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Feasibility and health effects of a 15-week combined exercise programme for sedentary elderly: a randomised controlled trial
Nielsen T-T, Moller TK, Andersen LL, Zebis MK, Hansen PR, Krustrup P
BioMed Research International 2019;(3081029):Epub
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

There is strong evidence that considerable health benefits can be achieved even with small amounts of physical activity. However, getting people to exercise regularly is a major challenge not least in the elderly population. This study investigated the feasibility and physiological health effects of a pragmatic 15-week exercise programme for sedentary elderly. In a single-blind randomised controlled trial, 45 sedentary 60 to 83-year-olds (25 women, 20 men) were randomly assigned (2:1 ratio) to a training group (TG n = 30) or a control group (CG n = 15). The training in TG consisted of a combination of exercise modalities (ie, strength, aerobic fitness, stability, and flexibility training) performed once a week as supervised group-based training and a weekly home-based training for 15 weeks. Feasibility outcomes were exercise intensity, adherence, and adverse events. The primary outcome was change in aerobic fitness (VO2max/kg). Adherence was high (81%) for the supervised exercise and low (0%) for the home-based exercise. No acute injuries occurred in TG, but 4 subjects (13%) reported considerable joint pain related to training. Average heart rate (HR) during the supervised training was 104 +/- 12 beats/min (69.3 +/- 8.0%HRmax), with 3.9 +/- 7.3% of training time > 90%HRmax. Intention-to-treat analyses revealed no between-group differences for aerobic fitness (p = 0.790) or any secondary cardiovascular outcomes at 15-week follow-up (resting HR or blood pressure; p > 0.05). Compared to CG, bodyweight (-2.3 kg, 95% CI -4.0 to -7.0; p = 0.006), total fat mass (-2.0 kg, 95% CI -3.5 to -0.5; p = 0.01), and total fat percentage (-1.6%, 95% CI -2.8 to -0.3; p = 0.01) decreased in TG. The group-based supervised training had high adherence and moderate exercise intensity, whereas the home-based training was not feasible in this study population. This exercise programme performed once a week did not improve aerobic fitness. Thus, supervised training with more vigorous intensity control appears advisable. Clinical study registration number is H-15016951.

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