The older population is the least likely to engage in regular physical activity and to meet international recommendations for performing 150 minutes of moderate-intensity physical activity per week. Additionally, older adults living in care institutions tend to have even lower levels of physical activity compared to those living in the community. This physical inactivity among institutionalized older adults carries harmful consequences, such as the loss of muscle mass and strength, both of which are associated with decreased balance and an increased risk of falling, an adverse event with personal, physical, economic, social, and potentially fatal implications. Although this situation is well described in the literature, little is known about whether increasing physical activity levels from near-optimal (almost 150 minutes of physical activity per week) to optimal (more than 150 minutes per week) can influence muscle strength and balance in institutionalized older adults, and thereby reduce the burden related to falls.
This type of research is essential, as weekly frequency may be a variable to consider in the prescription of physical exercise for this population. The American College of Sports Medicine (ACSM) recommends using the FITT principle (Frequency, Intensity, Type, and Time) to guide exercise prescription. By adjusting these factors, individuals can tailor workouts to their specific goals and fitness levels. While attention has been given to the type of training, its intensity, and its duration, it is important to recognize that total weekly volume may be a determining factor for improvements in components of physical fitness.
Considering that this population tends to be physically inactive, incorporating physical activity two or three times per week may lead to different outcomes. While exercising twice per week may seem suboptimal, as it does not meet international guidelines, engaging in physical activity three times per week may be the minimum necessary to observe positive effects on muscle strength and balance.
65 years to 90 years.
Apparently healthy and without medical contraindications to exercise.
Normal weight (BMI ≤ 24.99 kg/m2) or overweight (BMI > 25 ≤ 29.99 kg/m2)
Being institutionalized for more than 6 months.
High risk of cardiovascular disease (ACSM, 2021)
High blood pressure (≥ 140/90mmHg) in the pre-exercise evaluation (ESC, 2024)
High risk of fall (more than 1 fall over the last 6 months).
Acquired injury.
Parallel
Behavioral: 2 exercise sessions (2X)
BehavioralThe (1) control group (2X) will receive an exercise screening checklist and 24 group training sessions, 2 times per week during a 12-week period, based on International Exercise Recommendations in Older Adults (ICFSR; Izquierdo et al., 2021). These are the recommendations commonly used for older adults.
Behavioral: 2 exercise sessions (3X)
BehavioralThe (3) experimental group (3X) will receive an exercise screening checklist and 36 group training sessions, 3 times per week during a 12-week period, based on International Exercise Recommendations in Older Adults (ICFSR; Izquierdo et al., 2021). These are the recommendations commonly used for older adults. This additional session will increase weekly exercise volume compared to the control group, also being closer to complying to the WHO International Guidelines of weekly physical activity (Bull et al., 2020)
Training sessions attendance rate
Post-intervention weekly exercise frequency, objectively measured by the physiologist using an attendance sheet.
Waist measurement
Waist measurement is determined by using the midpoint between the lowest rib and the top of the hip bone, then wrapping a measurement tape around the waist.
Height
Height is determined by the vertical distance of the person from the base to the top using a stadiometer.
Weight
Weight is determined by the body mass of a person on a calibrated scale.
Body Mass Index
Body Mass Index is calculated by dividing weight in kilograms by the square of height in meters.
Resting blood pressure (mmHg)
Resting blood pressure is measured using an arm sleeve equipment monitor by placing the cuff so that its lower edge is about three centimeters above the elbow and the arm is supported on a table, so that the cuff is at the level of your heart.
Resting heart rate before exercise (bpm)
Resting heart rate is measured using an arm sleeve equipment monitor by placing the cuff so that its lower edge is about three centimeters above the elbow and the arm is supported on a table, so that the cuff is at the level of your heart.
Exercise intensity
Exercise intensity is measured using the talk test, which considers the ability a person can talk and/or breathe and based on that, determined intensity.
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