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1.
J Geriatr Phys Ther ; 42(2): E15-E22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29738405

RESUMO

BACKGROUND AND PURPOSE: Mild cognitive impairment (MCI) may be a precursor to dementia; however, its progression may be prevented or slowed with exercise. This study aimed at determining the effects of group aerobic and strength training on cognition, conditioning, muscle endurance, and balance in underprivileged community-dwelling older adults with MCI. METHODS: This was a single-blind, randomized, and matched-pair controlled (gender, age, body mass index, and Addenbrooke's Cognitive Examination-Revised for MCI diagnosis) clinical trial. It was developed in 4 community centers. Fifty-two sedentary, functionally independent individuals, aged 60 years or more, with MCI were randomized into intervention group (n = 26) and control group (n = 26). Participants were tested before and after a 24-week exercise program. Sociodemographic characteristics, cognition (Mini-Mental State Examination), conditioning (2-minute stationary walk test), lower-limb endurance (30-second sit/stand test), and balance data (Functional Reach test) were collected. The intervention group walked and exercised twice weekly (60 minutes each) using ankle weights, latex resistance bands, and dumbbells. The exercise load and intensity were regularly increased on the basis of a preestablished incremental number of sets and repetitions and on the basis of the participants' correct movement execution with a given load. Data were analyzed with Pearson χ test, Fisher exact test, Student t test, Mann-Whitney U test, 2-way repeated measures analysis of variance, and the Cohen d. RESULTS AND DISCUSSION: Before the intervention, no significant differences were found between groups for any of the variables. Postintervention, significant differences were observed in cognition, conditioning, muscle endurance, and balance. Significant time-by-group interactions were detected in all the intergroup analyses. The improvements observed in the intervention group had medium to large effect sizes (0.35-1.15). The control group's decrease in cognition (13.9%) had a large effect size, while its Functional Reach test decrease (11.4%) had a medium effect size, with no significant change in conditioning or muscle endurance. CONCLUSION: The training program improved cognitive function, muscle endurance, aerobic conditioning, and balance in older adults with MCI.


Assuntos
Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Treinamento Resistido , Caminhada/fisiologia , Caminhada/psicologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Resistência Física , Aptidão Física , Equilíbrio Postural , Método Simples-Cego , Teste de Caminhada
2.
Clin Rehabil ; 33(3): 439-449, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30514115

RESUMO

OBJECTIVE:: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. DESIGN:: Single blinded, randomized, matched pairs clinical trial. SETTING:: Four primary healthcare units. SUBJECTS:: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke's Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26). INTERVENTION:: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities' public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. MAIN MEASURES:: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. RESULTS:: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8-6); after: 2.5 (1-4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2-7.3); after: 4 (2-5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group's mobility and balance. Large effect sizes were observed the intervention group's mobility and balance. CONCLUSION:: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.


Assuntos
Disfunção Cognitiva/reabilitação , Depressão/terapia , Processos Grupais , Limitação da Mobilidade , Equilíbrio Postural , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/psicologia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Método Simples-Cego
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