The exercise intervention was particularly effective in enhancing the functionality of older adults with multimorbidity, especially in walking speed and balance skills. Perceptually regulated intensity during exercise training seemed to be a very interesting strategy to train individuals with low physical fitness and comorbidities. This study is registered with Clinicaltrials.gov (NCT04842396).

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1

Raincloud plot of the changes in the Performance-Oriented Mobility Assessment total score (POMA-T) and the Short Physical Performance Battery total score (SPPB-T) in the exercise (n = 12) and control groups (n = 12). Points are raw data obtained for each participant at each moment of measurement. Box plots represent the median (i.e., the line near the middle of the box) and interquartile range (IQR, lower quartile = 25th percentile and upper quartile = 75th percentile). The whiskers on either side of the IQR represent the lowest and highest quartiles of the data. The ends of the whiskers represent the maximum and minimum data values, and the individual dots beyond the whiskers represent outliers in the data set. Clouds represent probability density, and point and error bars in the base of the clouds are the mean ± SD. The dotted line represents the direction of the pre- and postintervention change in the two group means.

Figure 2

Pearson correlations between percentage changes in body composition variables. Changes in the control group (CG) are represented by a solid line, diamond points, and solid line density plot. Changes in the exercise group (EG) are represented by a long-dashed line, filled circle points, and a dashed line density plot. Significance: *p < 0.05, **p < 0.01, ***p < 0.001.

Figure 3

Consort flow chart for the selection and allocation of participants in the exercise and control groups.