Housing physical exercise program
Home physical exercise program was based on the recommendations of the
American College of Sports Medicine for exercise and physical activity
with the elderly.23 Home exercise program followed
that proposed in our previou study,18 which consisted
of a combination of aerobic exercises, muscle strengthening, balance,
coordination and flexibility, prioritizing exercises involving large
muscle groups, lasting 12 consecutive weeks, minimum frequency of 3
sessions per week, 40 minutes of execution time and performing 2 to 3
sets with 5 to 15 repetitions for each exercise at a target stress rate
of 13-15 (”a little difficult” to ”difficult”) on the
Borg24 perceived exertion scale of 6 to 20 points, and
the exercise can be performed in the most convenient shift for the
elderly.
The exercises were carried out individually at each participant’s home,
not supervised during their execution, but had guidelines through home
visits every fifteen days. Subjects were instructed to increase exercise
intensity using the Borg scale as a parameter and in proportion to their
ability to perform, as assessed by the research assistants at each
visit. This exercises were performed using the weight of the
participant’s own body and with the help of some low-cost equipment (for
example, recyclable plastic bottles to demarcate the signaling of the
course, sticks and weights of 1 and 2 kg for performing the resisted
exercises), and were constituted as follows, according to Brandão et
al.18,19
- Warm-up exercises - Active-free exercise of the upper and lower limbs
and shoulder rotation associated with breathing exercises;
- Aerobic exercises - Displacement of a walking stick with two hands,
from the knees to above the head and returning to the knees, and
walking exercises with alternating flexion of the thighs and
approaching the knee by hand on the opposite side;
- Resisted exercises - For the upper limbs: from the position with the
elbow extended and the hand resting on the opposite thigh, move the
whole diagonally upwards and then return the hand to the thigh. For
the lower limbs: squatting exercise, starting from the position
sitting in a chair and with arms crossed in front of the body, lift to
the orthostatic position and then return to the sitting position;
- Balance and coordination exercises - Walk on a straight line and walk
away from lined obstacles with progressively smaller distances. When
possible, the exercise evolved, and the walk was performed by placing
the heel of one foot on the toes of the other foot (standing foot).
- Note: To ensure safety, these exercises were performed close to fixed
furniture in the house, making it possible to lean when needed.
- Stretching Exercises - From the sitting position on the bed and with
their knees in extension, try to reach the tip of the feet; from the
sitting position in a chair and with the feet resting on the ground,
perform rotation of the trunk to one side and elevation of the upper
limb, on the same side, above the head, stretching as high as
possible.
During the period of 12 consecutive weeks, subjects from both groups
received periodic home visits to continue living guidelines and
encourage adherence to the program, but the IG, as well as guidelines on
lifestyle habits, received specific follow-up regarding exercise
practice and assistance to possible adverse events. After the
three-month period, the participants of the two groups were re-evaluated
and with the completion of the protocol the elderly of the IG were
encouraged to continue with the exercises, while the CG was made
available the follow-up of the home exercises for the same period
performed with the IG. Adherence to the exercise was verified through
the weekly records filled out by the elderly themselves, with the help
of family members and certified by the assistants during home visits.