title: Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: a randomized-controlled cross-over design.
abstract: BACKGROUND
  Older adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults.
  
  
  METHODS
  For this study, 117 participants, 71 to 90 years old, were randomized in immediate intervention group and a control group (delayed intervention group). The intervention consisted of daily endurance and twice-a-week strength training. The method was based on a randomized-controlled cross-over design. Short Physical Performance Battery (SPPB), 8 foot up-and-go test, strength performance, six min walking test (6 MW), physical activity, BMI and quality of life were obtained at baseline, after a 6-month intervention- and control phase, again after 6-month crossover- and delayed intervention phase, and after anadditional 6-month follow-up.
  
  
  RESULTS
  After 6 months of MTI, the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery (SPPB) score (mean diff = 0.6, 95 % CI: 0.1, 1.0) and 8-foot up-and-go test (mean diff = -1.0 s, 95 % CI: -1.5, -0.6), and in endurance performance via 6-minute walking test (6 MW) (mean diff = 44.2 meters, 95 % CI: 17.1, 71.2). In strength performance via knee extension the intervention group improved while control group declined (mean diff = 55.0 Newton, 95 % CI: 28.4, 81.7), and also in PA (mean diff = 125.9 cpm, 95 % CI: 96.0, 155.8). Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4: SPPB (1.1 points, 95 % CI: 0.8, 1.4); 8-foot up-and-go (-0.9 s, 95 % CI: -1.2, -0.6); 6 MW (18.7 m, 95 % CI: 6.5, 31.0); knee extension (4.2 Newton, 95 % CI: -10.0, 18.3); hand grip (6.7 Newton, 95 % CI: -4.4, 17.8); PA (-4.0 cpm, 95 % CI: -33.9, 26.0); BMI (-0.6 kg/m2, 95 % CI: -0.9, -0.3) and Icelandic quality of life (0.3 points, 95 % CI: -0.7, 1.4).
  
  
  CONCLUSIONS
  Our results suggest that regular MTI can improve and prevent decline in functional fitness in older individuals, influence their lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care.
  
  
  BACKGROUND
  This study was approved by the National Bioethics Committee in Iceland, VSNb20080300114/03-1.
authors.affiliation: Centre for Research in Sport and Health Sciences, University of Iceland, Laugarvatn, Iceland.
authors.forename: Janus
authors.initials: J
authors.lastname: Gudlaugsson
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.forename: Kristin
authors.initials: K
authors.lastname: Siggeirsdottir
authors.forename: Anna S
authors.initials: AS
authors.lastname: Olafsdottir
authors.forename: Palmi V
authors.initials: PV
authors.lastname: Jonsson
authors.forename: Sigurbjorn A
authors.initials: SA
authors.lastname: Arngrimsson
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Erlingur
authors.initials: E
authors.lastname: Johannsson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015992:Body Mass Index; D018592:Cross-Over Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010807:Physical Endurance / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D016138:Walking / Q000502:physiology