title: High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial.
abstract: The aims of this randomised controlled trial were to determine if a high-intensity functional exercise program improves balance, gait ability, and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training. One hundred and ninety-one older persons dependent in activities of daily living, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ? 10 participated. They were randomised to a high-intensity functional exercise program or a control activity, which included 29 sessions over 3 months, as well as to protein-enriched energy supplement or placebo. Berg Balance Scale, self-paced and maximum gait speed, and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA, using the intention-to-treat principle. At three months, the exercise group had improved significantly in self-paced gait speed compared with the control group (mean difference 0.04 m/s, p = 0.02). At six months, there were significant improvements favouring the exercise group for Berg Balance Scale (1.9 points, p = 0.05), self-paced gait speed (0.05 m/s, p = 0.009), and lower-limb strength (10.8 kg, p = 0.03). No interaction effects were seen between the exercise and nutrition interventions. In conclusion, a high-intensity functional exercise program has positive long-term effects in balance, gait ability, and lower-limb strength for older persons dependent in activities of daily living. An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training.
authors.affiliation: Department of Community Medicine and Rehabilitation, Umeå University, Sweden. erik.rosendahl@germed.umu.se
authors.forename: Erik
authors.initials: E
authors.lastname: Rosendahl
authors.forename: Nina
authors.initials: N
authors.lastname: Lindelöf
authors.forename: Håkan
authors.initials: H
authors.lastname: Littbrand
authors.forename: Elinor
authors.initials: E
authors.lastname: Yifter-Lindgren
authors.forename: Lillemor
authors.initials: L
authors.lastname: Lundin-Olsson
authors.forename: Lena
authors.initials: L
authors.lastname: Håglin
authors.forename: Yngve
authors.initials: Y
authors.lastname: Gustafson
authors.forename: Lars
authors.initials: L
authors.lastname: Nyberg
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004044:Dietary Proteins / Q000627:therapeutic use*; D019587:Dietary Supplements; D002149:Energy Intake; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D016330:Frail Elderly; D005684:Gait; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D010349:Patient Compliance; D004856:Postural Balance; D016896:Treatment Outcome; D014891:Weight Lifting
chemical_list: D004044:Dietary Proteins