Journal Article

Nordic walking training and nutritional supplementation in pre-frail older Indians: an open-labelled experimental pre-test and post-test pilot study to develop intervention model

Kumar, Deepa Anil, Dey, Aparajit Ballav, Kandel, Ramesh, Kumar, Prakash, Tyagi, Meenakshi, Grover, Kanika, Desai, Gaurav, Chaudhary, Preeti, Chatterjee, Prasun, Madan, Ruchika, Gupta, Shyama, Khan, Maroof Ahmad

2018

Overview

Background Identifying and treating people in a pre-frail state may be an effective way to prevent or delay frailty and preserve their functional capacity. This study aimed to assess the efficacy of, and compliance with, a 12 week individualized nutritional supplementation (INS) and Nordic walking (NW) program in pre-frail older Indians. The primary measure is physical performance, as indicated by Fried’s Frailty scale. Other measures include: cognition, as indicated by the Hindi Mental Status Examination; mood, by the Geriatric Depression Scale; and nutritional status, by the Mini Nutritional Assessment. Methods This is an open-labeled experimental pre-test and post-test study, which took place from October 2012 to December 2014. The study was approved by Institute Ethics committee (IEC/NP-350/2012/RP-26/2012) at the All India Institute of Medical Sciences (AIIMS), New Delhi. Participants were sixty-six pre-frail elderly, who were randomly allocated into three subgroups, namely: A (NW only), B (INS only), and C (NW and INS). One-way ANOVA was used to statistically assess differences in baseline characteristics for quantitative variables, with the Chi-Square/Fischer exact test utilized for qualitative variables. Paired t-tests were used to assess pre and post intervention difference within the group for quantitative variables, with McNemar’s Chi-Square test used for qualitative variables. Kruskal Wallis test was used to assess significant intervention effects among the groups. A p -value < 0.05 was considered as statistically significant. Results There was significant effect of intervention in gait speed in group A ( p  = 0.001) and C ( p  = 0.002), but not in group B ( p  = 0.926). While there was no significant change in grip strength in Group A ( p  = 0.488) and B ( p  = 0.852), a statistically significant increase was observed in group C ( p  = 0.013). Mood significantly improved in group B ( p =  0.025) and C (p  = 0.021). No significant difference was noted in cognitive status across groups. Following the interventions, a total of 18.18% of pre-frail participants were classified as non-frail. Conclusions Combining NW and INS provides a simple, pragmatic intervention with efficacy in the management of functionally vulnerable older adults, and allows their maintained independence. Future studies should replicate this readily applicable intervention in a larger cohort with a longer follow-up period. Trial registration Clinical Trial Registry-India CTRI/2016/05/006937 [Registered on: 16/05/2016]; Trial was Registered Retrospectively.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Activities of daily living / Adapted indoor Nordic walk / Age / Aged / Aged, 80 and over / Aging / Aging (Biology) / Analysis / Cognition & reasoning / Cognitive ability / Dietary Supplements / Elderly / Exercise / Exercise Therapy - statistics & numerical data / Female / Frailty / Frailty - prevention & control / Gait / Geriatric Assessment / Geriatrics / Geriatrics/Gerontology / Health aspects / Health Services for the Aged / Humans / India / Individualized nutritional supplementation / Intervention / Kruskal-Wallis test / Male / Medicine / Medicine & Public Health / Mental depression / Mood / Nutrition / Nutritional status / Older people / Outcome Assessment (Health Care) / Physical fitness / Physical functioning / physical health and activity / Pilot Projects / Population / Postural Balance / Rehabilitation / Research Article / Sarcopenia / Statistical analysis / Systematic review / Variables / Walking / Walking - physiology