4. Discussion
fatigue, muscle failure, muscle pain, muscular failure
HEART
This study aimed to assess the effects of an MPTP program divided into progressive phases on functional capacity, physical capacity, quality of life, exercise motivation, and body composition in older adults living in the community. To the best of our knowledge, this is the first intervention study that analyzes the effectiveness of an MPTP that is assembled in progressive blocks to gradually develop physical capacities thanks to the increase in intensity and volume of work over the weeks. This training program should be safe for the elderly who live in the community, since, as the scientific literature argues, training programs at these ages must comply with a series of specific characteristics, such as not continuing exercise until muscular failure, plenty of low/medium intensity work, and exercises and work methodologies that do not generate excessive fatigue or muscle pain associated with the demands of training that could discourage and abandon the practice of physical activity [The anthropometric variables did not show any changes at the end of the intervention, except for the abdominal perimeter in the EG. This could be explained since the training program was not aimed at generating changes in body composition, since it had a low weekly frequency (2 days a week) and also, in its last phases, strength and cardiorespiratory training were considerably reduced in relation to the total volume of the session [Regarding functional capacity, the main findings of this research showed that an MPTP distributed in progressive phases can improve functional capacity evaluated by the SPPB, TUG and 6 mGS tests. More specifically, when referring to the results recorded for the SPPB, it was possible to verify how the EG improved their scores after applying the PE program. These improvements in the functional capacity of the EG could be due to the very design of the MPTP program, since it has work and exercise methods that follow the recommendations of clinical guidelines recognized worldwide for the prescription of physical exercise, such as the American Heart Association (AHA) [Contrastingly, when comparing the scores obtained for the EG and the CG after the application of the training period, it was possible to verify that there were significant differences in the results obtained for the SPPB at a general level, and more specifically for the tests of balance in tandem, 4 mGS, and GUS5. Along the same line, the results obtained supported differences for the TUG and 6 mGS tests. These scores show that the application of an MPTP program allows not only a delay in the negative effects of aging associated with the lack of physical exercise at these ages, but also an improvement in the levels of functional capacity for the EG [Health-related quality of life was assessed using the SF-36 questionnaire. At the end of the intervention, the experimental group presented improvements (higher scores) in the dimensions of physical function, physical role, general health, and vitality. These findings can be explained because phase 1 aimed at developing strength around functional capacity. In relation to this objective, it has been shown that strength training increases functional capacity and ultimately translates into an improvement in the perception of health-related quality of life [Motivation for exercise showed improvements in the dimension’s intrinsic regulation, identified regulation (increases in both variables) and demotivation (decrease in the score of this variable), in the experimental group at the end of the intervention. These findings could be explained by the fact that physical exercise has been widely shown to enhance positive health outcomes, improve willingness to engage in physical activity in general, and improve quality of life in this population [The strengths of this study are mainly related to the design of the multicomponent program, since by applying it in progressive phases, it is possible to gradually rebuild the autonomy and independence of the elderly, which could be diminished as a result of the high levels of sedentary lifestyle present in this population. Another strength is that exercise was not continued to muscle failure, and so the feeling of fatigue and exhaustion within the session and throughout the program was low. This resulted in a higher rate of adherence and motivation. The limitations found in this study are related to the size of the sample, so it is necessary to replicate the study with a larger number of participants. Another possible limitation of this study is that it has a quasi-experimental design. Therefore, characteristics inherent to this type of approach must be assumed, such as the lack of control over other variables that can influence physical functional improvements and quality of life. These types of variables could be feeding control, stress levels and/or socioeconomic problems, which can influence and cause variations in the results obtained.