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Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome

Background and Objectives: The world’s population is rapidly aging, and it is estimated that, by 2050, every sixth person on earth will be older than 65 years. Around 30% of older adults entering cardiac rehabilitation (CR) meet the criteria of frailty. Frailty identification has not been included i...

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Autores principales: Beigienė, Aurelija, Petruševičienė, Daiva, Barasaitė, Vitalija, Kubilius, Raimondas, Macijauskienė, Jūratė
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705993/
https://www.ncbi.nlm.nih.gov/pubmed/34946289
http://dx.doi.org/10.3390/medicina57121344
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author Beigienė, Aurelija
Petruševičienė, Daiva
Barasaitė, Vitalija
Kubilius, Raimondas
Macijauskienė, Jūratė
author_facet Beigienė, Aurelija
Petruševičienė, Daiva
Barasaitė, Vitalija
Kubilius, Raimondas
Macijauskienė, Jūratė
author_sort Beigienė, Aurelija
collection PubMed
description Background and Objectives: The world’s population is rapidly aging, and it is estimated that, by 2050, every sixth person on earth will be older than 65 years. Around 30% of older adults entering cardiac rehabilitation (CR) meet the criteria of frailty. Frailty identification has not been included in the routine evaluation of CR patients yet, and there is a lack of evidence on what training regimen for improving physical performance in frail people is optimal. Therefore, the aim of our study was to determine the prevalence of frailty and to evaluate the effect of two different complementary training programs on the gait speed of older vulnerable and frail patients with acute coronary syndrome and mid-range-to-preserved left ventricular ejection fraction (≥40%) during short-term CR. Materials and Methods: This randomized controlled trial was conducted from January 2020 to September 2021. CR participants (n = 97) with a mean age of 73.1 ± 5.3 years were randomly allocated into three groups: control (CG, n = 32), intervention-1 (IG-1, n = 32) and intervention-2 (IG-2, n = 33). The patients of all three groups attended a usual inpatient CR program, and two intervention groups additionally received different resistance and balance training programs 3 days a week: the IG-1 underwent complementary training with traditional means of physical therapy, while the IG-2 underwent complementary training with mechanical devices. The mean CR duration was 18.9 ± 1.7 days. Frailty was assessed with the Edmonton Frail Scale, and the 5 m walk test was used to evaluate gait speed. Results: Frailty was determined in 37.1% of participants, and 42.3% met the criteria of being vulnerable. After CR, the gait speed of frail and vulnerable patients significantly improved in all three groups (p < 0.05). In the IG-2, slow gait speed was reversed to normal in the overwhelming majority of patients (p < 0.05), while the CG had the greatest proportion of patients who remained to be slow after CR (p < 0.05). Conclusions: A considerable part of patients entering CR are frail or vulnerable; therefore, it is of crucial importance to assess frailty status in all older people. All three CR programs improved gait speed in frail and vulnerable older patients with ischemic heart disease. Complementary resistance and balance training with mechanical devices more effectively reversed slow gait speed to normal during short-term CR.
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spelling pubmed-87059932021-12-25 Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome Beigienė, Aurelija Petruševičienė, Daiva Barasaitė, Vitalija Kubilius, Raimondas Macijauskienė, Jūratė Medicina (Kaunas) Article Background and Objectives: The world’s population is rapidly aging, and it is estimated that, by 2050, every sixth person on earth will be older than 65 years. Around 30% of older adults entering cardiac rehabilitation (CR) meet the criteria of frailty. Frailty identification has not been included in the routine evaluation of CR patients yet, and there is a lack of evidence on what training regimen for improving physical performance in frail people is optimal. Therefore, the aim of our study was to determine the prevalence of frailty and to evaluate the effect of two different complementary training programs on the gait speed of older vulnerable and frail patients with acute coronary syndrome and mid-range-to-preserved left ventricular ejection fraction (≥40%) during short-term CR. Materials and Methods: This randomized controlled trial was conducted from January 2020 to September 2021. CR participants (n = 97) with a mean age of 73.1 ± 5.3 years were randomly allocated into three groups: control (CG, n = 32), intervention-1 (IG-1, n = 32) and intervention-2 (IG-2, n = 33). The patients of all three groups attended a usual inpatient CR program, and two intervention groups additionally received different resistance and balance training programs 3 days a week: the IG-1 underwent complementary training with traditional means of physical therapy, while the IG-2 underwent complementary training with mechanical devices. The mean CR duration was 18.9 ± 1.7 days. Frailty was assessed with the Edmonton Frail Scale, and the 5 m walk test was used to evaluate gait speed. Results: Frailty was determined in 37.1% of participants, and 42.3% met the criteria of being vulnerable. After CR, the gait speed of frail and vulnerable patients significantly improved in all three groups (p < 0.05). In the IG-2, slow gait speed was reversed to normal in the overwhelming majority of patients (p < 0.05), while the CG had the greatest proportion of patients who remained to be slow after CR (p < 0.05). Conclusions: A considerable part of patients entering CR are frail or vulnerable; therefore, it is of crucial importance to assess frailty status in all older people. All three CR programs improved gait speed in frail and vulnerable older patients with ischemic heart disease. Complementary resistance and balance training with mechanical devices more effectively reversed slow gait speed to normal during short-term CR. MDPI 2021-12-09 /pmc/articles/PMC8705993/ /pubmed/34946289 http://dx.doi.org/10.3390/medicina57121344 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Beigienė, Aurelija
Petruševičienė, Daiva
Barasaitė, Vitalija
Kubilius, Raimondas
Macijauskienė, Jūratė
Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title_full Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title_fullStr Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title_full_unstemmed Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title_short Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome
title_sort frailty and different exercise interventions to improve gait speed in older adults after acute coronary syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705993/
https://www.ncbi.nlm.nih.gov/pubmed/34946289
http://dx.doi.org/10.3390/medicina57121344
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