The decrease of the autonomic nervous system (ANS) activity that occurs with age is associated with an increase of cardiovascular events and morbidities. It has been shown that physical activity helps reducing the ANS activity age-related decline but remains poorly practiced among nursing home residents. Therefore, we aim to compare the effects of a 9-month brisk walking training (1 time a week or 3 times a week) on the ANS activity in frail nursing home residents.

One hundred 60-year-old subjects and older will be recruited within the ten nursing homes of La mutualité française Loire Haute-Loire, France (ClinicalTrials.gov identifier: NCT03302923) and will be randomized into 3 groups: G1: one brisk walking session a week; G2: three brisk walking session a week; G3: Control group (no training).

Testing procedure will occur at the inclusion and after 3 months, 6 months and 9 months of training. The primary outcome is the heart rate variability measured by 24hours Holter ECG, especially global and parasympathetic indices such as SDNN and RMSSD respectively. The maximal distance performed during the 6-minute walk test is also used as a secondary outcome measure.

Twenty-three subjects aged 80.1±10.7 years currently accomplished the whole training protocol. Compared with control group, subjects trained 3 times a week experienced an increase of parasympathetic activity (RMSSD value) by 58.3% (P<0.01) while global (SDNN) activity did not differ significantly. Subjects from the latter group also improved their 6min walking distance by 12.0% (P<0.01).

A nine-month brisk walking training enhances parasympathetic activity and improves walking distance in frail institutionalized old people. In that view physical activity may prevent cardiovascular risks and might help to reduce the loss of autonomy even after 80.