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Incluye material complementario, Regular exercise training is a recognized lifestyle strategy to lower resting blood pressure (BP), but little is known about substrate metabolism in population with high BP. Thus, the purpose of this study was to investigate the effects of 16-weeks of HIIT on body composition, BP, cardiorespiratory fitness by (Formula presented.) O2max, and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity. We also aimed to test the potential association between changes in cardiorespiratory fitness, substrate utilization during exercise and BP. Forty-two physically inactive overweight/obese participants participated in 16-weeks of HIIT intervention. The HIIT frequency was three times a week (work ratio 1:2:10, for interval cycling: rest period: repeated times; 80–100% of the maximum heart rate). Groups were distributed based on their baseline BP: HIIT-hypertensive (H-HTN: age 47.7 ± 12.0 years; body mass index [BMI] 30.3 ± 5.5 kg/m2; systolic [SBP]/diastolic BP [DBP] 151.6 ± 10/81.9 ± 4.2 mmHg), HIIT-pre-hypertensive (H-PreHTN: age 37.6 ± 12.0 years; BMI 31.9 ± 5.3 kg/m2; SBP/DBP 134.4 ± 3.2/74.9 ± 7.0 mmHg), and a normotensive control group (H-CG: age 40.7 ± 11.0 years; BMI 29.5 ± 4.2 kg/m2; SBP/DBP 117.0 ± 6.2/72.4 ± 4.1 mmHg). Anthropometry/body composition, BP, and metabolic substrate utilization during exercise (fat [FATox], carbohydrate [CHOox] oxidation, respiratory exchange ratio [RER], and (Formula presented.) O2max), were measured before and after the 16-week HIIT intervention. Adjusted mixed linear models revealed a significant improved in (Formula presented.) O2max were + 3.34 in the H-CG, + 3.63 in the H-PreHTN, and + 5.92 mL⋅kg–1⋅min–1, in the H-HTN group, however, the Time × Group interaction were not significant (p = 0.083). All the exercise types induced similar decreases on SBP (−8.70) in the H-HTN, (−7.14) in the H-CG, and (−5.11) mmHg in the H-PreHTN, as well as DBP levels (−5.43) mmHg in H-CG group (p = 0.032 vs. H-HTN group). At 16-week, no significant correlations were noted for the changes of blood pressure, cardiorespiratory fitness or exercise metabolism substrates outcomes. In conclusion, our results suggest that a 16-week HIIT-intervention improved (Formula presented.) O2max and blood pressure BP, but these changes are independent of substrate utilization during exercise in normotensive and hypertensive participants with excessive adiposity., PD-F was funded by the Universidad de La Frontera. CÁ was funded by private funds and by the Universidad de Los Lagos. MI is also funded in part by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). RR-V is funded in part by a Postdoctoral Fellowship Resolution ID 420/2019 of the Universidad Pública de Navarra. DCA was supported by Vicerrectoria de Investigación throguh proyecto puente PEP I-2019050.

Background: physical exercise is an effective strategy for preserving functional capacity and improving the symptoms of frailty in older adults. In addition to functional gains, exercise is considered to be a cornerstone for enhancing cognitive function in frail older adults with cognitive impairment and dementia. We assessed the effects of the Vivifrail exercise intervention for functional capacity, cognition, and well-being status in community-dwelling older adults. Methods: in a multicentre randomized controlled trial conducted in three tertiary hospitals in Spain, a total of 188 older patients with mild cognitive impairment or mild dementia (aged >75 years) were randomly assigned to an exercise intervention (n = 88) or a usual-care, control (n = 100) group. The intervention was based on the Vivifrail tailored multicomponent exercise programme, which included resistance, balance, flexibility (3 days/week), and gait-retraining exercises (5 days/week) and was performed for three consecutive months (http://vivifrail.com). The usual-care group received habitual outpatient care. The main endpoint was change in functional capacity from baseline to 1 and 3 months, assessed with the Short Physical Performance Battery (SPPB). Secondary endpoints were changes in cognitive function and handgrip strength after 1 and 3 months, and well-being status, falls, hospital admission rate, visits to the emergency department, and mortality after 3 months. Results: the Vivifrail exercise programme provided significant benefits in functional capacity over usual-care. The mean adherence to the exercise sessions was 79% in the first month and 68% in the following 2 months. The intervention group showed a mean increase (over the control group) of 0.86 points on the SPPB scale (95% confidence interval [CI] 0.32, 1.41 points; P < 0.01) after 1 month of intervention and 1.40 points (95% CI 0.82, 1.98 points; P < 0.001) after 3 months. Participants in the usual-care group showed no significant benefit in functional capacity (mean change of −0.17 points [95% CI −0.54, 0.19 points] after 1 month and −0.33 points [95% CI −0.70, 0.04 points] after 3 months), whereas the exercise intervention reversed this trend (0.69 points [95% CI 0.29, 1.09 points] after 1 month and 1.07 points [95% CI 0.63, 1.51 points] after 3 months). Exercise group also obtained significant benefits in cognitive function, muscle function, and depression after 3 months over control group (P < 0.05). No between-group differences were obtained in other secondary endpoints (P > 0.05). Conclusions: the Vivifrail exercise training programme is an effective and safe therapy for improving functional capacity in community-dwelling frail/prefrail older patients with mild cognitive impairment or mild dementia and also seems to have beneficial effect on cognition, muscle function, and mood status., This study has been funded by a Gobierno de Navarra projectgrant and fondos FEDER (Resolución 426/2016, del 30 deseptiembre 28/16). Mikel Izquierdo is funded by a researchgrant PI17/01814 of the Ministerio de Economía, Industria yCompetitividad (ISCIII, FEDER).

Papers in this research topic highlight the notion that personalized exercise is a feasible and effective lifestyle modification strategy, for all individuals with, or at risk of, non-communicable chronic diseases.
Accordingly, more research is needed to compare the training paradigms in defined subgroups, for instance, at-risk subjects, and at different stages of disease join to the point. With many issues unresolved, further research is warranted before exercise can conscientiously be prescribed as “precision medicine” to address cardiometabolic risk factors and their progression to many non-communicable diseases., This study has been funded in part by a research grant PI17/01814 of the Ministerio de Economia, Industria y Competitividad (ISCIII, FEDER).

Background and objectives: exercise may reverse functional decline in hospitalized older adults, but the optimal duration is unclear. This study examined the potential relationship between in-hospital multicomponent exercise program duration and changes in physical function, cognition, and muscle function to maximize exercise-related health benefits in acutely hospitalized older patients. Research design and methods: this secondary analysis of a multicenter randomized controlled trial examined the relationship between the duration of an in-hospital multicomponent exercise program and changes in physical function, cognition, and muscle strength in 570 acutely hospitalized older adults. Participants completed 3, 4, or 5-7 consecutive days of exercise based on the progression of their acute medical illness. The acute clinical condition of the older patients was similar across the study groups (i.e., 3/4/5-7 days) at admission. Outcomes included the Short Physical Performance Battery (SPPB) for functional capacity, Gait Velocity Test for gait speed, handgrip for muscle strength, and cognitive tests. Results: of the 570 patients included in the analysis, 298 were women (52.3%), and the mean (SD) age was 87.3 (4.8) years. Exercise groups increased SPPB scores compared with controls, with gains of 1.09 points after three days, 1.97 points after four days, and 2.02 points after 5-7 days (p < .001). The 4-day program showed the most significant benefit for functional capacity. Gait velocity increased by 0.11 m/s after 4 and 5-7 days (p = .032). Similar dose-response relationships were seen for handgrip strength and cognition, with 5-7 days showing more significant gains than three days (p < .05). Discussion and implications: multicomponent exercise programs enhance physical and cognitive function in hospitalized older adults, regardless of exercise dosage. A 4-day program significantly boosts functional capacity, although 5-7 days improves handgrip strength and cognition, highlighting the importance of exercise dosage in countering functional decline. Implementing evidence-based inpatient exercise prescriptions can help reverse muscle weakness and improve cognitive and physical function., This study was funded by a Gobierno de Navarra project Resolución grant 2186/2014 and acknowledged with the 'Beca Ortiz de Landazuri' for the best research clinical project in 2014. This study was also funded by a research grant PI17/01814 from the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). N.M.-V. received funding from the 'la Caixa' Foundation (ID 100010434) under LCF/PR/PR15/51100006 agreement.

Background: bed rest during hospitalization can negatively impact functional independence and clinical status of older individuals. Strategies focused on maintaining and improving muscle function may help reverse these losses. This study investigated the effects of a short-term multicomponent exercise intervention on maximal strength and muscle power in hospitalized older patients. Methods: this secondary analysis of a randomized clinical trial was conducted in an acute care unit in a tertiary public hospital. Ninety (39 women) older patients (mean age 87.7 ± 4.8 years) undergoing acute-care hospitalization [median (IQR) duration 8 (1.75) and 8 (3) days for intervention and control groups, respectively]) were randomly assigned to an exercise intervention group (n = 44) or a control group (n = 46). The control group received standard care hospital including physical rehabilitation as needed. The multicomponent exercise intervention was performed for 3 consecutive days during the hospitalization, consisting of individualized power training, balance, and walking exercises. Outcomes assessed at baseline and discharge were maximal strength through 1 repetition maximum test (1RM) in the leg press and bench press exercises, and muscle power output at different loads (≤ 30% of 1RM and between 45% and 55% of 1RM) in the leg press exercise. Mean peak power during 10 repetitions was assessed at loads between 45% and 55% of 1RM. Results: at discharge, intervention group increased 19.2 kg (Mean ∆% = 40.4%) in leg press 1RM [95% confidence interval (CI): 12.1, 26.2 kg; P < 0.001] and 2.9 kg (Mean ∆% = 19.7%) in bench press 1RM (95% CI: 0.6, 5.2 kg; P < 0.001). The intervention group also increased peak power by 18.8 W (Mean ∆% = 69.2%) (95% CI: 8.4, 29.1 W; P < 0.001) and mean propulsive power by 9.3 (Mean ∆% = 26.8%) W (95% CI: 2.5, 16.1 W; P = 0.002) at loads ≤30% of 1RM. The intervention group also increased peak power by 39.1 W (Mean ∆% = 60.0%) (95% CI: 19.2, 59.0 W; P < 0.001) and mean propulsive power by 22.9 W (Mean ∆% = 64.1%) (95% CI: 11.7, 34.1 W; P < 0.001) at loads between 45% and 55% of 1RM. Mean peak power during the 10 repetitions improved by 20.8 W (Mean ∆% = 36.4%) (95% CI: 3.0, 38.6 W; P = 0.011). No significant changes were observed in the control group for any endpoint. Conclusions An individualized multicomponent exercise program including progressive power training performed over 3 days markedly improved muscle strength and power in acutely hospitalized older patients., This study was funded by a Gobierno de Navarra project Resolución grant 2186/2014 and acknowledged with the 'Beca Ortiz de Landazuri' for the best research clinical project in 2014, as well as by a research grant PI17/01814of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). N.M.-V received funding from 'la Caixa' Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006.

La actual disertación doctoral gira en torno a los efectos de una intervención de ejercicio físico
multicomponente en la capacidad funcional y función cognitiva de las personas mayores frágiles con
deterioro cognitivo a nivel comunitario. Las personas mayores con las condiciones previas son muchos más
vulnerables a presentar eventos negativos relacionados con la salud (prematura mortalidad, hospitalización,
deterioro de las actividades de la vida diaria, limitaciones funcionales, aumento del riesgo de fracturas y
fracturas). Una intervención de ejercicio físico multicomponente (aeróbico, fuerza, equilibrio y flexibilidad)
puede ser una terapia efectiva para mejorar la capacidad funcional y cognitiva en personas mayores frágiles
con deterioro cognitivo leve y demencia leve que viven en la comunidad. Esta tesis doctoral se basa en dos artículos científicos que han sido publicados en revistar científicas
internacionales. En el primer artículo (artículo 1) nuestro objetivo fue publicar el protocolo del estudio que se iba a llevar
cabo con los objetivos primarios y secundarios, el diseño, la metodología, las hipotésis y las posibles
implicaciones de los resultados que se esperaban encontrar según las hipótesis postuladas en relación a una
intervención de ejercicio físico multicomponente en personas mayores frágiles con deterioro cognitivo
comparado con cuidados convencionales (ClinicalTrials.gov NCT03657940. Registered on 5 September
2018). En el segundo artículo (artículo 2), el objetivo principal del estudio fue evaluar los efectos de una
intervención de ejercicio físico multicomponente VIVIFRAIL en la capacidad funcional y estado cognitivo
de las personas mayores frágiles con deterioro cognitivo leve y demencia leve que viven en la comunidad. En relación a los resultados del objetivo primario (artículo 2) se observó que el grupo intervención (ejercicio
físico multicomponente) mostró una mejoría media de 0,86 puntos en el SPPB (95% CI 0.32, 1.41; P <
0.01) después del primer mes y 1,40 puntos (95% CI 0.82, 1.98; P < 0.001) tras los 3 meses de ejercicio en
comparación con el grupo control (cuidados convencionales). Así mismo, la distribución de pacientes en
las diferentes categorías del VIVIFRAIL según la capacidad funcional (discapacidad, fragilidad,
prefragilidad y robustos) también presentó cambios significativos entre los dos grupos durante el periodo
de intervención (P < 0.001). En relación a los objetivos secundarios del estudio (artículo 2) se pudo observar como, la intervención de
ejercicio físico multicomponente parece tener efectos beneficiosos en la función cognitiva, donde el grupo
intervención en pacientes con deterioro cognitivo leve mostró una mejoría del MOCA tras los 3 meses de
ejercicio de 2.05 puntos (95% CI 0.80, 3.28; P 0.014) mientras que el grupo control mostró un
empeoramiento del MOCA tras los 3 meses de -0.13 puntos (95% CI -1.08, 0.82 P < 0.05). En los pacientes
con demencia leve, también se observó una diferencia entre grupos (grupo control vs grupo intervención),
a los 3 meses, en el que los que realizaron ejercicio físico mostraron una mejoría media estadísticamente
significativa de 1.13 puntos en el MEC-lobo (95% CI 0.18, 2.10 P < 0.05). Así mismo, también se han
observado diferencias estadísticamente significativas entre grupos a favor del grupo intervención en la
fuerza palmar -mejoría de 1.05kg (95% CI 0.05, 2.06 P < 0.05)- y en el estado de ánimo -mejoría de -1.12.
puntos en la escala Yesavage (95% CI 0.05, 2.06 P < 0.05)-. Por último, y en relación a otros objetivos secundarios, no se han observado diferencias estadísticamente
significativas en relación al número de caídas, ingresos hospitalarios, visitas a urgencias, mortalidad e
institucionalización. El programa de ejercicio físico multicomponente VIVIFRAIL parece ser una intervención efectiva y segura
para mejorar la capacidad funcional en personas mayores frágiles y prefrágiles que viven en la comunidad
con deterioro cognitivo leve y demencia en estadio leve. Además de la mejoría en la capacidad funcional,
el programa individualizado de ejercicio físico multicomponente también parece tener efectos beneficiosos
en la cognición, en la función muscular, y en el ánimo tras los 3 meses de intervención con ejercicio físico., The doctoral dissertation herein focuses on the effects of multicomponent physical exercise intervention on
functional capacity and cognitive functions in frail, community-dwelling older adults with cognitive
impairment. Older adults suffering from these conditions are far more vulnerable to negative health-related
events (i.e., premature mortality, hospitalisation, impairment in daily living activities, functional limitations
and increased risk of fractures). Multicomponent physical exercise intervention (aerobic, strength, balance
and mobility exercises) may be an effective therapy to improve functional and cognitive capacity in frail,
community-dwelling older adults with Mild Cognitive Impairment (MCI henceforth) and mild dementia. This doctoral thesis is based on two papers published in international scientific journals. The aim in the first paper (paper 1) was to publish the study protocol to be followed in relation to the
primary and secondary objectives, design, methodology, hypotheses and potential implications of the
predicted outcomes of multicomponent physical exercise intervention compared to conventional care in
frail older adults with cognitive impairment (ClinicalTrials.gov NCT03657940. Registered on 5 September,
2018). The main study objective in the second paper (paper 2) was to assess the effects of VIVIFRAIL
multicomponent physical exercise intervention on the functional capacity and cognitive status of frail,
community-dwelling older adults with MCI and mild dementia. With regard to the results of the primary objective (paper 2), it was observed that the intervention group
(multicomponent physical exercise) showed an average improvement of 0.86 points in the SPPB test (95%
CI 0.32, 1.41; P < 0.01) after the first month, and 1.40 points (95% CI 0.82, 1.98; P < 0.001) after a 3-
month exercise period compared to the control group (conventional care). Moreover, patient distribution
into the different VIVIFRAIL categories according to functional capacity (disabled, frail, pre-frail and
robust) also revealed significant differences between the two groups during the intervention period (P <
0.001). As for the secondary study objectives (paper 2), it was observed that multicomponent physical exercise
intervention appears to have beneficial effects on cognitive functions, where the intervention group in
patients suffering from MCI showed a 2.05 point improvement in the MoCA test after a 3-month exercise
period (95% CI 0.80, 3.28; p = 0.014) while the control group reported a -0.13 point decrease in the MoCA
test after a 3-month period (95% CI -1.08, 0.82, p < 0.05). In patients suffering from mild dementia, a
difference was also observed between groups (control vs. intervention group); after a 3-month period, those
who had engaged in physical exercise reported a statistically significant average improvement of 1.13
points in the MEC-Lobo test (95% CI 0.18, 2.10, p < 0.05). Furthermore, statistically significant differences
between groups in handgrip strength were also observed in favour of the intervention group – a 1.05kg
improvement (95% CI 0.05, 2.06, p < 0.05) –, and -1.12 point improvement on the Yesavage scale
considering the mood status (95% CI 0.05, 2.06 P < 0.05). Finally, regarding other secondary objectives, no statistically significant differences were observed in
relation to the number of falls, hospital admissions, emergency visits, mortality and institutionalisation. The VIVIFRAIL multicomponent physical exercise programme appears to be an effective and safe
intervention in order to improve functional capacity in frail and pre-frail, community-dwelling older adults
with MCI and mild dementia. In addition to improved functional capacity, the individualised
multicomponent physical exercise programme also seems to have beneficial effects on cognition, muscle
function and mood after a 3-month period of physical exercise intervention., This study was part of the project entitled Impact of a Multicomponent Exercise Program on Functional Capacity in Frail Aged Participants With Cognitive Decline (ClinicalTrials.gov NCT03657940. Registered on 5 September 2018), which was funded by a Gobierno de Navarra project Resolution grant (426/2016, September 30th) and acknowledged with the Beca Ortiz de Landázuri as the best research clinical project in 2016, as well as it is funded by ISCIII (IP, professor Mikel izquierdo) and Fondos FEDER (PI17/01814)., Programa de Doctorado en Ciencias de la Salud (RD 99/2011), Osasun Zientzietako Doktoretza Programa (ED 99/2011)

Background: Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods: This study is a secondary analysis of a randomized controlled trial conducted in the Department of Geriatric Medicine of a tertiary hospital. In addition to the standard care, an exercise-training multicomponent program was delivered to the intervention group during the acute hospitalization period. Multimorbidity patterns were determined through fuzzy c-means cluster analysis, over 38 chronic diseases. Functional, cognitive and affective outcomes were considered. Results: Three hundred and six patients were included in the analyses (154 control; 152 intervention), with a mean age of 87.2 years, and 58.5% being female. Four patterns of multimorbidity were identified: heart valves and prostate diseases (26.8%); metabolic diseases and colitis (20.6%); psychiatric, cardiovascular and autoimmune diseases (16%); and an unspecific pattern (36.6%). The Short Physical Performance Battery (SPPB) test improved across all patterns, but the intervention was most effective for patients in the metabolic/colitis pattern (2.48-point difference between intervention/control groups, 95% CI 1.60-3.35). Regarding the Barthel Index and the Mini Mental State Examination (MMSE), the differences were significant for all multimorbidity patterns, except for the psychiatric/cardio/autoimmune pattern. Differences concerning quality of life were especially high for the psychiatric/cardio/autoimmune pattern (16.9-point difference between intervention/control groups, 95% CI 4.04, 29.7).
Conclusions: Patients in all the analyzed multimorbidity patterns improved with this tailored program, but the improvement was highest for those in the metabolic pattern. Understanding how different chronic disease combinations are associated with specific functional and cognitive responses to a multicomponent exercise intervention may allow further tailoring such interventions to older patients’ clinical profile., The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. This work was supported by the Gobierno de Navarra project grant 2186/2014 and acknowledged with the “Beca Ortiz de Landázuri” as the best research clinical project in 2014, as well as by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). Additional contributions: NM-V received funding from “la Caixa” Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006.

Objectives: this study aimed to assess the prevalence and impact of loneliness (De Jong Gierveld scale) and isolation (Lubben scale) on the effects of a hospital-based exercise programme. Design: secondary analysis of a randomised clinical trial. Setting: Acute Geriatric Unit of a tertiary hospital in Spain. Participants: 103 hospitalised older adults. Intervention: individualised multicomponent exercise program (20-minute sessions twice a day for 3 consecutive days). Results: among the 103 randomised patients included in the analysis (both arms included), 58.3% were male, and their mean age was 87.3 (4.5) years. According to the Lubben scale, 15.8% of patients were at risk of isolation, while 62.7% were in a situation of severe or moderate loneliness according to the De Jong Gierveld scale. In the non-isolated group, training showed a substantial positive impact on Geriatric Depression Scale (B = -1.25, 95% CI = -0.24 to -0.27). In the isolated group, all outcomes improved, but only the Quality of Life showed significant changes (B = 35, 95% CI = 4.96-35.8). The SPPB test (B = 1.62, 95% CI = 0.19-3.04) and Quality of Life, (B = 17.1, 95% CI = 1.84-32.3) showed a significant improvement in the non-loneliness exercise group while no differences were found in the loneliness group. Conclusion: despite the high prevalence of loneliness and social isolation, individualised exercise programs provide significant benefits to hospitalised patients, especially in quality of life., This study was funded by a research grant PI17/01814 from the Ministerio de Economía, Industry y Competitividad (ISCIII, FEDER). N.M.-V. received funding from 'la Caixa' Foundation (ID100010434), under agreement LCF/PR/PR15/51100006, and has been awarded a research intensification grant by the Navarro Health Service-Osasunbidea, as per resolution 916/2023.

Background. Hospitalization exacerbates sarcopenia and physical dysfunction in older adults. Whether tailored inpatient exercise prevents acute sarcopenia is unknown. This study aimed to examine the effect of a multicomponent exercise programme on muscle and physical function in hospitalized older adults. We hypothesized that participation in a brief tailored exercise regimen (i.e., 3–5 days) would attenuate muscle function and structure changes compared with usual hospital care alone.
Methods. This randomized clinical trial with blinded outcome assessment was conducted from May 2018 to April 2021 at Hospital Universitario de Navarra, Spain. Participants were 130 patients aged 75 years and older admitted to an acute care geriatric unit. Patients were randomized to a tailored 3- to 5-day exercise programme (n = 64) or usual hospital care (control, n = 66) consisting of physical therapy if needed. The coprimary endpoints were between-group differences in changes in short physical performance battery (SPPB) score and usual gait velocity from hospital admission to discharge. Secondary endpoints included changes in rectus femoris echo intensity, cross-sectional area, thickness and subcutaneous and intramuscular fat by ultrasound.
Results. Among 130 randomized patients (mean [SD] age, 87.7 [4.6] years; 57 [44%] women), the exercise group increased their mean SPPB score by 0.98 points (95% CI, 0.28–1.69 points) and gait velocity by 0.09 m/s (95% CI, 0.03–0.15 m/s) more than controls (both p < 0.01). No between-group differences were observed in any ultrasound muscle outcomes. There were no study-related adverse events.
Conclusions. Three to 5 days of tailored multicomponent exercise provided functional benefits but did not alter muscle or fat architecture compared with usual hospital care alone among vulnerable older patients. Brief exercise may help prevent acute sarcopenia during hospitalization., This study was funded by a Gobierno de Navarra project Resolución grant 2186/2014 and acknowledged with the 'Beca Ortiz de Landazuri' forthe best research clinical project in 2014. Additionally, this study was funded by a research grant PI17/01814 from the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). N.M-V received funding from the 'la Caixa' Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006.

Background. Sex-based differences in the clinical presentation and outcomes are well-established in patients hospitalized for geriatric syndromes. We aimed to investigate sex differences in response to in-hospital exercise on function, strength, cognition, and quality of life in acute care admissions.
Methods. 570 patients (mean age 87 years, 298 females [52.3%]) admitted to acute care for elderly units were randomized to multicomponent exercise emphasizing progressive resistance training or usual care. Functional assessments included Short Physical Performance Battery (SPPB), grip strength, Mini-Mental State Examination (MMSE), and health-related quality of life (EQ-VAS).
Results. Exercising females showed more significant SPPB improvements than males (between-group difference 1.48 points, p = 0.027), exceeding the minimal clinically significant difference. While female participants significantly increased handgrip strength and male patients improved cognition after in-hospital exercise compared to the control group (all p < 0.001), no sex differences occurred.
Conclusions. Females demonstrate more excellent physical function improvements compared to male older patients. Findings highlight the importance of tailored exercise incorporating patient factors like biological sex in geriatric medicine.
Trial registration. NCT04600453, This study was funded by a Gobierno de Navarra project Resolución grant 2186/2014 and acknowledged with the “Beca Ortiz de Landazuri” for the best research clinical project in 2014. This study was also funded by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). N.M-V received funding from the “la Caixa” Foundation (ID100010434) under agreement LCF/PR/PR15/51100006.

We sought to assess the residual effects (post 72-h training cessation) on fasting plasma glucose (FPG) and fasting insulin (FI) after 12-weeks of high-intensity interval training (HIIT), resistance training (RT), or concurrent training (CT) in women with insulin resistance (IR). We also aimed to determine the training-induced, post-training residual impact of CT. A total of adult 45 women (age 38.5±9.2years) were included in the final analysis and were assigned to a control (CG; n=13, BMI 28.3±3.6kg/m2), HIIT [n=14, BMI 28.6±3.6kg/m2, three sessions/wk., 80–100% of the maximum heart rate (HRmax)], RT [n=8, BMI 29.4±5.5kg/m2, two sessions/wk., 8–10 points of the modified Borg, corresponding to 20 to 50% range of one maximum repetition test (1RM)], or CT group (n=10, BMI 29.1±3.0kg/m2, three sessions/wk., 80–100% of HRmax, and 8–10 Borg, or 20 to 50% range of 1RM, to each HIIT and RT compounds), with the latter including both HIIT and RT regimens. Training interventions lasted 12-weeks. The main outcomes were FPG and FI measured at pre- and 24-h and 72-h post-training (FPG24h, FI24h, and FPG72h, FI72h, respectively). Secondary endpoints were body composition/anthropometry and the adiposity markers waist circumference (WC) and tricípital skinfold (TSF). The residual effects 72-h post-training [delta (∆)] were significantly poorer (all p&lt;0.01) in the CT group (∆FPG72h+6.6mg/dl, η2: 0.76) than in the HIIT (∆FPG72h+1.2mg/dl, η2: 0.07) and RT (∆FPG72h+1.0mg/dl, η2: 0.05) groups. These findings reveal that HIIT reduces FPG and RT reduces FI 24-h post-training; both exercise interventions alone have remarkably better residual effects on FPG and FI (post-72h) than CT in women with insulin resistance., CA was funded partially by privates. MI was funded by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). EGC was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq #303399/2018-0) during this project.