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Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Research article

Effects of intermittent hypoxia-hyperoxia on mobility and perceived health in geriatric patients performing a multimodal training intervention: a randomized controlled trial

Authors: Ulrike Bayer, Rudolf Likar, Georg Pinter, Haro Stettner, Susanne Demschar, Brigitte Trummer, Stefan Neuwersch, Oleg Glazachev, Martin Burtscher

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Background

Additional benefits of passive exposures to intermittent hypoxia and hyperoxia on cognitive performance and functional exercise capacity have been demonstrated in geriatric patients who performed a multimodal training program. The main goal of the present study was to evaluate effects of adding intermittent hypoxic-hyperoxic training (IHHT) to a multimodal training intervention (MTI) on mobility and perceived health in old individuals at a Geriatric Day Hospital.

Methods

Thirty-four patients between 64 and 92 years participated in the double blind, randomized and controlled clinical trial. The elderly patients attended in a 5–7 weeks lasting MTI (strength, endurance, balance, reaction, flexibility, coordination, and cognitive exercises) and performed IHHT (breathing 10–14% oxygen for 4–7 min followed by 2–4 min 30–40% oxygen) in the Hypoxic Group (HG) or placebo treatment with ambient air in the Normoxic Group (NG) in parallel. Before and after all treatments, mobility was assessed by the Tinetti Mobility Test (TMT), the Timed-Up-and-Go Test (TUG) and Barthel-Index, while perceived health was assessed by one part of the EQ-5D Test, the EQ visual analogue scale (EQ VAS).

Results

After the MTI plus IHHT or normoxia sessions, results of the TMT, TUG, Barthel Index and EQ-VAS revealed no significant difference between HG and NG (+ 14.9% vs + 15.4%, p = 0.25; − 21% vs − 26.3%, p = 0.51; + 4.2% vs + 3.6%, p = 0.56; + 37.9% vs + 33.9%, p = 0.24;).

Conclusions

IHHT added to MTI did not elicit additional improvements in perceived health and mobility compared to MTI alone.
Literature
1.
go back to reference Murray CJ, Barber RM, Foreman KJ, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–91.CrossRef Murray CJ, Barber RM, Foreman KJ, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–91.CrossRef
2.
go back to reference Salomon JA, Wang H, Freeman MK, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the global burden disease study 2010. Lancet. 2012;380(9859):2144–62.CrossRef Salomon JA, Wang H, Freeman MK, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the global burden disease study 2010. Lancet. 2012;380(9859):2144–62.CrossRef
3.
go back to reference Jalayondeja C, Jalayondeja W, Suttiwong J, Sullivan PE, Nilanthi DL. Physical activity, self-esteem, and quality of life among people with physical disability. Southeast Asian J Trop Med Public Health. 2016;47(3):546–58.PubMed Jalayondeja C, Jalayondeja W, Suttiwong J, Sullivan PE, Nilanthi DL. Physical activity, self-esteem, and quality of life among people with physical disability. Southeast Asian J Trop Med Public Health. 2016;47(3):546–58.PubMed
4.
go back to reference Langlois F, Minh VTT, Chasse K, Dupuis G, Kergoat MJ, Bherer L. Benefits of physical exercise training on cognition and quality of life in frail older adults. J Gerontol B Psychol Sci Soc Sci. 2013;68(3):400–4.CrossRef Langlois F, Minh VTT, Chasse K, Dupuis G, Kergoat MJ, Bherer L. Benefits of physical exercise training on cognition and quality of life in frail older adults. J Gerontol B Psychol Sci Soc Sci. 2013;68(3):400–4.CrossRef
5.
go back to reference Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75:51–61.CrossRef Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75:51–61.CrossRef
6.
go back to reference Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention. 2006a;12:290–5.CrossRef Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention. 2006a;12:290–5.CrossRef
7.
go back to reference Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988 Dec 29;319(26):1701–7.CrossRef Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988 Dec 29;319(26):1701–7.CrossRef
9.
go back to reference Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care, Vol. 30, No. 6 (Jun., 1992), pp. 473-483. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care, Vol. 30, No. 6 (Jun., 1992), pp. 473-483.
10.
go back to reference Bayer U, Likar R, Pinter G, Stettner H, Demschar S, Trummer B, Neuwersch S, Glazachev O, Burtscher M. Intermittent hypoxic–hyperoxic training on cognitive performance in geriatric patients. Alzheimers Dementia (N Y). 2017;3:114–22. Bayer U, Likar R, Pinter G, Stettner H, Demschar S, Trummer B, Neuwersch S, Glazachev O, Burtscher M. Intermittent hypoxic–hyperoxic training on cognitive performance in geriatric patients. Alzheimers Dementia (N Y). 2017;3:114–22.
11.
go back to reference Serebrovskaya TV, Manukhina EB, Smith ML, Downey HF, Mallet RT. Intermittent hypoxia: cause of or therapy for systemic hypertension? Exp Biol Med. 2008;233:627–50.CrossRef Serebrovskaya TV, Manukhina EB, Smith ML, Downey HF, Mallet RT. Intermittent hypoxia: cause of or therapy for systemic hypertension? Exp Biol Med. 2008;233:627–50.CrossRef
13.
go back to reference Burtscher M, Pachinger O, Ehrenbourg I, et al. Intermittent hypoxia increases exercise tolerance in elderly men with and without coronary artery disease. Int J Cardiol. 2004;96:247–54.CrossRef Burtscher M, Pachinger O, Ehrenbourg I, et al. Intermittent hypoxia increases exercise tolerance in elderly men with and without coronary artery disease. Int J Cardiol. 2004;96:247–54.CrossRef
16.
go back to reference Glazachev O. Optimization of clinical application of interval hypoxic training. Biomed Eng. 2013;47(3):134–7.CrossRef Glazachev O. Optimization of clinical application of interval hypoxic training. Biomed Eng. 2013;47(3):134–7.CrossRef
17.
go back to reference Arkhipenko YV, Sazontova TG, Zhukova AG. Adapation to periodic hypoxia and hyperoxia improves resistance of membrane structures in heart, liver, and brain. Bull Exp Biol Med. 2005;140(3):278–81.CrossRef Arkhipenko YV, Sazontova TG, Zhukova AG. Adapation to periodic hypoxia and hyperoxia improves resistance of membrane structures in heart, liver, and brain. Bull Exp Biol Med. 2005;140(3):278–81.CrossRef
19.
go back to reference Liguori C, Stefani A, Sancesario G, Sancesario GM, Marciani MG, Pierantozzi M. CSF lactate levels, τ proteins, cognitive decline: a dynamic relationship in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2015;86:655–9.CrossRef Liguori C, Stefani A, Sancesario G, Sancesario GM, Marciani MG, Pierantozzi M. CSF lactate levels, τ proteins, cognitive decline: a dynamic relationship in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2015;86:655–9.CrossRef
21.
go back to reference Glazachev O. Intermittent hypoxia–hyperoxia exposure improves cardiometabolic profile, exercise tolerance and quality of life: a preliminary study in cardiac patients. European Journal of Preventive Cardiology EJPC-D-15-00334. abstract. Glazachev O. Intermittent hypoxia–hyperoxia exposure improves cardiometabolic profile, exercise tolerance and quality of life: a preliminary study in cardiac patients. European Journal of Preventive Cardiology EJPC-D-15-00334. abstract.
22.
go back to reference Hayes HB, Jayaraman A, Herrmann M, Mitchell GS, Rymer WZ, Trumbower RD. Daily intermittent hypoxia enhances walking after chronic spinal cord injury: a randomized trial. Neurology. 2014 Jan 14;82(2):104–13.CrossRef Hayes HB, Jayaraman A, Herrmann M, Mitchell GS, Rymer WZ, Trumbower RD. Daily intermittent hypoxia enhances walking after chronic spinal cord injury: a randomized trial. Neurology. 2014 Jan 14;82(2):104–13.CrossRef
23.
go back to reference Glazachev O, Platonenko A, Spirina G. Vorrichtung zur biologisch regelbaren Auswahl von individuellen Verlaufen für eine Intervall-Hypoxie-Therapie (Hypoxietraining): Gebrauchsmusters Nr. DE DE202012012602, 06.08.2013; Tag der Eintragung 01.06.2012 Gebrauchsmusterinhaber AI MEDIQ S.A., Luxembourg, LU Glazachev O, Platonenko A, Spirina G. Vorrichtung zur biologisch regelbaren Auswahl von individuellen Verlaufen für eine Intervall-Hypoxie-Therapie (Hypoxietraining): Gebrauchsmusters Nr. DE DE202012012602, 06.08.2013; Tag der Eintragung 01.06.2012 Gebrauchsmusterinhaber AI MEDIQ S.A., Luxembourg, LU
25.
go back to reference EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208. EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.
27.
go back to reference Lewis C. Balance, Gait Test Proves Simple Yet Useful. P.T. Bulletin, 1993; 2/10:9 & 40. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. JAGS. 1986;34:119–26.CrossRef Lewis C. Balance, Gait Test Proves Simple Yet Useful. P.T. Bulletin, 1993; 2/10:9 & 40. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. JAGS. 1986;34:119–26.CrossRef
28.
go back to reference Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991 Feb;39(2):142–8.CrossRef Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991 Feb;39(2):142–8.CrossRef
29.
go back to reference Mahoney FI, Barthel D. Functional evaluation: the Barthel index. Maryland State Med J. 1965;14:56–61. Mahoney FI, Barthel D. Functional evaluation: the Barthel index. Maryland State Med J. 1965;14:56–61.
31.
32.
go back to reference ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–7. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–7.
35.
go back to reference Huxham FE, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Aust J Physiother. 2001;47:89–100.CrossRef Huxham FE, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Aust J Physiother. 2001;47:89–100.CrossRef
36.
37.
go back to reference Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000;80(9):896–903.PubMed Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000;80(9):896–903.PubMed
38.
go back to reference Okumiya K, Matsubayashi K, Nakamura T, Fujisawa M, Osaki Y, Doi Y, Ozawa T. The timed "up & go" test is a useful predictor of falls in community-dwelling older people. J Am Geriatr Soc. 1998 Jul;46(7):928–30.CrossRef Okumiya K, Matsubayashi K, Nakamura T, Fujisawa M, Osaki Y, Doi Y, Ozawa T. The timed "up & go" test is a useful predictor of falls in community-dwelling older people. J Am Geriatr Soc. 1998 Jul;46(7):928–30.CrossRef
39.
go back to reference Delbaere K, Close JC, Heim J, et al. A multifactorial approach to understanding fall risk in older people. J Am Geriatr Soc. 2010;58(9):1679–85.CrossRef Delbaere K, Close JC, Heim J, et al. A multifactorial approach to understanding fall risk in older people. J Am Geriatr Soc. 2010;58(9):1679–85.CrossRef
44.
go back to reference Denkinger MD, Lukas A, Nikolaus T, Hauer K. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriatr Psychiatry. 2014;23(1):72–86.CrossRef Denkinger MD, Lukas A, Nikolaus T, Hauer K. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriatr Psychiatry. 2014;23(1):72–86.CrossRef
Metadata
Title
Effects of intermittent hypoxia-hyperoxia on mobility and perceived health in geriatric patients performing a multimodal training intervention: a randomized controlled trial
Authors
Ulrike Bayer
Rudolf Likar
Georg Pinter
Haro Stettner
Susanne Demschar
Brigitte Trummer
Stefan Neuwersch
Oleg Glazachev
Martin Burtscher
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1184-1

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