The intervention consisted of a multimodal exercise training, 3 days per week for 8 months.
Therefore, our results reinforce the importance not only of promoting multimodal exercise training but also of reducing sedentary behaviors in DC institutions for the elderly.
Previous studies have examined the effects of multimodal exercise training on skeletal muscle composition in older adults and have shown that IMAT may have the capacity to change with specific exercise intervention protocols [ 19, 20, 22].
If this randomised controlled trial demonstrates that multimodal exercise (that includes motor fitness training) can improve cognitive performance in later life, the benefits will be two-fold.
Despite minimal information about consistent areas of balance deficits, some researchers have found improvements in Romberg's test (eyes opened, closed or ratio) or one-legged stance in response to multimodal exercise programs with a significant strength training element for patients with FM [ 39- 41].
With regard to mode of exercise, multimodal exercise interventions including aerobic exercise + resistance training + stretching were implemented by seven studies [ 24– 30]; the pooled effect estimate for this subgroup showed significant reductions in CRF symptoms (SMD = −0.35, 95% CI −0.62 to −0.08), P = 0.01.
A multimodal exercise program that combined aerobic and resistance training was effective in improving all FF components related to daily living activities in all age groups except for flexibility of lower limbs in the age group 70 74 years.
Several studies [ 18– 20] have examined the effects of resistance training on IMAT as part of a multimodal exercise program in older adults, though only one has reported on the exclusive use of eccentric resistance training [ 2].
Our metaregression model showed that length (weeks of training), frequency (sessions/week), and duration (minutes/session) of the supervised multimodal exercise interventions were lineally associated with overall improvements in CRF levels (Tau-squared = 0.04, P = 0.04).
Multimodal strategies, including staff and resident education on falls and fractures, environmental modification, exercise training, and offering of hip protectors, as those described in the trial by Jensen et al. [39] appear to be beneficial in reducing falls, which is a desirable outcome in itself and may warrant implementation, if feasible and affordable for a facility.
It is unknown, however, what effect eccentric training may have on IMAT as compared to traditional resistance exercise as part of a multimodal exercise program for older adults.
