C. de Labra, C. Guimaraes-Pinheiro, A. Maseda, T. Lorenzo, J.C. Millàn-Calenti
BMC Geriatrics. 2015;15:154
Frailty is a common geriatric syndrome that influences several domains, such as gait, mobility, balance, muscle strength, motor processing, cognition, nutrition, endurance and physical activity. It is directly related to adverse consequences, such as falls, disability, the need for long term care, hospitalization, and even mortality.
Physical exercise has demonstrated its beneficial effects in reducing the risk of many adverse outcomes, such as frailty.
The major goal of this systematic review of randomized, controlled trials (RCTs) was to investigate the benefits of exercise programs in frail elderly people, considering only those studies where frailty had been defined.
Of 507 articles, nine papers met the inclusion criteria. Of these, six included multi-component exercise interventions, one included physical comprehensive training, and two included exercises based on strength training. All nine of these trials included a control group receiving no treatment, maintaining their habitual lifestyle or using a home-based low level exercise program. Five investigated the effects of exercise on falls, and among them, three found a positive impact of exercise interventions on this parameter. Six trials reported the effects of exercise training on several aspects of mobility, and among them, four showed enhancements in several measurements of this outcome. Three trials focused on the effects of exercise intervention on balance performance, and one demonstrated enhanced balance. Four trials investigated functional ability, and two showed positive results after the intervention. Seven trials investigated the effects of exercise intervention on muscle strength, and five of them reported increases; three trials investigated the effects of exercise training on body composition, finding improvements in this parameter in two of them; finally, one trial investigated the effects of exercise on frailty using Fried’s criteria and found an improvement in this measurement. Exercise interventions have demonstrated improvement in different outcome measurements in frail older adults, however, there were large differences between studies with regard to effect sizes.




Comment: Physical activity is a key component for a successful aging. It can be practiced by healthy and disabled older people. Not surprisingly it is one of the proposed interventions for the treatment of sarcopenia and frailty. In particular, this systematic review suggested that frail older adults seemed to benefit from exercise interventions, although the optimal program remains unclear. Multi-component exercise programs including some type of resistance training would promote better performance in the global functional capacity of frail older adults. More studies of this topic and with frail populations are needed to select the most favorable exercise program.