Background: Preserving health and physical fitness is critical to ensure independent living across the lifespan. Lower levels of physical fitness are associated with age-related cognitive decline and a higher prevalence of mild cognitive impairment (MCI). Thus, this study investigates the influence of a six-month dance intervention on selected measures of physical fitness in older adults with MCI. Methods: In this randomized controlled trial, 55 patients with MCI were randomized into a sportive dance training (IG; n = 26; age: 70.7 ± 5.6 years; 62% female) or an inactive control group (CG; n = 24; age: 69.1 ± 6.8 years; 46% female). The dance group received two 90 min dance training sessions per week over a duration of six-months, which focused on learning dance movement patterns. During the training sessions, heart rate was measured to control exercise intensity. Physical fitness was assessed using cardiopulmonary exercise testing (CPET), lower limb functional fitness via sit-to-stand test, handgrip strength, and heart rate variability (HRV). Results: We observed that the dance intervention preserved the cardiorespiratory fitness as measured by maximal oxygen uptake (VO2max) during CPET, which decreased in the CG. Furthermore, participants in the IG demonstrated increases in leg and handgrip strength, although these were not statistically significant. HRV displayed a non-significant decrease following the intervention. Conclusions: The results of this randomized controlled trial suggest that sportive dance training can preserve elements of physical fitness (i.e., cardiorespiratory fitness) in older adults with MCI. Although improvements in the other parameters (i.e., leg and handgrip strength) were statistically non-significant, likely due to the small sample size, stabilizing muscular fitness and preventing age-related decline in older adults with MCI is important for maintaining functional independence. For future studies, we recommend a longer training duration paired with precise control of regular physical activity levels, an important confounding factor.
Sports and exercise training research is constantly evolving to maintain, improve, or regain psychophysical, social, and emotional performance. Exercise training research requires a balance between the benefits and the potential risks. There is an inherent risk of scientific misconduct and adverse events in most sports; however, there is a need to minimize it. We aim to provide a comprehensive overview of the clinical and ethical challenges in sports and exercise research. We also enlist solutions to improve method design in clinical trials and provide checklists to minimize the chances of scientific misconduct. At the outset, historical milestones of exercise science literature are summarized. It is followed by details about the currently available regulations that help to reduce the risk of violating good scientific practices. We also outline the unique characteristics of sports-related research with a narrative of the major differences between sports and drug-based trials. An emphasis is then placed on the importance of well-designed studies to improve the interpretability of results and generalizability of the findings. This review finally suggests that sports researchers should comply with the available guidelines to improve the planning and conduct of future research thereby reducing the risk of harm to research participants. The authors suggest creating an oath to prevent malpractice, thereby improving the knowledge standards in sports research. This will also aid in deriving more meaningful implications for future research based on high-quality, ethically sound evidence.
Purpose: Handgrip strength is considered as important indicator for general fitness in older adults. However, it does not notably reflect adaptations from whole-body training but may reflect adaptions of multicomponent exercise training. These approaches seem to be more functional and related to relevant daily tasks. Effects of multicomponent agility training on handgrip strength are analysed. Methods: Healthy older adults (N = 79, 69.3 ± 4.4 years, 64% female) were randomly assigned to an intervention (IG) or control group (CG). IG took part in a twice weekly 60 min multicomponent agility training for 12 months. Adherence rate of the participants was 75 ± 10 %. Results: Neither maximum handgrip strength (Fmax) differed between groups (IG: 318 ± 97 N, CG: 302 ± 92 N) nor did it change after the intervention (IG: 315 ± 90 N, CG: 301 ± 97 N). Mixed ANOVA for Fmax (F(1,49) = 0.018, p = 0.893) revealed no significant group × time interaction with an effect size of $$\eta^2 \leq 0.001$$ . Similar results were observed for rate of force development (RFD) (F(1,49) = 0.038, p = 0.847) with an effect size $$\eta^2 = 0.001$$ . RFD did not differ between groups in pre (IG: 876 ± 585 N/s, CG: 712 ± 303 N/s) and post (IG: 890 ± 424 N/s, CG: 702 ± 368 N/s) measurements. Correlation for ACE and Fmax (r(64) = − 0.367, p = 0.005) and for RFD (r(64) = − 0.487, p < 0.001) was found to be negative. Conclusion: A 1-year multicomponent agility training does not affect handgrip strength in healthy older adults. However, handgrip strength (Fmax and RFD) is associated with agility, thus both handgrip strength indicators and agility might serve as local and functional vitality surrogates.
Background/Objectives: Older adults with mild cognitive impairment often exhibit reduced postural control and increased fall risk. As fall-related injuries consume substantial healthcare resources, the development of fall-preventive interventions is of public health relevance. This study aims to investigate the effects of a six-month dance intervention on postural control and fall-related measures in older adults with mild cognitive impairment. Methods: In this randomized controlled trial, 55 participants were allocated to either an intervention group or a control group. The intervention group performed two 90-min dance training sessions per week for six months, while the control group maintained their usual activities of daily living. Postural control was operationalized via balance performance, which was measured with the Sensory Organization Test and the Limits of Stability Test. Neuromuscular function of the lower extremities was assessed via muscle contraction velocity using tensiomyography. Fear of falling was quantified with the Falls Efficacy Scale, and participants reported fall history over the past year. It was hypothesized that older adults with mild cognitive impairment participating in the six-month dance training would show significantly greater improvements in postural control and fall-related outcomes than those in the control group. Results: A mixed analysis of variance (time × group) revealed no significant improvements in balance performance or neuromuscular function following the dance intervention (p > 0.05). However, several main effects for time were observed in the Sensory Organization Test, Limits of Stability Test, and muscle contraction velocity. Scores on the Falls Efficacy Scale improved significantly in the intervention group, reflecting reduced fear of falling, although only shown by a paired-samples t-test (t(23)= 2.276, p = 0.032, d = 0.465). Conclusions: This study did not provide evidence that a six-month dance intervention improves postural or neuromuscular functions. However, it cannot be ruled out that such null findings are related to confounding factors, such as insufficient training specificity or duration. Nonetheless, the fear of falling was significantly reduced in the intervention group, suggesting potential benefits for perceived fall risk in older adults with mild cognitive impairment.
The Short Physical Performance Battery (SPPB) is a common tool for examining lower extremity physical functioning and respective intervention effects in older adults. It is primarily used in community-dwelling older adults, but also in multimorbid populations such as nursing home residents. However, previous literature reported floor effects (receiving the lowest score) in this vulnerable population, particularly for the scoring of the 4-meter walking subtest. This study aimed to propose norm values and a scoring system addressing floor effects, to compare sensitivity to performance changes between the original and revised systems, and to externally validate the revised scoring. Data from three randomized controlled trials (PROCARE (n=399, 84.0±7.8 years, 77% female), PROfit (n=97, 82.4±9.8 years, 72% female), and PROGRESS (n=97, 84.6±7.7 years, 75% female)) were re-analyzed. SPPB was administered at baseline and post-intervention. Quartiles for time to complete the 4-meter walking test at baseline of the PROCARE dataset were analyzed, and norm values and a corresponding scoring system (0–4 points) were proposed. Floor effects were analyzed by comparing the number of participants in each scoring category. Sensitivity of the new scoring was evaluated by comparing means and standard deviations of time for completion at baseline and post-interventions. External validation was done using the PROfit and PROGRESS datasets. Based on the adjusted scoring system, a completion time faster than 5.65 seconds (old: 4.82 seconds) corresponded to the highest score (4 points), and a time exceeding 10.80 seconds (old: 8.70 seconds) to the lowest score (1 point). The proposed scoring system reduced the floor effect from 36% to 21%, and analysis of sensitivity revealed a better fit with time to completion. External validation indicated that the proposed scoring categories appropriately reflected participants’ functional and cognitive characteristics. The new scoring differentiated walking performance in a multimorbid sample, particularly within the group of low performers and better displayed changes in performance. Thus, it can contribute to detecting changes due to physiological deterioration, limited mobility, and use of walking aids which otherwise may be missed in this vulnerable population.