Physical Activity Clinical Trial
Official title:
Prevention Study, on Loss of Autonomy and Physical Dependence, Based on Physical Exercises and Nutrition Counseling Applied to 70 Years Old and More People.
According to several reports, the percentage of persons aged of more than 80 years is going
to be doubled for the 25 years, to reach 10 % of the population. This implies an adaptation
of practices of taken care for elderly people. Furthermore, the expectancy of life without
any disability at 65 years old is 10.4 years and remains much lower than the general
expectancy of life, which is of 24.4 years for women and 19.1 years for men.
Among predictive factors of loss of autonomy, the loss of mobility and muscular weakness are
major components (OR=3.28 up to 3 years). These two factors are the origins for disabilities
being responsible of falls, fractures, which lead to quality of life diminution, and increase
of mortality.
The only components easily employed in a preventive manner and which have proved their
efficacy are physical exercise and nutrition. But programs nowadays are still not implemented
into primary taken care.
A multimodal program including these two components for patients at risk of loss of mobility
is an imperative of public health.
Two groups will be identified :
A first group with a SPPB (Short physical performance battery) score between 8 and 10 and
walking more than 90 minutes per week. They will be asked to carry out 2 to 3 times a week a
series of exercises concerning the main muscle groups, using bodyweight, and without specific
equipment. An activity booklet will be given as support. In a complementary way, individual
objectives will be established to develop endurance by fighting against hyper-sedentariness
based on simple advice to the patient and his entourage. The volume of physical activity will
be developed from activities of daily living. A telephone coaching will be carried out every
4 weeks by a Adapted Physical Activity Monitor and a precise evaluation of the physical
performances will be carried out at 3 months.
A second group for patients with Short physical performance battery ≤ 8 or if >8 but
excessive sedentary walking less than 90 minutes per week, including running, or having
sarcopenia criteria.
They will be offered bi-weekly care by a Adapted Physical Activity Monitor. Training will be
conducted either in small group programs or at home (if unable to attend), at the frequency
of 2 sessions per week for 10 weeks. The personalized program of muscular reinforcement will
be of progressive intensity with and without additional load and with very simple and easily
usable devices including at home (elastic bands, weights. . . ).
During the dedicated geriatric consultation, the nutritional status will also be evaluated by
a food survey and biological samples in order to measure the usual serum nutritional markers.
The objective of the assessment is to ensure an adequate intake of macro nutrients, including
proteins, and energy; as well as micronutrient fruits and vegetables rich in antioxidants and
omega 3 fatty acids which also have a significant impact in terms of prevention and muscle
function.
Loss of autonomy : (ADL) Activities of Daily Living score will be calculated. This validated
scale requires 3 evaluations spread over time. A score > 6 indicates an addiction.
(Instrumental Activities of Daily Living) Lawton's IADL scale is essentially focused on the
person's usual behaviour and essentially assesses a patient's level of dependence through the
assessment of activities of daily living.
Useful for assessing the patient's state of functional autonomy and deciding on appropriate
aids (meals at home, household helper, life support, legal protection).
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