Clinical trial NCT05826314: Boxing Training, Physical-functional Fitness and Cognitive Performance in Older Adults
Official title: Impact of Boxing-based Training Program on Physical-functional Fitness, Cognitive Performance, and Risk of Falls in Community-dwelling Older Adults
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Healthy People Programs
Keywords: Public health
Boxing
Elderly
Physical Activity
Lead sponsor: Universidade do Porto
Sponsor class: OTHER
Collaborators: name: Faculdade de Desporto da Universidade do Porto
name: Foundation for Science and Technology, Portugal
First posted: 2023-04-24
Enrollment: 75
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The study includes a quasi-experimental design (non-randomized controlled trial), with repeated measures.
Primary purpose: TREATMENT

Brief summary: The aim of the study is to evaluate and to compare the effects of two exercise regimes (Boxing Training -BT and Multicomponent Training -MT) and 12 weeks of follow-up on cognitive health status, physical-functional fitness, and risk of falls in community-dwelling elders.

This is a quasi-experimental controlled trial using a parallel-group design. Participants will be allocated to 3 groups (i.e. BT, MT or control group \[no intervention\]). Both exercise programs (BT and MT) will last 24 weeks, twice a week, 45 minutes per session. Participants of all groups will be assessed for Senior Fitness test, and body weight at 4 moments (baseline, 12 weeks and 24 weeks of exercise and a follow-up period lasting 12 weeks).

Our hypotheses are:

1. In comparison with the control group, both exercise groups (BT and MT) will positively improve their physical-functional fitness, cognitive health status and risk of falls with the interventions
2. The observed effects on physical-functional fitness, cognitive health status, and risk of falls as a result of the exercise programs will be similar.
3. During the follow-up period, both exercise groups will experiment reductions on physical-functional fitness, cognitive health status, and risk of falls.

Detailed description: Aging is associated with functional and cognitive decline (1, 2), which are causal factors of falls in the elderly. According to available evidence, alleviation of these conditions can be achieved through regular exercise of the multicomponent type (MT) (3). However, in TM programs, \&#34;muscle power\&#34; takes a secondary role (5) although it is extremely important to preserve the integrity of the neuromuscular system (6). Studies indicate that combat sports may represent an exercise strategy that combines muscular fitness, cardiorespiratory fitness, agility, and balance (7), in addition to falling within the scope of dual-task programs (i.e., physical and cognitive) because they require memorization of combinations of attacking and defending movements, quick decision-making, and movement by coordinating simultaneous leg and hand movements (8). Seminal work with adapted boxing for elderly parkinsonians has demonstrated positive results in health indicators (9, 10). But the effectiveness of this modality in apparently healthy elderly is still unknown. Therefore, this project aims to compare the effects of boxing training and multi-component training on physical-functional fitness, cognitive performance, and the risk of falls in older people.

The study comprises a quantitative quasi-experimental design, will be conducted in the metropolitan area of Porto, Portugal. The study sample will consist of healthy individuals from the community, aged ≥ 60 years, who will be recruited in community programs, municipalities, health centers, and social media platforms through phone calls and informational flyers. Those who accept to participate will be informed about the project objectives and procedures. Participation will be voluntary, and everyone will be required to sign the Free and Informed Consent form.

Participants will be allocated into intervention groups: (Boxing training group or Multicomponent training group) or the Control Group (No intervention). The main results will be the physical-functional fitness measured through the Senior Fitness test, Cosmed K5b2, Handgrip strength, ball throw, isokinetic strength, cognitive performance evaluated by neurocognitive and psychological tests, in addition and the risk of falls evaluated by the Biodex® Balance System. Secondary outcomes will be brain activity by means of the electroencephalogram (EEG), bodycomposition, bone mineral density, quality of life and satisfaction with exercise.

The research protocol will follow the CONSORT/SPIRIT guidelines.

Eligibility criteria: Inclusion Criteria:

* Male or female participants aged ≥60 years;
* Community-dwelling older adults;
* Do not present any medical contraindication for physical activity;

Exclusion Criteria:

* Individuals diagnosed with certain disorders or conditions in which exercise is contraindicated such as unstable or ongoing cardiovascular and/or respiratory disorders;
* Presence of major neurological and Neurocognitive disorders (Portuguese version of the Montreal Cognitive Assessment - MoCA) (12);

Primary outcomes:
measure: Change from baseline Upper Body Power at 3 months and at 6 months, respectively.
timeFrame: Baseline, 6 months
measure: Change from Baseline peak oxygen uptake (VO2 peak) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline Lower-body strength and power at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline cognitive performance (Inhibition/cognitive flexibility) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline cognitive performance (Processing speed) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline cognitive performance (Selective recall test) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline cognitive performance (Verbal short-term memory and verbal working memory) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline cognitive performance (Memory) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline Psychological testing (Depression) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline Psychological testing (Anxiety and depression) at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline Psychological testing (Stress) at 6 months
timeFrame: Baseline, 6 months
measure: Change from baseline on Risk of Falls at 6 months
timeFrame: Baseline, 6 months
measure: Change from baseline on Handgrip strength to 3 and 6 months of exercise and 3-months of follow-up, respectively
timeFrame: Baseline, after 3 months of intervention, 6 months, 3 months follow-up
measure: Change from Baseline Brain Activity at 6 months
timeFrame: Baseline, 6 months
measure: Change from baseline Physical-Functional Fitness (upper and lower body strength) at 3 and 6 months of exercise and 3-months of follow-up, respectively
timeFrame: Baseline, after 3 months of intervention, 6 months, 3 months follow-up
measure: Change from baseline Physical-Functional Fitness (8-Foot Up and Go Test) at 3 and 6 months of exercise and 3-months follow-up, respectively.
timeFrame: Baseline, after 3 months of intervention, 6 months, 3 months follow-up.
measure: Change from baseline Physical-Functional Fitness (six-minute walk test) at 3 and 6 months of exercise and 3-months follow-up, respectively.
timeFrame: Time Frame: Baseline, after 3 months of intervention, 6 months, 3 months follow-up
measure: Change from baseline Physical-Functional Fitness (upper and lower body flexibility) at 3 and 6 months of exercise and 3-months follow-up, respectively.
timeFrame: ime Frame: Baseline, after 3 months of intervention, 6 months, 3 months follow-up
Secondary outcomes:
measure: Sociodemographic Assessments are going to measured at baseline.
timeFrame: Baseline
measure: Change from baseline Quality of Life at 6 months
timeFrame: Baseline, 6 months
measure: Change from Baseline Appendicular Skeletal Muscle Mass Index at 6 months
timeFrame: Baseline, 6 months
measure: Exercise satisfaction
timeFrame: 6 months
measure: Change from Baseline body mass, fat-free mass, fat mass at 3 and 6 months of exercise and 3-months of follow-up, respectively
timeFrame: Baseline, 3 months, 6 months, 3 months follow-up
measure: Change from Baseline Bone Mineral Density at 6 months
timeFrame: Baseline, 6 months.
Other outcomes:
measure: Change from baseline Caloric Intake at 6 months
timeFrame: Baseline, 6 months
measure: Exercise intensity
timeFrame: 6 months, during the intervention
measure: Applicability of the interventions
timeFrame: 6 months during the intervention
measure: Change from baseline Daily Physical Activity levels at 6 months
timeFrame: Baseline, 6 months
Locations:
city: Porto
country: Portugal
facility: Faculty of Sport, University of Porto
Study officials:
affiliation: Universidade do Porto
name: Lucimere Bohn, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Universidade do Porto
name: Kessketlen Miranda, PhD student
role: PRINCIPAL_INVESTIGATOR
References:
citation: Santos-Eggimann B, Sirven N. Screening for frailty: older populations and older individuals. Public Health Rev. 2016 Aug 22;37:7. doi: 10.1186/s40985-016-0021-8. eCollection 2016.
citation: Hill NL, Bhargava S, Brown MJ, Kim H, Bhang I, Mullin K, Phillips K, Mogle J. Cognitive complaints in age-related chronic conditions: A systematic review. PLoS One. 2021 Jul 7;16(7):e0253795. doi: 10.1371/journal.pone.0253795. eCollection 2021.
citation: Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, DiPietro L, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Wari V, Willumsen JF. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020 Dec;54(24):1451-1462. doi: 10.1136/bjsports-2020-102955.
citation: Streit IA, Pinto SS, Silva ADS, Bezerra ES. Body weight multicomponent program improves power and functional capacity responses in older adults: A quasi-experimental study. Exp Gerontol. 2021 Nov;155:111553. doi: 10.1016/j.exger.2021.111553. Epub 2021 Sep 14.
citation: Hunter SK, Pereira HM, Keenan KG. The aging neuromuscular system and motor performance. J Appl Physiol (1985). 2016 Oct 1;121(4):982-995. doi: 10.1152/japplphysiol.00475.2016. Epub 2016 Aug 11.
citation: Origua Rios S, Marks J, Estevan I, Barnett LM. Health benefits of hard martial arts in adults: a systematic review. J Sports Sci. 2018 Jul;36(14):1614-1622. doi: 10.1080/02640414.2017.1406297. Epub 2017 Nov 21.
citation: Domingos J, Radder D, Riggare S, Godinho C, Dean J, Graziano M, de Vries NM, Ferreira J, Bloem BR. Implementation of a Community-Based Exercise Program for Parkinson Patients: Using Boxing as an Example. J Parkinsons Dis. 2019;9(3):615-623. doi: 10.3233/JPD-191616.
citation: Shearin S, Braitsch M, Querry R. The effect of a multi-modal boxing exercise program on cognitive locomotor tasks and gait in persons with Parkinson disease. NeuroRehabilitation. 2021;49(4):619-627. doi: 10.3233/NRE-210218.
citation: Combs SA, Diehl MD, Staples WH, Conn L, Davis K, Lewis N, Schaneman K. Boxing training for patients with Parkinson disease: a case series. Phys Ther. 2011 Jan;91(1):132-42. doi: 10.2522/ptj.20100142. Epub 2010 Nov 18.
citation: Thompson PD, Arena R, Riebe D, Pescatello LS; American College of Sports Medicine. ACSM's new preparticipation health screening recommendations from ACSM's guidelines for exercise testing and prescription, ninth edition. Curr Sports Med Rep. 2013 Jul-Aug;12(4):215-7. doi: 10.1249/JSR.0b013e31829a68cf. No abstract available.