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Original Study
Effects of a Combined Physical Training and Nutrition Intervention on Physical Performance and Health-Related Quality of Life in Prefrail Older Women Living in the Community: A Randomized Controlled Trial

https://doi.org/10.1016/j.jamda.2014.12.005Get rights and content

Abstract

Objectives

The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life (HRQOL) among prefrail elderly women living in the community.

Design

This was a randomized controlled trial in which participants were recruited and randomly assigned to the exercise and nutrition group (EN, n = 30), exercise only group (E, n = 28), and control group (C, n = 31).

Setting

Group training classes were held at a research center in Itabashi Ward, Tokyo, Japan.

Participants

Eighty-nine prefrail women aged 70 years or older.

Intervention

The EN group participated in an exercise training and nutritional program (cooking class) once a week, and the E group participated in the exercise training program only.

Measurements

Outcome measures that included physical performance (handgrip strength, balance, walking speed) and HRQOL (Medical Outcomes Study 36-Item Short Form Health Survey) were obtained at entry, the end of the 12-week intervention, and 6 months after completion of the intervention program.

Results

At the end of the 12-week intervention, significant improvements in the physical component summary score and 3 (role physical, bodily pain, role emotional) of the 8 domains of the Medical Outcomes Study 36-Item Short Form Health Survey were observed in the EN group. The E group exhibited a significantly increased handgrip strength at postintervention. The positive effects, however, were not maintained at 6-month follow-up, but were reduced.

Conclusions

The combined physical exercise training and nutritional intervention program has beneficial effects on several domains of HRQOL and handgrip strength in prefrail elderly women living in the community. However, further studies are needed to examine approaches that facilitate maintenance of the improved outcomes by combined exercise training and nutritional intervention.

Section snippets

Study Design

A 3-arm randomized controlled trial was designed to examine the effects of a combined exercise training and nutritional program intervention, compared with exercise training alone and control group (neither exercise nor nutrition program).

Participants

The participants were recruited from a “mass health checkup” of older residents in Itabashi Ward, Tokyo, Japan. The mass health checkup is a public comprehensive health examination program for community-dwelling older adults with the aim of preventing

Study Population

In total, 89 participants were randomized and 10 participants dropped out during the intervention. The mean age of the 79 participants was 76.8 (range 70–84) years. Compared with those who completed the 12-week intervention (n = 79), participants who dropped out (n = 10) did not differ significantly, except for the higher percentage of type 2 diabetes and lower SF-36 scores in several domains (Appendix C).

Baseline Characteristics

We compared baseline characteristics of the participants randomly assigned to each

Discussion

This study selected older women who were prefrail, defined by weak handgrip strength and slow walking speed, and examined how group sessions of physical exercise training and nutritional intervention affect their physical performance and HRQOL, and whether any improvement attained can be sustained long term. Overall, the effect on physical performance was not significant, except for the exercise group, compared with the control group, demonstrating a meaningful increase in hand grip strength

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    The authors declare no conflicts of interest.

    This study was supported in part by a Grant in Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan (18700570) from April 2006 to March 2007. Yunhwan Lee was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (2012R1A1B3002939).

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