Procedure
low active mobility, plantar flexion exercise
The interventions for the IG and CG were applied for 12 weeks, with a total of 32 sessions at a rate of 2 sessions per week. Each session lasted approximately 45 min and there were at least 48 h between sessions. The participants assigned to the IG were submitted to a multicomponent training program in which each bout of training began with a 5-min activation period, consisting of walking at the usual walking speed (obtained during the evaluation of the SPPB test battery) on a treadmill at 1% inclination (Treadmill Run 100, Domyos, Decathlon, France). The patients then performed two resistance exercises aimed at improving lower limb muscle power: leg press (Bodytone Evolution E59, Murcia, Spain) and plantar flexion exercise in standing using steps. For the leg press exercise, 3 to 4 sets of 8 to 15 repetitions were performed at an intensity between 30 to 60% of maximal strength (F0), with 1 min rest between sets. For plantar flexion, patients performed 3 sets of 4 to 12 repetitions with their body weight using one or both legs, with 1 min of recovery between sets. After that, participants performed an aerobic and intervallic exercise protocol on a treadmill, consisting in an 8–10 min program with 6–10 intervals, reaching ratios of 1:3 (30 s at maximum walking speed and 90 s at 50% of normal walking speed, and so on). In accordance with the principle of progression and individualization, the first two weeks were conceived as conditioning and the volume and intensity of the strength and aerobic exercises were adjusted. Finally, the program ended with 5 min of low active mobility.The CG performed the nursing home’s usual care exercises program based on active mobility of most of the articular groups of the extremities during the 12 weeks of intervention.