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© 2016 EDIZIONI MINERVA MEDICA Online version at http://www.minervamedica.it
The Journal of Sports Medicine and Physical Fitness 2017 March;57(3):272-7 DOI: 10.23736/S0022-4707.16.06514-2
ORIGINAL ARTICLE EPIDEMIOLOGY AND CLINICAL MEDICINE
Effects of eight weeks of functional training in the functional autonomy of elderly women: a pilot study Dihogo G. DE MATOS 1, Mauro L. MAZINI FILHO 1, Osvaldo C. MOREIRA 2, 3, Cláudia E. P. DE OLIVEIRA 3, 4, Gabriela R. DE OLIVEIRA VENTURINI 5, Marzo E. DA SILVA-GRIGOLETTO 6, 7, Felipe J. AIDAR 8, 9 * 1Department of Sports Science, Exercise and Health of the Trás-os-Montes e Alto Douro University, Vila Real, Portugal; 2Campus Florestal,
Institute of Biological Sciences and Health, Federal University of Viçosa, Florestal, Brazil; 3Institute of Biomedicine, University of Leon, Leon, Spain; 4Department of Physical Education, Campus Viçosa, Federal University of Viçosa, Viçosa, Brazil; 5Laboratory of Physical Activity and Health Promotion, State University of Rio de Janeiro, Rio de Janeiro, Brazil; 6Center of Biological and Health Sciences, Federal University of Sergipe, Aracaju, Brazil; 7Scientific Sport, Córdoba, Spain; 8Department of Physical Education, Federal University of Sergipe, São Cristóvão, Brazil; 9Graduate Program in Physical Education, Federal University of Sergipe, São Cristóvão, Brazil *Corresponding author: Felipe J. Aidar, Federal University of Sergipe, Cidade Universitária Prof. José Aloísio de Campos Av. Marechal Rondon s/n, Jardim Rosa Elze, 49100000, São Cristóvão, SE, Brazil. E-mail:
[email protected]
A B S T RAC T BACKGROUND: This study aimed to evaluate the effects of eight weeks of practical training on the functional autonomy of the elderly. METHODS: The study included 52 elderly women, 65.42±10.31 years, 65.29±11.30 kg body mass, 1.58±0.07 height, 26.30±4.52 body mass index, 86.48±10.96 cm waist circumference. These elderly women received a specific functional training protocol where their functional autonomy was assessed at three specific times (0, 10 and 20 sessions). The evaluation consisted of a set of five tests defined by the Latin-American Development Group for the Elderly (GDLAM) to determine the functional autonomy of the elderly: walk 10 meters (C10m); stand up from a chair and walk straightaway (SUCWA); dress and undress a T-shirt (DUT); stand up from a sitting position (SUSP); stand up from a lying position (SULP). In each test, the time taken to complete the task was measured. RESULTS: There were statistically significant differences in all functional autonomy tests after 20 training sessions: C10m (pre: 8.10±1.27; post: 7.55±1.10); SUCWA (pre: 40.98±2.77; post: 38.44±2.57); DUT (pre: 13.25±0.88; post: 11.85±0.82); SUSP (pre: 10.74±0.52; post: 8.98±056) and SULP (pre: 3.86±0.37; post: 2.82±0.37). CONCLUSIONS: It was determined that 20 functional training sessions were enough to improve the functional autonomy of elderly women. However, we believe that higher volume and intensity of training could be interesting alternatives for even stronger results in future interventions. (Cite this article as: de Matos DG, Mazini Filho ML, Moreira OC, de Oliveira CEP, de Oliveira Venturini GR, Da Silva-Grigoletto ME, et al. Effects of eight weeks of functional training in the functional autonomy of elderly women: a pilot study. J Sports Med Phys Fitness 2017;57:272-7. DOI: 10.23736/S0022-4707.16.06514-2) Key words: Aging - Personal autonomy - Psychomotor performance - Motor skills - Exercise therapy - Aged.
I
n recent years, research has shown that the regular practice of strength training can promote adaptations in the human body, emphasizing the improvement of physical and structural changes such as reduced levels of adipose tissue and increased muscle mass and bone density.1-4 Apart from observations in training centers and the daily lives of physically active individuals, there is sci-
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entific evidence confirming the benefits of this type of training. However, questions have been raised in the recent literature about the effectiveness of strength training, performed in its traditional form, in improving physical fitness for day-to-day activities.5 As an alternative to this potential limitation, functional training (FT) arises as an overall physical preparation that prioritizes the improvement of the common
The Journal of Sports Medicine and Physical Fitness
March 2017
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, log or other proprietary information of the Publisher.
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COPYRIGHT 2017 EDIZIONI MINERVA MEDICA FUNCTIONAL TRAINING IN ELDERLY WOMEN DE MATOS
movements of the individual in activities that are peculiar or specific.6, 7 According to Hibbs et al.,8 FT consists of a set of multi-joint movements characterized by levels of high and low intensity, which seek to add to neuromuscular and aerobic stimulation as well as other features such as proprioceptive stimulus, agility and coordination. FT is based on performing exercises aimed at improving control, stability and motor coordination. Functional training improves functional capacity through exercises that stimulate the proprioceptive receptors in the body, which provide improvement in the development of kinesthetic awareness and body control, static and dynamic muscle balance, reduce the incidence of damage and increase efficiency of movements.6, 9 In this sense, specifically in the elderly, adequate levels of muscular strength and flexibility, among other factors, are crucial to the effectiveness in the implementation of the different movements involved in performing the activities of daily living (ADL). The decrease in the functionality of these components with advancing age may compromise the partial or complete performance of ADL, resulting in greater dependency for the elderly and reducing their quality of life.10, 11 In this sense, the regular practice of physical exercise, focused on the development of muscle strength and flexibility, has been recommended as a measure to mitigate or counteract the negative effects related to aging and/or factors associated with it on these components of functional autonomy.10 Given this perspective, this study aimed to determine whether FT could promote changes in the functional autonomy of the elderly by evaluating the effects of eight weeks of functional training on the functional autonomy of elderly women. Materials and methods The study included 52 elderly female volunteers, averaging 65.42±10.31 years old, 65.29±11.30 kg of body weight and 1.58±0.07 m of height. The exclusion criteria were: 1) patients with musculoskeletal or cardiometabolic problems that limited or contraindicated the practice of the programmed exercise; 2) subjects who participated in other regular exercise programs; 3) subjects who attended fewer than 20 sessions (two or three times a week with an interval of 48 hours between
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each training session) during the eight weeks of training provided by the program. The inclusion criteria were: being physically fit to participate in the experimental study, determined by a medical examination; being independent in the performance of ADL; did not present any physical, hearing or visual disability that precluded the tests; did not participate in other exercise programs. All women evaluated participated voluntarily, signed the informed consent form and were given information regarding the study, as determined in Resolution 466/2012 of the National Health Council. The study was approved by the Ethics Committee for research involving human subjects of the Federal University of Juiz de Fora, Minas Gerais, Brazil (license no. 0284.0.180.00008). The voluntary group was evaluated in three different moments. The first evaluation was performed at the beginning of the program, before the “zero” training session (S0); the second evaluation occurred after the tenth training session (S10) and the third evaluation took place at the end of the program, after the twentieth training session (S20), as shown in Figure 1. Anthropometry To define the characteristics of the sample (evaluation S0), the anthropometric parameters were evaluated using the Body Mass Index (BMI), a scale (Filizola, Brazil, 2002) for measuring individual body weight with a precision of 0.1 kg and a stadiometer (Sanny - American Medical do Brasil, São Bernardo do Campo, Brazil) to accurately measure the height with a precision of 0.1 cm. To measure waist circumference (WC), each participant remained standing and the evaluator used a Sanny measuring tape (Sanny) to determine the smallest point of the circumference to the nearest 0.1 cm. All measures followed the procedures indicated by the International Society for the Advancement of Kinanthropometry.12 Functional autonomy The GDLAM Protocol 13 comprises five tests, which are described below. 1) “Walk 10 meters” (C10m) consists of measuring the time the individual takes to cover the distance of 10 meters. 2) “Get up from a sitting position” (SUSP) assesses
The Journal of Sports Medicine and Physical Fitness
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This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, log or other proprietary information of the Publisher.
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COPYRIGHT 2017 EDIZIONI MINERVA MEDICA DE MATOS FUNCTIONAL TRAINING IN ELDERLY WOMEN
the functional capacity of the lower limbs. For this test, the individual sits, with arms alongside the body, on a chair without armrests and with a ground clearance of 50 cm. The individual must then stand up and sit five consecutive times. 3) “Stand up from lying position” (SULP) evaluates the ability of the individual to stand up from the floor. The test consists of starting from a prone position, with arms alongside the body and, given a previously established command, the individual must stand up in the shortest time possible. 4) In “Stand up from a chair and walk straightaway” (SUCWA) the goal is to assess the individual’s agility and balance in day-to-day situations. To perform this test, a chair was placed on the ground and two cones were set diagonally to the chair, at a distance of four meters to the right and three meters to the left. The individual starts the test sitting in the chair with the feet off the ground. After the previously agreed upon signal is given, she gets up, moves to the right, circles the cone, returns to the chair, sits and removes both feet from the ground. She then immediately repeats the previous movements but goes to the left cone instead. The individual must complete the sequence of movements in the shortest time possible. 5) “Dress and undress “T-shirt” (DUT) assesses the agility and coordination of the upper limbs’ movements. For this test, the individual should be in a standing position, with arms alongside the body and a T-shirt in one hand. Upon the previously agreed command, the individual has to put on the T-shirt and immediately take it off, thus returning to the starting position. Table I shows the scores of the evaluation of functional autonomy proposed by the GDLAM protocol. Functional training The individuals underwent eight weeks of physical exercises based on functional training, encompassing physical and motor abilities: endurance, strength,
speed, agility, balance, flexibility and coordination. The classes took place three times a week with an average duration of 60 minutes. Each session included a five to ten minute warm up on the treadmill or bike, supervised by the teacher. The elderly individuals were told to walk as fast as possible without exceeding their limitations, thus respecting each person’s fitness level. Afterwards, the individuals performed about five minutes of core stabilization exercises (integrated unit consisting of 29 pairs of muscles that support the complex hip-pelvis-lumbar) with abdominal flexion of the trunk on the FitBall, followed by 25 minutes of functional resistance exercises. This part of the training began with the total-body resistance exercise (TRX) according to the following sequence: TRX drawn with a neutral grip, gradually varying the inclination as the weeks passed for the purpose of increasing intensity. Standing bench press was also performed using elastic band (Thera-Band). Intensity varied from light to moderate, according to the elastic bands’ color. Standing hip abduction was executed using Thera-Bands, also varying intensity according to the bands’ colors. In addition, dumbbell biceps curl with a 2-kg weight was also performed. The planning of periodization was according to the following schedule: two series of twelve repetitions in the first week, increasing to fifteen repetitions in the second week and to three sets of fifteen repetitions in the following weeks; and, one-minute intervals between series in the first two weeks decreasing to 45 seconds in the following weeks. Adjustments such as gradients and added variations were made when necessary, also considering each person’s body weight. The end of the training session was composed of four different exercises, including lateral movement with hip flexion on the agility training ladder and frontal, lateral and zig-zag movements using cones. The volunteers started by completing the circuit only once but gradually increased the number of circuit repetitions per week. They also began with one-minute intervals between ex-
Table I.—Standard assessment of functional autonomy proposed by the GDLAM protocol. Tests
C10m (s)
SUSP (s)
SULP (s)
DUT (s)
SUCWA (s)
Scores
Weak Regular Good Very good
+7.09 7.08-6.34 6.33-5.71
