Physical activity and performance in older persons with musculoskeletal impairment: results of a pilot study with 9-month follow-up

Background and aims : Physical activity in older adults improves fitness, but few studies have examined the short- and long-term effects on physical performance. This analysis is preliminary to a RCT investigating physical activity effects on performance over time in older persons with musculoskeletal impairment. Methods : Fifty sedentary participants, aged 65+, with musculoskeletal impairment and difficulties in complex mobility, but independent in basic activities of daily living (ADLs) were randomly assigned to 3- monthly, twice-a-week, supervised physical exercise (E) or unsupervised regular walking (W), and advised to keep active. Assessments: baseline (T0), discharge (T1), 6 (T2) and 9 (T3) months from baseline. Outcome: Summary of Performance Score (SPS), strength, flexibility; general mental health (GMH), vitality, and self-reported disability. Results : All participants completed follow-ups. At T3, only 12 E and 2 W participants reported exercising regularly. Each outcome, except for GMH, trunk flexibility and basic ADLs, changed over time significantly more in E than in W. After training, E increased SPS (1 point), along with muscle strength, flexibility, vitality, and reduced difficulties in complex mobility. At 9 months, all parameters, except passive hip flexion and shoulder abduction, had reverted to baseline levels. In the same time-frame, W progressively decreased SPS, knee flexion/extension strength and passive flexion, and increased difficulties in basic and complex mobility. Conclusions : In this physically impaired sample, a 3-month exercise program, compared with unsupervised regular walking, was associated with improved performance, fitness and vitality after discharge, and to delayed physical decline in the next 6-month follow-up.