Lusa Cadore, Eduardo

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https://academica-e.unavarra.es/handle/2454/49478

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Lusa Cadore

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Eduardo

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Ciencias de la Salud

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1173573

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810462

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Now showing 1 - 10 of 23

Open Access
Do frailty and cognitive impairment affect dual-task cost during walking in the oldest old institutionalized patients?
(Springer, 2015-12-14) Lusa Cadore, Eduardo; Casas Herrero, Álvaro; Zambom Ferraresi, Fabrício; Martínez Ramírez, Alicia; Millor Muruzábal, Nora; Gómez Fernández, Marisol; Bays Moneo, Ana Beatriz; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Matemáticas; Matematika
Open Access
Strength training with repetitions to failure does not provide additional strength and muscle hypertrophy gains in young women
(PAGEPress, 2017) Martorelli, Saulo; Lusa Cadore, Eduardo; Izquierdo Redín, Mikel; Celes, Rodrigo; Martorelli, André; Cleto, Vitor Alonso; Alvarenga, José Gustavo; Bottaro, Martim; Ciencias de la Salud; Osasun Zientziak
This study investigated the effects of a 10-week resistance training to failure on neuromuscular adaptations in young women. Eighty-nine active young women were randomly assigned to one of three groups: 1) repetitions to failure (RF; three sets of repetitions to failure); 2) repetitions not to failure with equalized volume (RNFV; four sets of 7 repetitions); and 3) repetitions not to failure (RNF; three sets of 7 repetitions). All groups performed the elbow flexor exercise (bilateral biceps curl) and trained 2 days per week using 70% of 1RM. There were significant increases (p<0.05) in muscle strength after 5 (15.9% for RF, 18.4% for RNF, and 19.9% for RNFV) and 10 (28.3% for RF, 26.8% for RNF, and 28.3% for RNFV) weeks of training, with no significant differences between groups. Additionally, muscular endurance increased after 5 and 10 weeks, with no differences between groups. However, peak torque (PT) increased significantly at 180°.s-1 in the RNFV (13.7%) and RNF (4.1%) groups (p<0.05), whereas no changes were observed in the RF group (-0.5%). Muscle thickness increased significantly (p<0.05) in the RF and RNFV groups after 5 (RF: 8.4% and RNFV: 2.3%) and 10 weeks of training (RF: 17.5%, and RNFV: 8.5%), whereas no significant changes were observed in the RNF group (3.9 and 2.1% after 5 and 10 weeks, respectively). These data suggest that short-term training of repetitions to failure do not yield additional overall neuromuscular improvements in young women.
Open Access
Effects of short-term multicomponent exercise intervention on muscle power in hospitalized older patients: a secondary analysis of a randomized clinical trial
(Wiley, 2023) Lusa Cadore, Eduardo; Izquierdo Redín, Mikel; Teodoro, Juliana Lopes; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; Moriguchi, Emilio Hideyuki; López Sáez de Asteasu, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: bed rest during hospitalization can negatively impact functional independence and clinical status of older individuals. Strategies focused on maintaining and improving muscle function may help reverse these losses. This study investigated the effects of a short-term multicomponent exercise intervention on maximal strength and muscle power in hospitalized older patients. Methods: this secondary analysis of a randomized clinical trial was conducted in an acute care unit in a tertiary public hospital. Ninety (39 women) older patients (mean age 87.7 ± 4.8 years) undergoing acute-care hospitalization [median (IQR) duration 8 (1.75) and 8 (3) days for intervention and control groups, respectively]) were randomly assigned to an exercise intervention group (n = 44) or a control group (n = 46). The control group received standard care hospital including physical rehabilitation as needed. The multicomponent exercise intervention was performed for 3 consecutive days during the hospitalization, consisting of individualized power training, balance, and walking exercises. Outcomes assessed at baseline and discharge were maximal strength through 1 repetition maximum test (1RM) in the leg press and bench press exercises, and muscle power output at different loads (≤ 30% of 1RM and between 45% and 55% of 1RM) in the leg press exercise. Mean peak power during 10 repetitions was assessed at loads between 45% and 55% of 1RM. Results: at discharge, intervention group increased 19.2 kg (Mean ∆% = 40.4%) in leg press 1RM [95% confidence interval (CI): 12.1, 26.2 kg; P < 0.001] and 2.9 kg (Mean ∆% = 19.7%) in bench press 1RM (95% CI: 0.6, 5.2 kg; P < 0.001). The intervention group also increased peak power by 18.8 W (Mean ∆% = 69.2%) (95% CI: 8.4, 29.1 W; P < 0.001) and mean propulsive power by 9.3 (Mean ∆% = 26.8%) W (95% CI: 2.5, 16.1 W; P = 0.002) at loads ≤30% of 1RM. The intervention group also increased peak power by 39.1 W (Mean ∆% = 60.0%) (95% CI: 19.2, 59.0 W; P < 0.001) and mean propulsive power by 22.9 W (Mean ∆% = 64.1%) (95% CI: 11.7, 34.1 W; P < 0.001) at loads between 45% and 55% of 1RM. Mean peak power during the 10 repetitions improved by 20.8 W (Mean ∆% = 36.4%) (95% CI: 3.0, 38.6 W; P = 0.011). No significant changes were observed in the control group for any endpoint. Conclusions An individualized multicomponent exercise program including progressive power training performed over 3 days markedly improved muscle strength and power in acutely hospitalized older patients.
Open Access
Enhancing health outcomes in institutionalized older adults: the critical role of combined exercise and nutritional interventions
(Springer, 2024) Lusa Cadore, Eduardo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Significant progress in health sciences has led to increased life expectancy, yet the potential to decelerate, halt, or reverse the aging process remains uncertain. This remarkable achievement has enabled many individuals to reach advanced ages in good health and with independence, enhancing their quality of life and time spent with family and friends. However, extending lifespan alone does not ensure independent aging or improved quality of life. Despite the additional years gained in recent decades, many adults do not engage in the recommended levels of physical activity. Consequently, these additional years are often marked by increased disability. Inactive aging leads to an unhealthy phenotype among the older population, characterized by diminished physical work capacity and a greater risk of non-communicable diseases. As individuals age, physical inactivity increases their risk of falls, fractures, ospitalizations, frailty, and institutionalization. In particular, the very elderly in institutional settings exhibit reduced functional and cognitive capacities, placing them at higher risk of frailty and disability. Older adults with low functional capacity, especially those institutionalized, are associated with increased public health expenditures compared to their healthier, noninstitutionalized counterparts [3]. Therefore, it is crucial to develop strategies to combat physical frailty in this vulnerable population. Among these, physical exercise interventions, especially those integrating exercise with nutritional support, have shown exceptional costeffectiveness in addressing frailty in institutionalized older adults.
Open Access
Dose-response relationship between exercise duration and enhanced function and cognition in acutely hospitalized older adults: a secondary analysis of a randomized clinical Trial
(Oxford University Press, 2024-06-01) López Sáez de Asteasu, Mikel; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; Galbete Jiménez, Arkaitz; Ramírez Vélez, Robinson; Lusa Cadore, Eduardo; Abizanda, Pedro; Gómez-Pavón, Javier; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute of Smart Cities - ISC; Gobierno de Navarra / Nafarroako Gobernua
Background and objectives: exercise may reverse functional decline in hospitalized older adults, but the optimal duration is unclear. This study examined the potential relationship between in-hospital multicomponent exercise program duration and changes in physical function, cognition, and muscle function to maximize exercise-related health benefits in acutely hospitalized older patients. Research design and methods: this secondary analysis of a multicenter randomized controlled trial examined the relationship between the duration of an in-hospital multicomponent exercise program and changes in physical function, cognition, and muscle strength in 570 acutely hospitalized older adults. Participants completed 3, 4, or 5-7 consecutive days of exercise based on the progression of their acute medical illness. The acute clinical condition of the older patients was similar across the study groups (i.e., 3/4/5-7 days) at admission. Outcomes included the Short Physical Performance Battery (SPPB) for functional capacity, Gait Velocity Test for gait speed, handgrip for muscle strength, and cognitive tests. Results: of the 570 patients included in the analysis, 298 were women (52.3%), and the mean (SD) age was 87.3 (4.8) years. Exercise groups increased SPPB scores compared with controls, with gains of 1.09 points after three days, 1.97 points after four days, and 2.02 points after 5-7 days (p < .001). The 4-day program showed the most significant benefit for functional capacity. Gait velocity increased by 0.11 m/s after 4 and 5-7 days (p = .032). Similar dose-response relationships were seen for handgrip strength and cognition, with 5-7 days showing more significant gains than three days (p < .05). Discussion and implications: multicomponent exercise programs enhance physical and cognitive function in hospitalized older adults, regardless of exercise dosage. A 4-day program significantly boosts functional capacity, although 5-7 days improves handgrip strength and cognition, highlighting the importance of exercise dosage in countering functional decline. Implementing evidence-based inpatient exercise prescriptions can help reverse muscle weakness and improve cognitive and physical function.
Open Access
International exercise recommendations in older adults (ICFSR): expert consensus guidelines
(Springer, 2021) Izquierdo Redín, Mikel; Merchant, R.A.; Morley, John E.; Anker, S.D.; Aprahamian, I.; Arai, H.; Aubertin-Leheudre, M.; Bernabei, R.; Lusa Cadore, Eduardo; Cesari, Matteo; Chen, L.-K.; Souto Barreto, Philipe de; Duque, Gustavo; Ferrucci, L.; Fielding, R.A.; García Hermoso, Antonio; Gutiérrez Robledo, L.M.; Harridge, S.D.R.; Kirk, B.; Kritchevsky, S.; Landi, F.; Lazarus, N.; Martin, F.C.; Marzetti, E.; Pahor, M.; Ramírez Vélez, Robinson; Rodríguez Mañas, Leocadio; Rolland, Y.; Ruiz, J.G.; Theou, O.; Villareal, D.T.; Waters, D.L.; Won Won, C.; Woo, J.; Vellas, Bruno; Fiatarone Singh, Maria; Ciencias de la Salud; Osasun Zientziak
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living-experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.
Open Access
Assessing the impact of physical exercise on cognitive function in older medical patients during acute hospitalization: secondary analysis of a randomized trial
(PLoS, 2019) López Sáez de Asteasu, Mikel; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; Casas Herrero, Álvaro; Lusa Cadore, Eduardo; Galbete Jiménez, Arkaitz; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: Acute illness requiring hospitalization frequently is a sentinel event leading to long-term disability in older people. Prolonged bed rest increases the risk of developing cognitive impairment and dementia in acutely hospitalized older adults. Exercise protocols applied during acute hospitalization can prevent functional decline in older patients, but exercise benefits on specific cognitive domains have not been previously investigated. We aimed to assess the effects of a multicomponent exercise intervention for cognitive function in older adults during acute hospitalization. Methods and findings: We performed a secondary analysis of a single-blind randomized clinical trial (RCT) conducted from February 1, 2015, to August 30, 2017 in an Acute Care of the Elderly (ACE) unit in a tertiary public hospital in Navarre (Spain). 370 hospitalized patients (aged ≥75 years) were randomly allocated to an exercise intervention (n = 185) or a control (n = 185) group (usual care). The intervention consisted of a multicomponent exercise training program performed during 5–7 consecutive days (2 sessions/day). The usual care group received habitual hospital care, which included physical rehabilitation when needed. The main outcomes were change in executive function from baseline to discharge, assessed with the dual-task (i.e., verbal and arithmetic) Gait Velocity Test (GVT) and the Trail Making Test Part A (TMT-A). Changes in the Mini Mental State Examination (MMSE) test and verbal fluency ability were also measured after the intervention period. The physical exercise program provided significant benefits over usual care. At discharge, the exercise group showed a mean increase of 0.1 m/s (95% confidence interval [CI], 0.07, 0.13; p < 0.001) in the verbal GVT and 0.1 m/s (95% CI, 0.08, 0.13; p < 0.001) in the arithmetic GVT over usual care group. There was an apparent improvement in the intervention group also in the TMT-A score (−31.1 seconds; 95% CI, −49.5, −12.7 versus −3.13 seconds; 95% CI, −16.3, 10.2 in the control group; p < 0.001) and the MMSE score (2.10 points; 95% CI, 1.75, 2.46 versus 0.27 points; 95% CI, −0.08, 0.63; p < 0.001). Significant benefits were also observed in the exercise group for the verbal fluency test (mean 2.16 words; 95% CI, 1.56, 2.74; p < 0.001) over the usual care group. The main limitations of the study were patients’ difficulty in completing all the tasks at both hospital admission and discharge (e.g., 25% of older patients were unable to complete the arithmetic GVT, and 47% could not complete the TMT-A), and only old patients with relatively good functional capacity at preadmission (i.e., Barthel Index score ≥60 points) were included in the study. Conclusions: An individualized, multicomponent exercise training program may be an effective therapy for improving cognitive function (i.e., executive function and verbal fluency domains) in very old patients during acute hospitalization. These findings support the need for a shift from the traditional (bedrest-based) hospitalization to one that recognizes the important role of maintaining functional capacity and cognitive function in older adults, key components of intrinsic capacity.
Open Access
Strength and endurance training prescription in healthy and frail elderly
(International Society on Aging and Disease (ISOAD), 2014) Lusa Cadore, Eduardo; Pinto, Ronei Silveira; Bottaro, Martim; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Aging is associated with declines in the neuromuscular and cardiovascular systems, resulting in an impaired capacity to perform daily activities. Frailty is an age-associated biological syndrome characterized by decreases in the biological functional reserve and resistance to stressors due to changes in several physiological systems, which puts older individuals at special risk of disability. To counteract the neuromuscular and cardiovascular declines associated with aging, as well as to prevent and treat the frailty syndrome, the strength and endurance training seems to be an effective strategy to improve muscle hypertrophy, strength and power output, as well as endurance performance. The first purpose of this review was discuss the neuromuscular adaptations to strength training, as well as the cardiovascular adaptations to endurance training in healthy and frail elderly subjects. In addition, the second purpose of this study was investigate the concurrent training adaptations in the elderly. Based on the results found, the combination of strength and endurance training (i.e., concurrent training) performed at moderate volume and moderate to high intensity in elderly populations is the most effective way to improve both neuromuscular and cardiorespiratory functions. Moreover, exercise interventions that include muscle power training should be prescribed to frail elderly in order to improve the overall physical status of this population and prevent disability.
Open Access
Multicomponent exercise with power training: a vital intervention for frail older adults
(Elsevier, 2024) Izquierdo Redín, Mikel; Lusa Cadore, Eduardo; Ciencias de la Salud; Osasun Zientziak
Maintaining functional abilities is critical for healthy aging. Physical inactivity in older adults is linked to chronic diseases, functional declines, and increased risks of multimorbidity, falls, hospitalization, institutionalization, and mortality. Exercise interventions are essential to improve function and health in this population. Recent advancements highlight the importance of tailored exercise prescriptions, cost impacts, minimal effective power training doses, and multicomponent interventions such as the VIVIFRAIL program. This review emphasizes the significance of multicomponent exercise with power training in improving physical function in frail older adults. Resistance and power training alone may not enhance gait and balance, but a 12-week multicomponent program combining these elements significantly improves various physical and cognitive outcomes. Economic analyses demonstrate that such interventions reduce healthcare costs by decreasing hospitalizations. The VIVIFRAIL program successfully implements these approaches in community and healthcare settings, underscoring the positive impact on the well-being of older adults. Ongoing research and implementation of multicomponent exercise programs are vital for promoting health and independence in the aging population.
Open Access
Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR).
(Elsevier, 2025-01-01) Izquierdo Redín, Mikel; Souto Barreto, Philipe de; Arai, Hidenori; Bischoff-Ferrari, Heike A.; Lusa Cadore, Eduardo; Cesari, Matteo; Chen, L.-K.; Coen, Paul M.; Courneya, Kerry S.; Duque, Gustavo; Ferrucci, L.; Fielding, R. A.; García Hermoso, Antonio; Gutiérrez Robledo, L.M.; Harridge, S.D.R.; Kirk, B.; Kritchevsky, S.; Landi, F.; Lazarus, N.; Liu-Ambrose, T.; Marzetti, E.; Merchant, R.A.; Morley, John E.; Pitkälä, Kaisu H.; Ramírez Vélez, Robinson; Rodríguez Mañas, Leocadio; Rolland, Y.; Ruiz, J.G.; López Sáez de Asteasu, Mikel; Villareal, D.T.; Waters, D.L.; Won Won, C.; Vellas, Bruno; Fiatarone Singh, Maria; Ciencias de la Salud; Osasun Zientziak
Aging, a universal and inevitable process, is characterized by a progressive accumulation of physiological alterations and functional decline over time, leading to increased vulnerability to diseases and ultimately mortality as age advances. Lifestyle factors, notably physical activity (PA) and exercise, significantly modulate aging phenotypes. Physical activity and exercise can prevent or ameliorate lifestyle-related diseases, extend health span, enhance physical function, and reduce the burden of non-communicable chronic diseases including cardiometabolic disease, cancer, musculoskeletal and neurological conditions, and chronic respiratory diseases as well as premature mortality. Physical activity influences the cellular and molecular drivers of biological aging, slowing aging rates¿a foundational aspect of geroscience. Thus, PA serves both as preventive medicine and therapeutic agent in pathological states. Sub-optimal PA levels correlate with increased disease prevalence in aging populations. Structured exercise prescriptions should therefore be customized and monitored like any other medical treatment, considering the dose-response relationships and specific adaptations necessary for intended outcomes. Current guidelines recommend a multifaceted exercise regimen that includes aerobic, resistance, balance, and flexibility training through structured and incidental (integrated lifestyle) activities. Tailored exercise programs have proven effective in helping older adults maintain their functional capacities, extending their health span, and enhancing their quality of life. Particularly important are anabolic exercises, such as Progressive resistance training (PRT), which are indispensable for maintaining or improving functional capacity in older adults, particularly those with frailty, sarcopenia or osteoporosis, or those hospitalized or in residential aged care. Multicomponent exercise interventions that include cognitive tasks significantly enhance the hallmarks of frailty (low body mass, strength, mobility, PA level, and energy) and cognitive function, thus preventing falls and optimizing functional capacity during aging. Importantly, PA/exercise displays dose-response characteristics and varies between individuals, necessitating personalized modalities tailored to specific medical conditions. Precision in exercise prescriptions remains a significant area of further research, given the global impact of aging and broad effects of PA. Economic analyses underscore the cost benefits of exercise programs, justifying broader integration into health care for older adults. However, despite these benefits, exercise is far from fully integrated into medical practice for older people. Many healthcare professionals, including geriatricians, need more training to incorporate exercise directly into patient care, whether in settings including hospitals, outpatient clinics, or residential care. Education about the use of exercise as isolated or adjunctive treatment for geriatric syndromes and chronic diseases would do much to ease the problems of polypharmacy and widespread prescription of potentially inappropriate medications. This intersection of prescriptive practices and PA/exercise offers a promising approach to enhance the well-being of older adults. An integrated strategy that combines exercise prescriptions with pharmacotherapy would optimize the vitality and functional independence of older people whilst minimizing adverse drug reactions. This consensus provides the rationale for the integration of PA into health promotion, disease prevention, and management strategies for older adults. Guidelines are included for specific modalities and dosages of exercise with proven efficacy in randomized controlled trials. Descriptions of the beneficial physiological changes, attenuation of aging phenotypes, and role of exercise in chronic disease and disability management in older adults are provided. The use of exercise in cardiometabolic