Introduction: Concurrent training has been shown to be a beneficial approach to improve overall health status in older adults. However, little is known about the adaptations of this type of training in the long term (i.e., after cessation of exercise), even less in older people affected by frailty syndrome. Therefore, this study aimed (i) to assess the effects of a 6-week concurrent training program composed of power-oriented resistance training and fast walking interval training on physical function, muscle power, disability in activities of daily living and frailty in pre-frail and frail older people, and (ii) to assess the effects of a 6-month detraining period on these outcomes. Methods: A total of 59 pre-frail and frail older adults (>75 years old; Frailty Phenotype >1) were allocated into intervention (INT; n = 32; 81.8 years; 21 women) or control (CON; n = 27; 82.5 years; 19 women) groups. Primary outcomes of this study were Short Physical Performance Battery (SPPB), relative sit-to-stand (STS) power, Barthel index, Lawton scale and Frailty Phenotype. Assessments were performed at baseline (PRE), after the concurrent training programme (POST) and after 6 months of follow-up (DET) in both groups. Mixed model repeated measures ANOVA with Bonferroni’s post hoc tests was used. Results: Immediately after the intervention (∆ = POST-PRE), INT improved SPPB (∆ = 3.0 points; p < 0.001), relative STS power (∆ = 0.87 W·kg−1; p < 0.001) and reduced their frailty levels (∆ = −1.42 criteria; p < 0.001), while no changes were observed in CON. After 6 months of detraining (∆ = DET-PRE), INT showed higher SPPB (∆ = 2.2 points; p < 0.001), higher relative STS power (∆ = 0.73 W·kg−1; p < 0.001) and lower frailty (∆ = −1.24 criteria; p < 0.001) values than those reported at baseline, which were significantly different than those reported by CON. Both, Barthel index and Lawton scale values were not modified during the study in either group. Conclusions: The 6-week concurrent training program improved physical function, muscle power and reduced frailty in pre-frail and frail older people and these improvements were maintained above baseline levels after 6 months of detraining. However, due to the individual variability found, future studies of long-term responders versus non-responders in frail populations are required.

1.
Dent
E
,
Martin
FC
,
Bergman
H
,
Woo
J
,
Romero-Ortuno
R
,
Walston
JD
.
Management of frailty: opportunities, challenges, and future directions
.
Lancet
.
2019
;
394
(
10206
):
1376
86
.
2.
Xue
QL
.
The frailty syndrome: definition and natural history
.
Clin Geriatr Med
.
2011
;
27
(
1
):
1
15
.
3.
Collard
RM
,
Boter
H
,
Schoevers
RA
,
Oude Voshaar
RC
.
Prevalence of frailty in community-dwelling older persons: a systematic review
.
J Am Geriatr Soc
.
2012
;
60
(
8
):
1487
92
.
4.
Barnett
K
,
Mercer
SW
,
Norbury
M
,
Watt
G
,
Wyke
S
,
Guthrie
B
.
Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
.
Lancet
.
2012
;
380
(
9836
):
37
43
.
5.
Fried
LP
,
Tangen
CM
,
Walston
J
,
Newman
AB
,
Hirsch
C
,
Gottdiener
J
, et al
.
Frailty in older adults: evidence for a phenotype
.
J Gerontol A Biol Sci Med Sci
.
2001
;
56
(
3
):
M146
56
.
6.
Kidd
T
,
Mold
F
,
Jones
C
,
Ream
E
,
Grosvenor
W
,
Sund-Levander
M
, et al
.
What are the most effective interventions to improve physical performance in pre-frail and frail adults? A systematic review of randomised control trials
.
BMC Geriatr
.
2019
;
19
(
1
):
184
.
7.
Cadore
EL
,
Pinto
RS
,
Bottaro
M
,
Izquierdo
M
.
Strength and endurance training prescription in healthy and frail elderly
.
Aging Dis
.
2014
;
5
(
3
):
183
95
.
8.
Alcazar
J
,
Losa-Reyna
J
,
Rodriguez-Lopez
C
,
Alfaro-Acha
A
,
Rodriguez-Manas
L
,
Ara
I
, et al
.
The sit-to-stand muscle power test: an easy, inexpensive and portable procedure to assess muscle power in older people
.
Exp Gerontol
.
2018
;
112
:
38
43
.
9.
Bahat
G
,
Kilic
C
,
Eris
S
,
Karan
MA
.
Power versus sarcopenia: associations with functionality and physical performance measures
.
J Nutr Health Aging
.
2020
.
10.
Baltasar-Fernandez
I
,
Alcazar
J
,
Mañas
A
,
Alegre
LM
,
Alfaro-Acha
A
,
Rodriguez-Mañas
L
, et al
.
Relative sit-to-stand power cut-off points and their association with negatives outcomes in older adults
.
Sci Rep
.
2021
;
11
(
1
):
19460
.
11.
Baltasar-Fernandez
I
,
Alcazar
J
,
Rodriguez-Lopez
C
,
Losa-Reyna
J
,
Alonso-Seco
M
,
Ara
I
, et al
.
Sit-to-stand muscle power test: comparison between estimated and force plate-derived mechanical power and their association with physical function in older adults
.
Exp Gerontol
.
2021
;
145
:
111213
.
12.
Losa-Reyna
J
,
Alcazar
J
,
Carnicero
J
,
Alfaro-Acha
A
,
Castillo-Gallego
C
,
Rosado-Artalejo
C
, et al
.
Impact of relative muscle power on hospitalization and all-cause mortality in older adults
.
J Gerontol A Biol Sci Med Sci
.
2022
;
77
(
4
):
781
9
.
13.
Marriott
CFS
,
Petrella
AFM
,
Marriott
ECS
,
Boa Sorte Silva
NC
,
Petrella
RJ
.
High-intensity interval training in older adults: a scoping review
.
Sports Med Open
.
2021
;
7
(
1
):
49
.
14.
Sillanpää
E
,
Häkkinen
K
,
Holviala
J
,
Häkkinen
A
.
Combined strength and endurance training improves health-related quality of life in healthy middle-aged and older adults
.
Int J Sports Med
.
2012
;
33
(
12
):
981
6
.
15.
García-Pinillos
F
,
Laredo-Aguilera
JA
,
Muñoz-Jiménez
M
,
Latorre-Román
PA
.
Effects of 12-week concurrent high-intensity interval strength and endurance training program on physical performance in healthy older people
.
J Strength Cond Res
.
2019
;
33
(
5
):
1445
52
.
16.
Losa-Reyna
J
,
Baltasar-Fernandez
I
,
Alcazar
J
,
Navarro-Cruz
R
,
Garcia-Garcia
FJ
,
Alegre
LM
, et al
.
Effect of a short multicomponent exercise intervention focused on muscle power in frail and pre frail elderly: a pilot trial
.
Exp Gerontol
.
2019
;
115
:
114
21
.
17.
Müller
DC
,
Izquierdo
M
,
Boeno
FP
,
Aagaard
P
,
Teodoro
JL
,
Grazioli
R
, et al
.
Adaptations in mechanical muscle function, muscle morphology, and aerobic power to high-intensity endurance training combined with either traditional or power strength training in older adults: a randomized clinical trial
.
Eur J Appl Physiol
.
2020
;
120
(
5
):
1165
77
.
18.
Alcazar
J
,
Losa-Reyna
J
,
Rodriguez-Lopez
C
,
Navarro-Cruz
R
,
Alfaro-Acha
A
,
Ara
I
, et al
.
Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD
.
Scand J Med Sci Sports
.
2019
;
29
(
10
):
1591
603
.
19.
Izquierdo
M
,
Laosa
O
,
Cadore
EL
,
Abizanda
P
,
Garcia-Garcia
FJ
,
Hornillos
M
, et al
.
Two-year follow-up of a multimodal intervention on functional capacity and muscle power in frail patients with type 2 diabetes
.
J Am Med Dir Assoc
.
2021
;
22
(
9
):
1906
11
.
20.
Guralnik
JM
,
Simonsick
EM
,
Ferrucci
L
,
Glynn
RJ
,
Berkman
LF
,
Blazer
DG
, et al
.
A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission
.
J Gerontol
.
1994
;
49
(
2
):
M85
94
.
21.
Mahoney
FI
,
Barthel
DW
.
Functional EVALUATION: the barthel INDEX
.
Md State Med J
.
1965
;
14
:
61
5
.
22.
Lawton
MP
,
Brody
EM
.
Assessment of older people: self-maintaining and instrumental activities of daily living
.
Gerontologist
.
1969
;
9
(
3 Part 1
):
179
86
.
23.
Alcazar
J
,
Rodriguez-Lopez
C
,
Ara
I
,
Alfaro-Acha
A
,
Manas-Bote
A
,
Guadalupe-Grau
A
, et al
.
The force-velocity relationship in older people: reliability and validity of a systematic procedure
.
Int J Sports Med
.
2017
;
38
(
14
):
1097
104
.
24.
Cadore
EL
,
Rodriguez-Manas
L
,
Sinclair
A
,
Izquierdo
M
.
Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review
.
Rejuvenation Res
.
2013
;
16
(
2
):
105
14
.
25.
Clegg
A
,
Young
J
,
Iliffe
S
,
Rikkert
MO
,
Rockwood
K
.
Frailty in elderly people
.
Lancet
.
2013
;
381
(
9868
):
752
62
.
26.
Rodriguez-Mañas
L
,
Laosa
O
,
Vellas
B
,
Paolisso
G
,
Topinkova
E
,
Oliva-Moreno
J
, et al
.
Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus
.
J Cachexia Sarcopenia Muscle
.
2019
;
10
(
4
):
721
33
.
27.
Toraman
NF
,
Ayceman
N
.
Effects of six weeks of detraining on retention of functional fitness of old people after nine weeks of multicomponent training
.
Br J Sports Med
.
2005
;
39
(
8
):
565
8
; discussion 68.
28.
Carvalho
MJ
,
Marques
E
,
Mota
J
.
Training and detraining effects on functional fitness after a multicomponent training in older women
.
Gerontology
.
2009
;
55
(
1
):
41
8
.
29.
Bouaziz
W
,
Malgoyre
A
,
Schmitt
E
,
Lang
P-O
,
Vogel
T
,
Kanagaratnam
L
.
Effect of high-intensity interval training and continuous endurance training on peak oxygen uptake among seniors aged 65 or older: a meta-analysis of randomized controlled trials
.
Int J Clin Pract
.
2020
;
74
(
6
):
e13490
.
30.
Fatouros
IG
,
Kambas
A
,
Katrabasas
I
,
Nikolaidis
K
,
Chatzinikolaou
A
,
Leontsini
D
, et al
.
Strength training and detraining effects on muscular strength, anaerobic power, and mobility of inactive older men are intensity dependent
.
Br J Sports Med
.
2005
;
39
(
10
):
776
80
.
31.
Alcazar
J
,
Alegre
LM
,
Van Roie
E
,
Magalhães
JP
,
Nielsen
BR
,
González-Gross
M
, et al
.
Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort
.
J Cachexia Sarcopenia Muscle
.
2021
;
12
(
4
):
921
32
.
32.
Arrieta
H
,
Rezola-Pardo
C
,
Gil
SM
,
Virgala
J
,
Iturburu
M
,
Antón
I
, et al
.
Effects of multicomponent exercise on frailty in long-term nursing homes: a randomized controlled trial
.
J Am Geriatr Soc
.
2019
;
67
(
6
):
1145
51
.
33.
Cadore
EL
,
Casas-Herrero
A
,
Zambom-Ferraresi
F
,
Idoate
F
,
Millor
N
,
Gomez
M
, et al
.
Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians
.
Age
.
2014
;
36
(
2
):
773
85
.
34.
Shah
S
,
Vanclay
F
,
Cooper
B
.
Improving the sensitivity of the Barthel Index for stroke rehabilitation
.
J Clin Epidemiol
.
1989
;
42
(
8
):
703
9
.
35.
Giné-Garriga
M
,
Guerra
M
,
Pagès
E
,
Manini
TM
,
Jiménez
R
,
Unnithan
VB
.
The effect of functional circuit training on physical frailty in frail older adults: a randomized controlled trial
.
J Aging Phys Act
.
2010
;
18
(
4
):
401
24
.
36.
Tarazona-Santabalbina
FJ
,
Gómez-Cabrera
MC
,
Pérez-Ros
P
,
Martínez-Arnau
FM
,
Cabo
H
,
Tsaparas
K
, et al
.
A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: a randomized clinical trial
.
J Am Med Dir Assoc
.
2016
;
17
(
5
):
426
33
.
37.
Suijker
JJ
,
van Rijn
M
,
Ter Riet
G
,
Moll van Charante
EP
,
de Rooij
SE
,
Buurman
BM
.
Minimal important change and minimal detectable change in activities of daily living in community-living older people
.
J Nutr Health Aging
.
2017
;
21
(
2
):
165
72
.
38.
Bouwstra
H
,
Smit
EB
,
Wattel
EM
,
van der Wouden
JC
,
Hertogh
C
,
Terluin
B
, et al
.
Measurement properties of the Barthel index in geriatric rehabilitation
.
J Am Med Dir Assoc
.
2019
;
20
(
4
):
420
5.e1
.
39.
Romero-Ortuno
R
,
Hartley
P
,
Davis
J
,
Knight
SP
,
Rizzo
R
,
Hernández
B
, et al
.
Transitions in frailty phenotype states and components over 8 years: evidence from the Irish longitudinal study on ageing
.
Arch Gerontol Geriatr
.
2021
;
95
:
104401
.
40.
Sadjapong
U
,
Yodkeeree
S
,
Sungkarat
S
,
Siviroj
P
.
Multicomponent exercise program reduces frailty and inflammatory biomarkers and improves physical performance in community-dwelling older adults: a randomized controlled trial
.
Int J Environ Res Public Health
.
2020
;
17
(
11
):
3760
.
You do not currently have access to this content.