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Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: A randomized-controlled cross-over design

Janus Gudlaugsson1, Vilmundur Gudnason23, Thor Aspelund23, Kristin Siggeirsdottir2, Anna S Olafsdottir1, Palmi V Jonsson34, Sigurbjorn A Arngrimsson1, Tamara B Harris5 and Erlingur Johannsson1*

  • * Corresponding author: Erlingur Johannsson

Author Affiliations

1 Centre for Research in Sport and Health Sciences, University of Iceland, Laugarvatn, Iceland

2 Icelandic Heart Association, Reykjavik, Iceland

3 Faculty of Medicine, University of Iceland, Reykjavik, Iceland

4 Department of Geriatrics, Landspitali – University Hospital, Reykjavik, Iceland

5 Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute of Aging, Baltimore, MD, USA

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International Journal of Behavioral Nutrition and Physical Activity 2012, 9:107  doi:10.1186/1479-5868-9-107

Published: 10 September 2012



Older adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults.


For this study, 117 participants, 71 to 90 years old, were randomized in immediate intervention group and a control group (delayed intervention group). The intervention consisted of daily endurance and twice-a-week strength training. The method was based on a randomized-controlled cross-over design. Short Physical Performance Battery (SPPB), 8 foot up-and-go test, strength performance, six min walking test (6 MW), physical activity, BMI and quality of life were obtained at baseline, after a 6-month intervention- and control phase, again after 6-month crossover- and delayed intervention phase, and after anadditional 6-month follow-up.


After 6 months of MTI, the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery (SPPB) score (mean diff = 0.6, 95 % CI: 0.1, 1.0) and 8-foot up-and-go test (mean diff = −1.0 s, 95 % CI: -1.5, -0.6), and in endurance performance via 6-minute walking test (6 MW) (mean diff = 44.2 meters, 95 % CI: 17.1, 71.2). In strength performance via knee extension the intervention group improved while control group declined (mean diff = 55.0 Newton, 95 % CI: 28.4, 81.7), and also in PA (mean diff = 125.9 cpm, 95 % CI: 96.0, 155.8). Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4: SPPB (1.1 points, 95 % CI: 0.8, 1.4); 8-foot up-and-go (−0.9 s, 95 % CI: -1.2, -0.6); 6 MW (18.7 m, 95 % CI: 6.5, 31.0); knee extension (4.2 Newton, 95 % CI: -10.0, 18.3); hand grip (6.7 Newton, 95 % CI: -4.4, 17.8); PA (−4.0 cpm, 95 % CI: -33.9, 26.0); BMI (−0.6 kg/m2, 95 % CI: -0.9, -0.3) and Icelandic quality of life (0.3 points, 95 % CI: -0.7, 1.4).


Our results suggest that regular MTI can improve and prevent decline in functional fitness in older individuals, influence their lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care.

Trial registration

This study was approved by the National Bioethics Committee in Iceland, VSNb20080300114/03-1

Physical activity; Functional fitness; SPPB; 6 MW; Strength; Cross-over design