Effects of a 20-week Combined Mat-Pilates Training With Dual Task Exercise for Improving Trunk Strength and Stability, Balance, Cognitive Function, and Risk of Falls in Older Adults.
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 67
- 试验地点
- 2
- 主要终点
- Balance- Biodex balance System SD
研究概览
简要总结
Our aims are to evaluate the impact of 24-week combined Pilates and dual-task exercises on physical fitness, balance, cognitive function, bone density in older adults. Participants ≥ 65 years of both genders will be randomly allocated to a control (n= 55) or intervention group (n= 55). Twice a week, sessions will take place in the FADEUP- UPORTO, with moderate intensity Pilates exercise and dual-task exercises. Trunk strength and stability, balance, cognitive function, and physical fitness will be accessed before and after the intervention. The Pilates method is easy to apply, low cost and widely accepted by older adults and it can integrate dual-task exercises easily. The researcher expected the intervention to improve balance, physical and cognitive skills of the participants, which may reduce the number of falls. The investigators seek to contribute with relevant information and enlighten the Dual Task-Pilates program as a safe strategy to reduce falls and maintain elderly's autonomy.
详细描述
To accomplish our aims the following tasks will be conducted:
- Disclosure, recruitment and participants characterization (3 months). Participants of both genders, ≥ 65 years old, living in the community, with independent mobility, will be recruited through the "Mais Ativos Mais Vividos" project (in FADEUP), senior universities, and healthcare centers.
This is a longitudinal experimental study. For sample size, an a priori calculation of statistical power (G*Power 3.1, Dusseldorf, Germany) was performed based on an Ancova. The sample size required to detect an effect size of 0.40; α err prob 0.05 and a power of 0.80 is 111 subjects to accommodate a maximum dropout rate of 20%. 2. Participant´ Assessments (2 months) Participants will be submitted to the following measurements at 2 time points, baseline and post-intervention.
I - Sociodemographic data and clinical characterization, collected by questionnaire; and health status with Short Form Health Survey (SF-36) II - Weight and height will be measured with a SECA 899 scale and SECA 217 stadiometer (Hamburg, Germany); III - Body composition and bone mineral density will be determined by DEXA, Hologic Explorer QDR 4500 (Bedford, MA / USA); IV - Habitual physical activity assessed by Link ActiGraph GT9X accelerometers for 7 consecutive days (confounder); V - Functional evaluation by the senior fitness test (SFT) including lower (chair stand) and upper (arm curl) limb strength, lower (sit reach) and upper (back scratch) limb flexibility, agility and dynamic balance (timed up and go) and cardiorespiratory endurance (walk 6 min); VI- Handgrip strength with the Jamar analog dynamometer; VII- Balance assessment made in Biodex Balance System SD platform (Biodex Medical Systems, Shirley, NY), including Sensory Integration (CTSIB) and Falls Risk; VIII- Trunk strength assessed using the Biodex System 4 Pro isokinetic dynamometer (Medical Systems, Shirley, NY, USA); IX- Stability of the trunk muscles with Stabilizer Pressure Biofeedback; X- Assessment of cognitive function using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Color and Word Test (SCWT), Wechsler Adult Intelligence Scale (WAIS III) e Wechsler Memory Scale (WMS), conducted by an experienced psychologist; XI-Assessment of the cost of dual tasking using the Cognitive timed up ang go. 3. Intervention (5 months) Participants will be allocated to the Experimental Group (EG) and Control Group (CG) in a 1:1 ratio. In the EG, participants will be divided into small groups of 15 to 18 individuals.
The exercise program, conducted at FADEUP, will run for 20 weeks, consisting of two 60-minute sessions per week at moderate to vigorous intensity. Heart rate monitors (GARMIN Vivosmart 4) and the Borg Rating of Perceived Exertion Scale (1 to 10) will be used to monitor intensity. The program will begin with a 3-week period at light intensity (57% to 63% of maximum heart rate), followed by a progression to moderate intensity (64% to 76%) from weeks 4 to 10, and to moderate-to-vigorous intensity (77% to 95%) from week 11 onward, with increasing complexity of exercises.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Older adults (≥ 60 years)
- •Both sexes
- •Healthy (no diseases or diagnoses that prevent physical exercise)
- •Community-dwelling
排除标准
- •Individuals diagnosed with medical conditions for which physical activity is not recommended, including, but not limited to, musculoskeletal problems, cardiovascular diseases, and/or severe respiratory diseases.
- •Participants with neurological diseases or disabling conditions that compromise balance.
- •Individuals with moderate or severe cognitive impairment, according to established normative test values.
结局指标
主要结局
Balance- Biodex balance System SD
时间窗: Baseline, post 20 weeks.
The Biodex Balance System SD plataform was used to assess balance through the Sensory Integration Test (CTSIB) and the Falls Risk Test. These assessments evaluate how the central nervous system processes sensory inputs (visual, and proprioceptive systems) to maintain postural control, helping to identify balance impairments and fall risk (Biodex Medical Systems, Shirley, NY).
Stability of the trunk muscles- Stabilzer Pressure Biofeedback Unit
时间窗: Baseline, post 20 weeks
The study by Grooms et al. (2013) evaluated trunk muscle stability using the Stabilizer Pressure Biofeedback Unit, a device that measures the activation of deep abdominal muscles during exercises. It helps ensure proper engagement of core stabilizers, such as the transversus abdominis and multifidus, making it useful for both assessment and rehabilitation.
Balance- Single-Leg Stance Test
时间窗: Baseline, post 20 weeks.
The Single-Leg Stance Test is a simple and widely used method for assessing static postural balance. It involves standing on one leg, with eyes open, for up to 45 seconds. This test has been validated by Springer et al. (2007), who demonstrated its reliability in detecting balance deficits and fall risk, particularly in older adults and clinical populations.
Functional Fitness (Strength)- SFT
时间窗: Baseline, 20 weeks.
The Senior Fitness Test includes specific assessments for upper and lower body strength in older adults. Lower body strength is measured using the 30-second chair stand test, which evaluates leg strength and endurance. Upper body strength is assessed with the 30-second arm curl test, measuring arm muscle strength. These tests were validated by Rikli and Jones (1999) and are considered reliable indicators of functional fitness in elderly populations.
Functional Fitness (Flexibility)- SFT
时间窗: Beseline, post 20 weeks.
The Senior Fitness Test includes two flexibility assessments aimed at older adults: the Sit and Reach Test, which evaluates lower body flexibility, particularly of the hamstrings and lower back; and the Back Scratch Test, which assesses upper body flexibility, focusing on shoulder mobility. Both tests were validated by Rikli and Jones (1999) and are widely used to detect limitations in functional range of motion.
Cardiorespiratory endurance- SFT
时间窗: Baseline, post 20 weeks.
The 6-Minute Walk Test is part of the Senior Fitness Test and evaluates cardiorespiratory endurance in older adults. Participants are instructed to walk as far as possible in six minutes along a 50-meter rectangular course. This test was validated by Rikli and Jones (1999) and is considered an excellent indicator of functional capacity for daily activities, such as climbing stairs or performing household tasks.
Dynamic balance and agility- 8-Foot Up-and-Go Test
时间窗: Baseline, post 20 weeks.
The 8-Foot Up-and-Go Test is part of the Senior Fitness Test and assesses agility and dynamic balance in older adults. The participant must stand up from a chair, walk 2.44 meters (8 feet) quickly, turn around a cone, and return to the seat as fast as possible (Rikli and Jones, 1999).
Handgrip strength
时间窗: Baseline, 20 weeks.
Handgrip strength was assessed using the Jamar analog dynamometer (Sammons Preston Inc., Bolingbrook, Illinois, USA), a gold-standard instrument widely used to measure upper limb strength. The test is simple, quick, and provides a reliable indicator of overall functional strength. The Jamar dynamometer has well-established validity in clinical research.
Trunk strength- Biodex System 4 Pro isokinetic dynamometer
时间窗: Baseline, 20 weeks
Trunk strength was assessed using the Biodex System 4 Pro isokinetic dynamometer (Biodex Medical Systems, Shirley, NY, USA), a highly accurate device used to measure muscular torque and power at various speeds. It is widely used in clinical and research settings to analyze muscular performance in a standardized and safe manner.
次要结局
- Cognitive function- MoCA(Baseline, 20 weeks.)
- Cognitive function- Trail Making Test(Baseline, 20 weeks.)
- Cognitive function- Stroop Color and Word Test(Baseline, 20 weeks.)
- General intelligence- Wechsler Adult Intelligence Scale (WAIS-III)(Baseline, 20 weeks)
- Cognitive function- Memory function(Baseline, 20 weeks.)
- Sociodemographic questionnaire and and clinical characterization(Baseline, 20 weeks.)
- Height assessment(Baseline, 20 weeks)
- Body mass(Baseline, 20 weeks.)
- Bone mineral density(Baseline, 20 sections)