Characteristics and effects of physical exercise programs for older adults during the COVID-19 pandemic: an integrative review
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Published:
Mar 26, 2023
Keywords:
aging, COVID-19, elderly, exercise
Main Article Content
Abstract
Objective: To evaluate the characteristics of physical exercise programs for older adults and their effects during the COVID-19 pandemic. Methods: An integrative review was conducted between January and March 2022. A search was conducted in MEDLINE via PubMed, Lilacs via BVS, PEDro, and Cochrane Library. Experimental articles (randomized clinical trials, non-randomized trials, or quasi-experimental studies) published from 2019 to 2021, with no language restriction, and that used physical exercise programs for older adults (> 60 years) in their intervention were included. The studies were selected by reading the title, abstract, and full text. The selected articles had their results extracted using an online form, tabulated using an electronic spreadsheet, and analyzed qualitatively and quantitatively. Results: 113 studies were identified; 7 met the eligibility criteria and were included in the review, all randomized controlled trials. The multi-component exercise programs were more frequent (resistance, balance, flexibility, and aerobic), delivered remotely and performed 2 to 7 times a week, lasting between 30 and 50 minutes. Significant effects were observed on physical function, body composition, blood triglycerides, the incidence of falls, physical activity, and functional capacity. Conclusions: The physical exercise programs used during the COVID-19 pandemic showed promising results for older adults. The programs proved to be a viable alternative for maintaining the physical, mental, and cognitive functions of older adults in times of public calamity.
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1.
Santos VR da S, Damasceno AWC, Silva MJG da, Cabral DLF, Oliveira ACA de. Characteristics and effects of physical exercise programs for older adults during the COVID-19 pandemic: an integrative review. HSJ [Internet]. 2023Mar.26 [cited 2024Jul.3];13(1):3-13. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1358
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References
1. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60. https://doi.org/10.23750/abm.v91i1.9397
2. Richardson DL, Duncan MJ, Clarke ND, Myers TD, Tallis J. The influence of COVID-19 measures in the United Kingdom on physical activity levels, perceived physical function and mood in older adults: A survey-based observational study. J Sports Sci. 2021;39(8):887-99. https://doi.org/10.1080/02640414.2020.1850984
3. Wu B. Social isolation and loneliness among older adults in the context of COVID-19: a global challenge. Glob Heal Res Policy. 2020;5(1):27. https://doi.org/10.1186/s41256-020-00154-3
4. Bezerra GKSD, Sousa ACPA, Araújo MCM, Lucena GA, Fernandes LFQ, Morais PHM, et al. Efeitos do isolamento social para a saúde de pessoas idosas no contexto da pandemia de Covid-19: um estudo de revisão integrativa. Res Soc Dev. 2021;10(4):e23010414070. https://doi.org/10.33448/rsd-v10i4.14070
5. Kucharski AJ, Klepac P, Conlan AJK, Kissler SM, Tang ML, Fry H, et al. Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study. Lancet Infect Dis. 2020;20(10):1151-60. https://doi.org/10.1016/S1473-3099(20)30457-6
6. Qin F, Song Y, Nassis GP, Zhao L, Dong Y, Zhao C, et al. Physical Activity, Screen Time, and Emotional Well-Being during the 2019 Novel Coronavirus Outbreak in China. Int J Environ Res Public Health. 2020;17(14):5170. https://doi.org/10.3390/ijerph17145170
7. Schuch FB, Bulzing RA, Meyer J, Vancampfort D, Firth J, Stubbs B, et al. Associations of moderate to vigorous physical activity and sedentary behavior with depressive and anxiety symptoms in self-isolating people during the COVID-19 pandemic: A cross-sectional survey in Brazil. Psychiatry Res. 2020;292:113339. https://doi.org/10.1016/j.psychres.2020.113339
8. Roschel H, Artioli GG, Gualano B. Risk of Increased Physical Inactivity During COVID‐19 Outbreak in Older People: A Call for Actions. J Am Geriatr Soc. 2020;68(6):1126-8. https://doi.org/10.1111/jgs.16550
9. Brasil, Ministério da Saúde. Pesquisa nacional de saúde: 2019: percepção do estado de saúde, estilos de vida, doenças crônicas e saúde bucal: Brasil e grandes regiões. IBGE (ed). Rio de Janeiro; 2020 [cited 2023 Mar 19]. 105 p. Available from: https://bit.ly/3TH7LeV
10. Silva DRP, Werneck AO, Malta DC, Souza Júnior PRB, Azevedo LO, Barros MBA, et al. Changes in the prevalence of physical inactivity and sedentary behavior during COVID-19 pandemic: a survey with 39,693 Brazilian adults. Cad Saude Publica. 2021;37(3):e00221920. https://doi.org/10.1590/0102-311x00221920
11. Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Post-COVID-19 Syndrome and the Potential Benefits of Exercise. Int J Environ Res Public Health. 2021;18(10):5329. https://doi.org/10.3390/ijerph18105329
12. Silva Filho E, Xavier J, Cezarino L, Sales H, Albuquerque J. Comment on "The importance of physical exercise during the coronavirus (COVID-19) pandemic." Rev Assoc Med Bras. 2020;66(9):1311-3. https://doi.org/10.1590/1806-9282.66.9.1311
13. Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Context - Enferm. 2008;17(4):758-64. https://doi.org/10.1590/S0104-07072008000400018
14. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850
15. Santos CMC, Pimenta CAM, Nobre MRC. The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem. 2007;15(3):508-11. https://doi.org/10.1590/S0104-11692007000300023
16. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4
17. Grant D, Tomlinson D, Tsintzas K, Kolić P, Onambele-Pearson GL. The Effects of Displacing Sedentary Behavior With Two Distinct Patterns of Light Activity on Health Outcomes in Older Adults (Implications for COVID-19 Quarantine). Front Physiol. 2020;11:574595. https://doi.org/10.3389/fphys.2020.574595
18. Vitale JA, Bonato M, Borghi S, Messina C, Albano D, Corbetta S, et al. Home-Based Resistance Training for Older Subjects during the COVID-19 Outbreak in Italy: Preliminary Results of a Six-Months RCT. Int J Environ Res Public Health. 2020;17(24):9533. https://doi.org/10.3390/ijerph17249533
19. Beauchamp MR, Hulteen RM, Ruissen GR, Liu Y, Rhodes RE, Wierts CM, et al. Online-Delivered Group and Personal Exercise Programs to Support Low Active Older Adults' Mental Health During the COVID-19 Pandemic: Randomized Controlled Trial. J Med Internet Res. 2021;23(7):e30709. https://doi.org/10.2196/30709
20. Li F, Harmer P, Voit J, Chou L-S. Implementing an Online Virtual Falls Prevention Intervention During a Public Health Pandemic for Older Adults with Mild Cognitive Impairment: A Feasibility Trial. Clin Interv Aging. 2021;16:973-83. https://doi.org/10.2147/CIA.S306431
21. Liang IJ, Perkin OJ, McGuigan PM, Thompson D, Western MJ. Feasibility and Acceptability of Home-Based Exercise Snacking and Tai Chi Snacking Delivered Remotely to Self-Isolating Older Adults During COVID-19. J Aging Phys Act. 2022;30(1):33-43. https://doi.org/10.1123/japa.2020-0391
22. Chen X, Zhao L, Liu Y, Zhou Z, Zhang H, Wei D, et al. Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID‐19: A randomised controlled trial. J Clin Nurs. 2021;10.1111/locn.15964. https://doi.org/10.1111/jocn.15964
23. Courel-Ibáñez J, Pallarés JG, García-Conesa S, Buendía-Romero Á, Martínez-Cava A, Izquierdo M. Supervised Exercise (Vivifrail) Protects Institutionalized Older Adults Against Severe Functional Decline After 14 Weeks of COVID Confinement. J Am Med Dir Assoc . 2021;22(1):217-219.e2. https://doi.org/10.1016/j.jamda.2020.11.007
24. Lee K, Jeong G-C, Yim J. Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review. Int J Environ Res Public Health. 2020;17(21):8098. https://doi.org/10.3390/ijerph17218098
25. Baez M, Khaghani Far I, Ibarra F, Ferron M, Didino D, Casati F. Effects of online group exercises for older adults on physical, psychological and social wellbeing: a randomized pilot trial. Peer J. 2017;5:e3150. https://doi.org/10.7717/peerj.3150
26. Yerrakalva D, Yerrakalva D, Hajna S, Griffin S. Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis. J Med Internet Res. 2019;21(11):e14343. https://doi.org/10.2196/14343
27. Guimarães JAC, Guerra PH, Ueno DT, Christofoletti AEM, Nakamura PM. Estudo transversal sobre uso de ferramentas virtuais para orientar a atividade física durante a COVID-19. Rev Bras Ativ Fís Saúde. 2020;25:1-8. https://doi.org/10.12820/rbafs.25e0150
28. World Health Organization. COVID-19 transmission and protective measures [Internet]. 2022 [updated 21 Sep 2022]. Available from: http://bit.ly/3lvcKlV
29. Centers for Disease Control and Prevention. COVID-19 Risks and Inormation for Older Adults [Internet]. [updated 22 Feb 2023]. Available from: http://bit.ly/3n2rrgO
30. Pradhan D, Biswasroy P, Kumar Naik P, Ghosh G, Rath G. A Review of Current Interventions for COVID-19 Prevention. Arch Med Res. 2020;51(5):363-74. https://doi.org/10.1016/j.arcmed.2020.04.020
31. Lima Junior LC. Alimentação saudável e exercícios físicos em meio à pandemia da Covid-19. Bol Conjunt. 2020;3(9):33-41. Available from: https://bit.ly/3JR8ZAU
32. Santos DAS, Fernandes CC, Watanabe LAR. Cinesioterapia em Idosos de Instituições de Longa Permanência. Amaz Sci Heal. 2016;4(4):32-6. Available from: https://bit.ly/3yP2ZlH
33. Rugbeer N, Ramklass S, Mckune A, van Heerden J. The effect of group exercise frequency on health related quality of life in institutionalized elderly. Pan Afr Med J. 2017;26:35. https://doi.org/10.11604/pamj.2017.26.35.10518
34. Espejo-Antúnez L, Pérez-Mármol JM, Cardero-Durán MÁ, Toledo-Marhuenda JV, Albornoz-Cabello M. The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2020;101(10):1780-8. https://doi.org/10.1016/j.apmr.2020.06.010
35. Borges-Machado F, Silva N, Farinatti P, Poton R, Ribeiro Ó, Carvalho J. Effectiveness of Multicomponent Exercise Interventions in Older Adults With Dementia: A Meta-Analysis. Gerontologist. 2021;61(8):e449-62. https://doi.org/10.1093/geront/gnaa091
36. Sadjapong U, Yodkeeree S, Sungkarat S, Siviroj P. Multicomponent Exercise Program Reduces Frailty and Inflammatory Biomarkers and Improves Physical Performance in Community-Dwelling Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020;17(11):3760. https://doi.org/10.3390/ijerph17113760
37. Roy J, Jain R, Golamari R, Vunnam R, Sahu N. COVID‐19 in the geriatric population. Int J Geriatr Psychiatry. 2020;35(12):1437-41. https://doi.org/10.1002/gps.5389
38. Cadore EL, Sáez de Asteasu ML, Izquierdo M. Multicomponent exercise and the hallmarks of frailty: Considerations on cognitive impairment and acute hospitalization. Exp Gerontol. 2019;122:10-4https://doi.org/10.1016/j.exger.2019.04.007
39. Freiberger E, Häberle L, Spirduso WW, Rixt Zijlstra GA. Long‐Term Effects of Three Multicomponent Exercise Interventions on Physical Performance and Fall‐Related Psychological Outcomes in Community‐Dwelling Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc. 2012;60(3):437-46. https://doi.org/10.1111/j.1532-5415.2011.03859.x
40. Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-53. https://doi.org/10.1007/s12603-021-1665-8
41. World Health Organization. Guidelines on physical activity and sedentary behaviour: at a glance. World Health Organization: Geneva; 25 Nov 2020 [cited 19 Mar 2023]. Available from: http://bit.ly/3LyoPS4
42. Lazarus NR, Izquierdo M, Higginson IJ, Harridge SDR. Exercise Deficiency Diseases of Ageing: The Primacy of Exercise and Muscle Strengthening as First-Line Therapeutic Agents to Combat Frailty. J Am Med Dir Assoc. 2018;19(9):741-3. https://doi.org/10.1016/j.jamda.2018.04.014
43. Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25(Suppl 3):1-72. https://doi.org/10.1111/sms.12581
44. Zhao M, Veeranki SP, Magnussen CG, Xi B. Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study. BMJ. 2020;370:m2031. https://doi.org/10.1136/bmj.m2031
45. Wade KH, Richmond RC, Davey Smith G. Physical activity and longevity: how to move closer to causal inference. Br J Sports Med. 2018;52(14):890-1. https://doi.org/10.1136/bjsports-2017-098995
46. Stensvold D, Viken H, Steinshamn SL, Dalen H, Støylen A, Loennechen JP, et al. Effect of exercise training for five years on all-cause mortality in older adults-the Generation 100 study: randomised controlled trial. BMJ. 2020;m3485. https://doi.org/10.1136/bmj.m3485
47. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;63(3):386-8. https://doi.org/10.1016/j.pcad.2020.03.009
48. Sepúlveda-Loyola W, Rodríguez-Sánchez I, Pérez-Rodríguez P, Ganz F, Torralba R, Oliveira D V, et al. Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations. J Nutr Health Aging. 2020;24(9):938-47. https://doi.org/10.1007/s12603-020-1469-2
49. Dipietro L, Campbell WW, Buchner DM, Erickson KI, Powell KE, Bloodgood B, et al. Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review. Med Sci Sport Exerc. 2019;51(6):1303-13. https://doi.org/10.1249/MSS.0000000000001942
50. Theodorakopoulos C, Jones J, Bannerman E, Greig CA. Effectiveness of nutritional and exercise interventions to improve body composition and muscle strength or function in sarcopenic obese older adults: A systematic review. Nutr Res. 2017;43:3-15. https://doi.org/10.1016/j.nutres.2017.05.002
51. Chen N, He X, Feng Y, Ainsworth BE, Liu Y. Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials. Eur Rev Aging Phys Act. 2021;18(1):23. https://doi.org/10.1186/s11556-021-00277-7
52. Blasco-Lafarga C, Monteagudo P, Roldán A, Cordellat A, Pesce C. Strategies to change body composition in older adults: do type of exercise and dose distribution matter? J Sports Med Phys Fitness. 2020;60(4):552-61. https://doi.org/10.23736/S0022-4707.20.10321-9
53. da Rosa Orssatto LB, de la Rocha Freitas C, Shield AJ, Silveira Pinto R, Trajano GS. Effects of resistance training concentric velocity on older adults' functional capacity: A systematic review and meta-analysis of randomised trials. Exp Gerontol. 2019;127:110731. https://doi.org/10.1016/j.exger.2019.110731
54. Liu C, Shiroy DM, Jones LY, Clark DO. Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. Eur Rev Aging Phys Act. 2014;11(2):95-106. https://doi.org/10.1007/s11556-014-0144-1
55. Telenius EW, Engedal K, Bergland A. Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial. BMC Geriatr. 2015;15(1):158. https://doi.org/10.1186/s12877-015-0151-8
56. Raafs BM, Karssemeijer EGA, Van der Horst L, Aaronson JA, Olde Rikkert MGM, Kessels RPC. Physical Exercise Training Improves Quality of Life in Healthy Older Adults: A Meta-Analysis. J Aging Phys Act. 2020;28(1):81-93. https://doi.org/10.1123/japa.2018-0436
57. Paluska SA, Schwenk TL. Physical Activity and Mental Health. Sport Med. 2000;29(3):167-80. https://doi.org/10.2165/00007256-200029030-00003
2. Richardson DL, Duncan MJ, Clarke ND, Myers TD, Tallis J. The influence of COVID-19 measures in the United Kingdom on physical activity levels, perceived physical function and mood in older adults: A survey-based observational study. J Sports Sci. 2021;39(8):887-99. https://doi.org/10.1080/02640414.2020.1850984
3. Wu B. Social isolation and loneliness among older adults in the context of COVID-19: a global challenge. Glob Heal Res Policy. 2020;5(1):27. https://doi.org/10.1186/s41256-020-00154-3
4. Bezerra GKSD, Sousa ACPA, Araújo MCM, Lucena GA, Fernandes LFQ, Morais PHM, et al. Efeitos do isolamento social para a saúde de pessoas idosas no contexto da pandemia de Covid-19: um estudo de revisão integrativa. Res Soc Dev. 2021;10(4):e23010414070. https://doi.org/10.33448/rsd-v10i4.14070
5. Kucharski AJ, Klepac P, Conlan AJK, Kissler SM, Tang ML, Fry H, et al. Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study. Lancet Infect Dis. 2020;20(10):1151-60. https://doi.org/10.1016/S1473-3099(20)30457-6
6. Qin F, Song Y, Nassis GP, Zhao L, Dong Y, Zhao C, et al. Physical Activity, Screen Time, and Emotional Well-Being during the 2019 Novel Coronavirus Outbreak in China. Int J Environ Res Public Health. 2020;17(14):5170. https://doi.org/10.3390/ijerph17145170
7. Schuch FB, Bulzing RA, Meyer J, Vancampfort D, Firth J, Stubbs B, et al. Associations of moderate to vigorous physical activity and sedentary behavior with depressive and anxiety symptoms in self-isolating people during the COVID-19 pandemic: A cross-sectional survey in Brazil. Psychiatry Res. 2020;292:113339. https://doi.org/10.1016/j.psychres.2020.113339
8. Roschel H, Artioli GG, Gualano B. Risk of Increased Physical Inactivity During COVID‐19 Outbreak in Older People: A Call for Actions. J Am Geriatr Soc. 2020;68(6):1126-8. https://doi.org/10.1111/jgs.16550
9. Brasil, Ministério da Saúde. Pesquisa nacional de saúde: 2019: percepção do estado de saúde, estilos de vida, doenças crônicas e saúde bucal: Brasil e grandes regiões. IBGE (ed). Rio de Janeiro; 2020 [cited 2023 Mar 19]. 105 p. Available from: https://bit.ly/3TH7LeV
10. Silva DRP, Werneck AO, Malta DC, Souza Júnior PRB, Azevedo LO, Barros MBA, et al. Changes in the prevalence of physical inactivity and sedentary behavior during COVID-19 pandemic: a survey with 39,693 Brazilian adults. Cad Saude Publica. 2021;37(3):e00221920. https://doi.org/10.1590/0102-311x00221920
11. Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Post-COVID-19 Syndrome and the Potential Benefits of Exercise. Int J Environ Res Public Health. 2021;18(10):5329. https://doi.org/10.3390/ijerph18105329
12. Silva Filho E, Xavier J, Cezarino L, Sales H, Albuquerque J. Comment on "The importance of physical exercise during the coronavirus (COVID-19) pandemic." Rev Assoc Med Bras. 2020;66(9):1311-3. https://doi.org/10.1590/1806-9282.66.9.1311
13. Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Context - Enferm. 2008;17(4):758-64. https://doi.org/10.1590/S0104-07072008000400018
14. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850
15. Santos CMC, Pimenta CAM, Nobre MRC. The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem. 2007;15(3):508-11. https://doi.org/10.1590/S0104-11692007000300023
16. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4
17. Grant D, Tomlinson D, Tsintzas K, Kolić P, Onambele-Pearson GL. The Effects of Displacing Sedentary Behavior With Two Distinct Patterns of Light Activity on Health Outcomes in Older Adults (Implications for COVID-19 Quarantine). Front Physiol. 2020;11:574595. https://doi.org/10.3389/fphys.2020.574595
18. Vitale JA, Bonato M, Borghi S, Messina C, Albano D, Corbetta S, et al. Home-Based Resistance Training for Older Subjects during the COVID-19 Outbreak in Italy: Preliminary Results of a Six-Months RCT. Int J Environ Res Public Health. 2020;17(24):9533. https://doi.org/10.3390/ijerph17249533
19. Beauchamp MR, Hulteen RM, Ruissen GR, Liu Y, Rhodes RE, Wierts CM, et al. Online-Delivered Group and Personal Exercise Programs to Support Low Active Older Adults' Mental Health During the COVID-19 Pandemic: Randomized Controlled Trial. J Med Internet Res. 2021;23(7):e30709. https://doi.org/10.2196/30709
20. Li F, Harmer P, Voit J, Chou L-S. Implementing an Online Virtual Falls Prevention Intervention During a Public Health Pandemic for Older Adults with Mild Cognitive Impairment: A Feasibility Trial. Clin Interv Aging. 2021;16:973-83. https://doi.org/10.2147/CIA.S306431
21. Liang IJ, Perkin OJ, McGuigan PM, Thompson D, Western MJ. Feasibility and Acceptability of Home-Based Exercise Snacking and Tai Chi Snacking Delivered Remotely to Self-Isolating Older Adults During COVID-19. J Aging Phys Act. 2022;30(1):33-43. https://doi.org/10.1123/japa.2020-0391
22. Chen X, Zhao L, Liu Y, Zhou Z, Zhang H, Wei D, et al. Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID‐19: A randomised controlled trial. J Clin Nurs. 2021;10.1111/locn.15964. https://doi.org/10.1111/jocn.15964
23. Courel-Ibáñez J, Pallarés JG, García-Conesa S, Buendía-Romero Á, Martínez-Cava A, Izquierdo M. Supervised Exercise (Vivifrail) Protects Institutionalized Older Adults Against Severe Functional Decline After 14 Weeks of COVID Confinement. J Am Med Dir Assoc . 2021;22(1):217-219.e2. https://doi.org/10.1016/j.jamda.2020.11.007
24. Lee K, Jeong G-C, Yim J. Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review. Int J Environ Res Public Health. 2020;17(21):8098. https://doi.org/10.3390/ijerph17218098
25. Baez M, Khaghani Far I, Ibarra F, Ferron M, Didino D, Casati F. Effects of online group exercises for older adults on physical, psychological and social wellbeing: a randomized pilot trial. Peer J. 2017;5:e3150. https://doi.org/10.7717/peerj.3150
26. Yerrakalva D, Yerrakalva D, Hajna S, Griffin S. Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis. J Med Internet Res. 2019;21(11):e14343. https://doi.org/10.2196/14343
27. Guimarães JAC, Guerra PH, Ueno DT, Christofoletti AEM, Nakamura PM. Estudo transversal sobre uso de ferramentas virtuais para orientar a atividade física durante a COVID-19. Rev Bras Ativ Fís Saúde. 2020;25:1-8. https://doi.org/10.12820/rbafs.25e0150
28. World Health Organization. COVID-19 transmission and protective measures [Internet]. 2022 [updated 21 Sep 2022]. Available from: http://bit.ly/3lvcKlV
29. Centers for Disease Control and Prevention. COVID-19 Risks and Inormation for Older Adults [Internet]. [updated 22 Feb 2023]. Available from: http://bit.ly/3n2rrgO
30. Pradhan D, Biswasroy P, Kumar Naik P, Ghosh G, Rath G. A Review of Current Interventions for COVID-19 Prevention. Arch Med Res. 2020;51(5):363-74. https://doi.org/10.1016/j.arcmed.2020.04.020
31. Lima Junior LC. Alimentação saudável e exercícios físicos em meio à pandemia da Covid-19. Bol Conjunt. 2020;3(9):33-41. Available from: https://bit.ly/3JR8ZAU
32. Santos DAS, Fernandes CC, Watanabe LAR. Cinesioterapia em Idosos de Instituições de Longa Permanência. Amaz Sci Heal. 2016;4(4):32-6. Available from: https://bit.ly/3yP2ZlH
33. Rugbeer N, Ramklass S, Mckune A, van Heerden J. The effect of group exercise frequency on health related quality of life in institutionalized elderly. Pan Afr Med J. 2017;26:35. https://doi.org/10.11604/pamj.2017.26.35.10518
34. Espejo-Antúnez L, Pérez-Mármol JM, Cardero-Durán MÁ, Toledo-Marhuenda JV, Albornoz-Cabello M. The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2020;101(10):1780-8. https://doi.org/10.1016/j.apmr.2020.06.010
35. Borges-Machado F, Silva N, Farinatti P, Poton R, Ribeiro Ó, Carvalho J. Effectiveness of Multicomponent Exercise Interventions in Older Adults With Dementia: A Meta-Analysis. Gerontologist. 2021;61(8):e449-62. https://doi.org/10.1093/geront/gnaa091
36. Sadjapong U, Yodkeeree S, Sungkarat S, Siviroj P. Multicomponent Exercise Program Reduces Frailty and Inflammatory Biomarkers and Improves Physical Performance in Community-Dwelling Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020;17(11):3760. https://doi.org/10.3390/ijerph17113760
37. Roy J, Jain R, Golamari R, Vunnam R, Sahu N. COVID‐19 in the geriatric population. Int J Geriatr Psychiatry. 2020;35(12):1437-41. https://doi.org/10.1002/gps.5389
38. Cadore EL, Sáez de Asteasu ML, Izquierdo M. Multicomponent exercise and the hallmarks of frailty: Considerations on cognitive impairment and acute hospitalization. Exp Gerontol. 2019;122:10-4https://doi.org/10.1016/j.exger.2019.04.007
39. Freiberger E, Häberle L, Spirduso WW, Rixt Zijlstra GA. Long‐Term Effects of Three Multicomponent Exercise Interventions on Physical Performance and Fall‐Related Psychological Outcomes in Community‐Dwelling Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc. 2012;60(3):437-46. https://doi.org/10.1111/j.1532-5415.2011.03859.x
40. Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-53. https://doi.org/10.1007/s12603-021-1665-8
41. World Health Organization. Guidelines on physical activity and sedentary behaviour: at a glance. World Health Organization: Geneva; 25 Nov 2020 [cited 19 Mar 2023]. Available from: http://bit.ly/3LyoPS4
42. Lazarus NR, Izquierdo M, Higginson IJ, Harridge SDR. Exercise Deficiency Diseases of Ageing: The Primacy of Exercise and Muscle Strengthening as First-Line Therapeutic Agents to Combat Frailty. J Am Med Dir Assoc. 2018;19(9):741-3. https://doi.org/10.1016/j.jamda.2018.04.014
43. Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25(Suppl 3):1-72. https://doi.org/10.1111/sms.12581
44. Zhao M, Veeranki SP, Magnussen CG, Xi B. Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study. BMJ. 2020;370:m2031. https://doi.org/10.1136/bmj.m2031
45. Wade KH, Richmond RC, Davey Smith G. Physical activity and longevity: how to move closer to causal inference. Br J Sports Med. 2018;52(14):890-1. https://doi.org/10.1136/bjsports-2017-098995
46. Stensvold D, Viken H, Steinshamn SL, Dalen H, Støylen A, Loennechen JP, et al. Effect of exercise training for five years on all-cause mortality in older adults-the Generation 100 study: randomised controlled trial. BMJ. 2020;m3485. https://doi.org/10.1136/bmj.m3485
47. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;63(3):386-8. https://doi.org/10.1016/j.pcad.2020.03.009
48. Sepúlveda-Loyola W, Rodríguez-Sánchez I, Pérez-Rodríguez P, Ganz F, Torralba R, Oliveira D V, et al. Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations. J Nutr Health Aging. 2020;24(9):938-47. https://doi.org/10.1007/s12603-020-1469-2
49. Dipietro L, Campbell WW, Buchner DM, Erickson KI, Powell KE, Bloodgood B, et al. Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review. Med Sci Sport Exerc. 2019;51(6):1303-13. https://doi.org/10.1249/MSS.0000000000001942
50. Theodorakopoulos C, Jones J, Bannerman E, Greig CA. Effectiveness of nutritional and exercise interventions to improve body composition and muscle strength or function in sarcopenic obese older adults: A systematic review. Nutr Res. 2017;43:3-15. https://doi.org/10.1016/j.nutres.2017.05.002
51. Chen N, He X, Feng Y, Ainsworth BE, Liu Y. Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials. Eur Rev Aging Phys Act. 2021;18(1):23. https://doi.org/10.1186/s11556-021-00277-7
52. Blasco-Lafarga C, Monteagudo P, Roldán A, Cordellat A, Pesce C. Strategies to change body composition in older adults: do type of exercise and dose distribution matter? J Sports Med Phys Fitness. 2020;60(4):552-61. https://doi.org/10.23736/S0022-4707.20.10321-9
53. da Rosa Orssatto LB, de la Rocha Freitas C, Shield AJ, Silveira Pinto R, Trajano GS. Effects of resistance training concentric velocity on older adults' functional capacity: A systematic review and meta-analysis of randomised trials. Exp Gerontol. 2019;127:110731. https://doi.org/10.1016/j.exger.2019.110731
54. Liu C, Shiroy DM, Jones LY, Clark DO. Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. Eur Rev Aging Phys Act. 2014;11(2):95-106. https://doi.org/10.1007/s11556-014-0144-1
55. Telenius EW, Engedal K, Bergland A. Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial. BMC Geriatr. 2015;15(1):158. https://doi.org/10.1186/s12877-015-0151-8
56. Raafs BM, Karssemeijer EGA, Van der Horst L, Aaronson JA, Olde Rikkert MGM, Kessels RPC. Physical Exercise Training Improves Quality of Life in Healthy Older Adults: A Meta-Analysis. J Aging Phys Act. 2020;28(1):81-93. https://doi.org/10.1123/japa.2018-0436
57. Paluska SA, Schwenk TL. Physical Activity and Mental Health. Sport Med. 2000;29(3):167-80. https://doi.org/10.2165/00007256-200029030-00003