Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial

Abstract

The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min–max = 2.0–10.2) to 3.0 pg/l (min–max = 2.0–20.8), and CRP rose from 0.2 mg/dl (min–max = 0.1–0.9) to 0.3 mg/dl (min–max = 0.1–3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33–15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study

“…However, several studies have shown the beneficial effects of physical training in RA patients [ 29 , 37 ], and physical training should, therefore, be implemented in RA patients for many different reasons. In addition, the effect of physical training on chronic inflammation has been shown in several studies [ 38 , 39 ], and this could, in addition to many other benefits, also improve sexual function. Furthermore, our results, in line with other studies, show how frequent sexual problems are in patients with RA, and it is, therefore, necessary to address sexual health and actively ascertain sexual function in RA patients.…”

Home Exercise Interventions in Frail Older Adults

“…Due to the previously mentioned lack of a standard definition for frailty, only studies utilizing a valid construct to define frailty for inclusion criteria were included. In total, 8 studies were included in this narrative review [15][16][17][18][19][20][21][22] (results from one intervention was published in four separate articles) [15][16][17][18].…”

“…We reviewed 8 studies (Table 1) [15][16][17][18][19][20][21][22]. The analyzed interventions included a total sample of 1030 communityliving older adults (53% women) with a mean age of 79.6 ± 7.1 years.…”

“…Four studies were conducted in Austria [15][16][17][18], one in the UK [19], one in the Netherlands [20•], one in Japan [21], and the other in Taiwan [22•]. These studies used 5 different criteria for frailty: the Edmonton Frail Scale (EFS) [19], the Groningen Frailty Indictor (GFI) [20•], Survey of Health, Ageing, and Retirement Group (SHARE-FI) [15][16][17][18], the Fried criteria (CHS) [22•], and the Kibon Checklist [21]. These studies examined the effects of exercise on a variety of outcomes such as feasibility, frailty status, physical performance measures, lean body mass, skeletal muscle mass, physiological outcomes, mental health, nutritional status, and incidence of falls in frail elderly.…”

“…Among the included studies, type of exercise intervention varied to consist of strength training [19], combined strength and balance training [20•], combined strength training with nutrition education [15][16][17][18], and a multicomponent exercise program including strength, flexibility, balance, and endurance training [21,22]. Additionally, the duration of the interventions ranged from 12 weeks to 6 months and frequency of exercise sessions varied from 2 to 7 times per week.…”