Exercise prescription to reverse frailty

Appl Physiol Nutr Metab. 2016 Oct;41(10):1112-1116. doi: 10.1139/apnm-2016-0226. Epub 2016 Sep 21.

Abstract

Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1-2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2-3 times a week, for 45-60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized. On the other hand, frail (CHS-frailty phenotype ≥ 3 physical deficits) older adults should exercise 3 times per week, for 30-45 min for each session with an emphasis on aerobic training. During aerobic, balance, and flexibility training, both frail and pre-frail older adults should work at an intensity equivalent to a rating of perceived exertion of 3-4 ("somewhat hard") on the Borg CR10 scale. Resistance-training intensity should be based on a percentage of 1-repetition estimated maximum (1RM). Program onset should occur at 55% of 1RM (endurance) and progress to higher intensities of 80% of 1RM (strength) to maximize functional gains. Exercise is the medicine to reverse or mitigate frailty, preserve quality of life, and restore independent functioning in older adults at risk of frailty.

Keywords: aging; entraînement physique; exercice contre résistance; exercise prescription; exercise recommendations; exercise training; fragilité; frailty; prescription d’exercice; recommandations en matière d’exercice physique; resistance exercise; vieillissement.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging*
  • Evidence-Based Medicine*
  • Exercise*
  • Frail Elderly*
  • Geriatric Assessment
  • Healthy Lifestyle*
  • Humans
  • Independent Living*
  • Physical Exertion
  • Physical Fitness
  • Postural Balance
  • Practice Guidelines as Topic
  • Quality of Life*
  • Range of Motion, Articular
  • Resistance Training
  • Sensation Disorders / prevention & control
  • Sensation Disorders / therapy
  • Terminology as Topic
  • Time Factors