Efeitos de um programa remoto de treinamento físico combinado com treinamento cognitivo para pessoas idosas com risco aumentado de vulnerabilidade clínico-funcional: um ensaio clínico randomizado

Abstract

The aim of this study was to assess the chronic effects of a 12-week remote program of combined physical and cognitive training for elderly individuals with an increased risk of clinical-functional vulnerability on parameters of functional capacity, cognitive ability, quality of life, and occupational performance. The study included 26 elderly participants, with a mean age of 68.8 ± 6.4 years, of both sexes, sedentary, and at an elevated risk of clinical-functional vulnerability. Participants were randomized and allocated in a 1:1 ratio to two training groups: the combined physical and cognitive training group (CPT; n=13) and the active control group involving only physical training (PT; n=13). Both groups received remote, home-based, and supervised training. The training programs lasted for 12 weeks, with PT receiving two weekly sessions and CPT receiving three weekly sessions, including cognitive training. To maintain moderate intensity, the Borg Scale was used (intensity 3). Pre- and post-training tests were conducted in both groups, assessing primary outcomes such as cognitive function using the Mini Mental State Examination (MMSE), dynamic balance with and without dual-task using the Timed Up And Go (TUG) test, and secondary outcomes including the Clinical-Functional Vulnerability Index (CFVI), grip strength, 30-second Chair Stand Test, World Health Organization Quality of Life-bref (WHOQOL-bref), Hospital Anxiety and Depression Scale (HADS), Canadian Occupational Performance Measure (COPM), Digit Span Test (DST), and Verbal Fluency Category Animals. Data analysis was performed on an intention-to-treat (ITT) basis using the Generalized Estimating Equations (GEE) test and post-hoc Bonferroni analysis (α=0.05). The results demonstrated a statistically significant improvement in the time effect (p=0.01 and p=0.02, respectively) for TUG and dual-task TUG in both groups, as well as CFVI (p <0.01), WHOQOL-bref physical (p=0.01), psychological (p=0.02), and environmental (p=0.04) domains, Verbal Fluency Category Animals (p <0.01), DST (p=0.03), 30-second Chair Stand (p <0.01), diastolic blood pressure (p=0.01), COPM performance (p <0.01), and satisfaction (p <0.01). It can be concluded that the study presented positive results for the population; however, cognitive training did not bring additional benefits when compared to physical training alone.