Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study

Artery Research volume 26, pages 56–63 (2020)Cite this article

Abstract

Introduction

This study was aimed at evaluating the changes in the Ventricular-Arterial Coupling (VAC) of old adults after the implementation of a multidisciplinary intervention program comprising a tailored physical exercise component.

Methods

A non-randomized pilot study, enrolling 21 old adults with age above 65 years of age (mean 81.08 years). The participants were divided into two groups (Group 1 and 2), both subject to a baseline thorough and multidisciplinary diagnostic evaluation. A tailored intervention program was implemented for a period of 3 months, after which the participants were re-evaluated. The Group 2 included a component of tailored exercise training and physiotherapy intervention. Central and peripheral Blood Pressure (BP) and hemodynamic parameters related to cardiovascular efficiency were evaluated by transthoracic echocardiography and pulse wave analysis. Self-efficacy for exercise scales as well as handgrip strength and nutritional status were also evaluated at baseline and after intervention.

Results

Baseline diagnostic information was similar in both groups. After the intervention, significant changes were observed in Group 2, mainly a reduction in BP, in arterial stiffness and a better cardiovascular efficiency was also depicted, with a decrease in the stroke work and an increase in the VAC, as well as in the left ventricle efficiency parameter. Regarding the indicators of frailty, there was an improvement in handgrip strength and self-efficacy for exercise in Group 2. No significant changes were observed in Group 1.

Conclusion

The results of this pilot study highlight the positive modulation provided by a tailored physical exercise approach of the old adult, increasing cardiac efficiency and thus constituting a factor for improving overall well-being. Large randomized trials are needed to further validate these findings.

References

  1. Instituto Nacional de Estatística. Estimativas de População Residente em Portugal 2017, Instituto Nacional de Estatística; 2018, pp. 1–13.

  2. World Health Organization (WHO). Active ageing: a policy framework. Geneva, Switzerland: World Health Organization; 2002.

  3. de Rezende Mikael L, de Paiva AMG, Gomes MM, Sousa ALL, Jardim PCBV, de Oliveira Vitorino PV, et al. Vascular aging and arterial stiffness. Arq Bras Cardiol 2017;109:253–8.

    Google Scholar 

  4. Pereira T. Abordagem geriátrica ampla na promoção de um envelhecimento ativo e saudável. Instituto Politécnico de Coimbra IPC | Inovar Para Crescer: Coimbra, Portugal; 2019.

  5. Lee HY, Oh BH. Aging and arterial stiffness. Circ J 2010;74:2257–62.

    Google Scholar 

  6. Li Y, Hanssen H, Cordes M, Rossmeissl A, Endes S, Schmidt-Trucksäss A. Aerobic, resistance and combined exercise training on arterial stiffness in normotensive and hypertensive adults: a review. Eur J Sport Sci 2015;15:443–57.

    Google Scholar 

  7. Cameron JD, Rajkumar C, Kingwell BA, Jennings GL, Dart AM. Higher systemic arterial compliance is associated with greater exercise time and lower blood pressure in a young older population. J Am Geriatr Soc 1999;47:653–6.

    Google Scholar 

  8. Singh MA. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci 2002;57:M262–M82.

    Google Scholar 

  9. Norman KV. Exercise and wellness for older adults. 2nd ed. Champaign, IL, USA: Human Kinetics; 2010.

    Google Scholar 

  10. Hirase T, Kataoka H, Inokuchi S, Nakano J, Sakamoto J, Okita M. Effects of exercise training combined with increased physical activity to prevent chronic pain in community-dwelling older adults: a preliminary randomized controlled trial. Pain Res Manage 2018;2018:2132039.

    Google Scholar 

  11. Gallè F, Di Onofrio V, Romano Spica V, Mastronuzzi R, Russo Krauss P, Belfiore P, et al. Improving physical fitness and health status perception in community-dwelling older adults through a structured program for physical activity promotion in the city of Naples, Italy: a randomized controlled trial. Geriatr Gerontol Int 2017;17:1421–8.

    Google Scholar 

  12. Sebo P, Haller DM, Favrat B, Huber P, Mueller Y, Vaucher P. Adherence to guidelines when evaluating fitness-to-drive in the elderly: a practice review of Swiss physicians. Swiss Med Wkly 2018;148:w14632.

    Google Scholar 

  13. Carrick-Ranson G, Hastings JL, Bhella PS, Fujimoto N, Shibata S, Palmer MD, et al. The effect of lifelong exercise dose on cardiovascular function during exercise. J Appl Physiol (1985) 2014; 116:736–45.

    Google Scholar 

  14. Little WC, Cheng CP. Effect of exercise on left ventricular- arterial coupling assessed in the pressure-volume plane. Am J Physiol 1993;264:H1629–H33.

    Google Scholar 

  15. Sunagawa K, Maughan WL, Burkhoff D, Sagawa K. Left ventricular interaction with arterial load studied in isolated canine ventricle. Am J Physiol 1983;245:H773–H80.

    Google Scholar 

  16. Najjar SS, Schulman SP, Gerstenblith G, Fleg JL, Kass DA, O’Connor F, et al. Age and gender affect ventricular-vascular coupling during aerobic exercise. J Am Coll Cardiol 2004;44:611–17.

    Google Scholar 

  17. Martins AC, Moreira J, Silva C, Silva J, Tonelo C, Baltazar D, et al. Multifactorial screening tool for determining fall risk in community- dwelling adults aged 50 years or over (fallsensing): protocol for a prospective study. JMIR Res Protoc 2018;7:e10304.

    Google Scholar 

  18. Loureiro MH. Validação do Mini Nutritional Assessment em idosos Portugueses. Master’s Thesis, Tese de Mestrado, Universidade de Coimbra, Faculdade de Medicina, Coimbra, Portugal; 2008.

  19. Robbins TW, James M, Owen AM, Sahakian BJ, Lawrence AD, McInnes L, et al. A study of performance on tests from the CANTAB battery sensitive to frontal lobe dysfunction in a large sample of normal volunteers: implications for theories of executive functioning and cognitive aging. Cambridge Neuropsychological Test Automated Battery. J Int Neuropsychol Soc 1998;4:474–90.

    Google Scholar 

  20. Robbins TW, James M, Owen AM, Sahakian BJ, McInnes L, Rabbitt P. Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia 1994;5:266–81.

    Google Scholar 

  21. World Health Organization (WHO). WHO STEPwise approach to surveillance (STEPS). Geneva, Switzerland: World Health Organization; 2008.

  22. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24: 987–1003.

    Google Scholar 

  23. World Health Organization (WHO). Global recommendations on physical activity for health 18 – 64 years old. Geneva, Switzerland: World Health Organization; 2011.

  24. Shubert TE, Goto LS, Smith ML, Jiang L, Rudman H, Ory MG. The Otago exercise program: innovative delivery models to maximize sustained outcomes for high risk, homebound older adults. Front Public Health 2017;5:54.

    Google Scholar 

  25. Weber T, Wassertheurer S, Rammer M, Maurer E, Hametner B, Mayer CC, et al. Validation of a brachial cuff-based method for estimating central systolic blood pressure. Hypertension 2011;58:825–32.

    Google Scholar 

  26. Papaioannou TG, Argyris A, Protogerou AD, Vrachatis D, Nasothimiou EG, Sfikakis PP, et al. Non-invasive 24 hour ambulatory monitoring of aortic wave reflection and arterial stiffness by a novel oscillometric device: the first feasibility and reproducibility study. Int J Cardiol 2013;169:57–61.

    Google Scholar 

  27. Feistritzer HJ, Reinstadler SJ, Klug G, Kremser C, Seidner B, Esterhammer R, et al. Comparison of an oscillometric method with cardiac magnetic resonance for the analysis of aortic pulse wave velocity. PLoS One 2015;10:e0116862.

    Google Scholar 

  28. Hametner B, Wassertheurer S, Kropf J, Mayer C, Eber B, Weber T. Oscillometric estimation of aortic pulse wave velocity: comparison with intra-aortic catheter measurements. Blood Press Monit 2013;18:173–6.

    Google Scholar 

  29. The Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J 2010;31:2338–50.

  30. Cunha PG, Boutouyrie P, Nilsson PM, Laurent S. Early vascular ageing (EVA): definitions and clinical applicability. Curr Hypertens Rev 2017;13:8–15.

    Google Scholar 

  31. Evangelista A, Flachskampf F, Lancellotti P, Badano L, Aguilar R, Monaghan M, et al. European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr 2008;9:438–48.

    Google Scholar 

  32. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28: 1–39.e14.

    Google Scholar 

  33. Dubin J, Wallerson DC, Cody RJ, Devereux RB. Comparative accuracy of Doppler echocardiographic methods for clinical stroke volume determination. Am Heart J 1990;120:116–23.

    Google Scholar 

  34. Chantler PD, Lakatta EG, Najjar SS. Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise. J Appl Physiol 2008;105:1342–51.

    Google Scholar 

  35. Taylor AW, Johnson MJ. Physiology of exercise and healthy aging. Champaign, IL, USA: Human Kinetics; 2008.

    Google Scholar 

  36. Rikli RE, Jones CJ. Development and validation of a functional fitness test for community- residing older adults. J Aging Phys Act 1999;7:129–161.

    Google Scholar 

  37. Bell V, McCabe EL, Larson MG, Rong J, Merz AA, Osypiuk E, et al. Relations between aortic stiffness and left ventricular mechanical function in the community. J Am Heart Assoc 2017;6: pii: e004903.

    Google Scholar 

  38. Lee PG, Jackson EA, Richardson CR. Exercise prescriptions in older adults. Am Fam Physician 2017;95:425–32.

    Google Scholar 

  39. Chantler PD. Arterial ventricular uncoupling with age and disease and recoupling with exercise. Exerc Sport Sci Rev 2017;45:70–9.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Physiology Department, Polytechnic Institute of Coimbra, Coimbra Health School, LabinSaude, Portugal

    Telmo Pereira, Inês Cipriano & Joaquim Castanheira

Authors
  1. Telmo Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Inês Cipriano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joaquim Castanheira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Telmo Pereira.

Additional information

Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: Data used in this study are available from the authors upon reasonable request and with permission of the AGA@4life Consortium collaborators.

Rights and permissions

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pereira, T., Cipriano, I. & Castanheira, J. Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study. Artery Res 26, 56–63 (2020). https://doi.org/10.2991/artres.k.200222.001

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2991/artres.k.200222.001

Keywords

Artery Research

ISSN: 1876-4401

Contact us