Effects of a Multicomponent Exercise Program on Functional Ability in Community-Dwelling, Frail Older Adults

2001 ◽  
Vol 9 (4) ◽  
pp. 414-424 ◽  
Author(s):  
Charlotte H. Worm ◽  
Esther Vad ◽  
Lis Puggaard ◽  
Henrik Støvring ◽  
Jens Lauritsen ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Older People ◽  
Functional Ability ◽  
Intervention Group ◽  
Exercise Program ◽  
Voluntary Contraction ◽  
Community Dwelling ◽  
Controlled Study ◽  
Control Group ◽  
Frail Older People

The purpose of this study was to determine the effects of a multicomponent exercise program on basic daily functions and muscle strength in community-dwelling frail older people. The randomized, controlled study comprised 46 community-dwelling frail older people (above 74 years of age and not able to leave their home without mobility aids). For 12 weeks the intervention group (n = 22) was transported to 2 class-based exercise sessions each week. Assessment of physical function was obtained using Berg's Balance Scale and a walking test. Self-reported functional ability was assessed through SF-36. Maximal oxygen uptake and maximal voluntary contraction of the shoulders' abductors were measured. The intervention group had a significant improvement in balance, muscle strength, walking function, and self-assessed functional ability compared with the control group. This study demonstrates that multicomponent exercise has a significant effect on basic daily functions and muscle strength in community-dwelling frail older people and might improve their ability to live an independent life.

CAN AN INTERVENTION WITH TESTOSTERONE AND NUTRITIONAL SUPPLEMENT IMPROVE THE FRAILTY LEVEL OF UNDER-NOURISHED OLDER PEOPLE?

2016 ◽  
pp. 1-6
Author(s):  
O. THEOU ◽  
L. WIJEYARATNE ◽  
C. PIANTADOSI ◽  
K. LANGE ◽  
V. NAGANATHAN ◽  
...  
Keyword(s):  
Older People ◽  
Controlled Trial ◽  
Frailty Index ◽  
Intervention Group ◽  
Nutritional Supplement ◽  
Community Dwelling ◽  
Self Report ◽  
Control Group ◽  
Testosterone Undecanoate ◽  
High Calorie

Objective: To examine whether a testosterone and a high calorie nutritional supplement intervention can reduce frailty scores in undernourished older people using multiple frailty tools. Design: Randomized controlled trial. Setting/Participants: 53 community-dwelling, undernourished men and women aged >65 years from South Australia, Victoria and New South Wales. Intervention: Intervention group received oral testosterone undecanoate and a high calorie supplement (2108-2416 kJ/day) whereas the control group received placebo testosterone and low calorie supplement (142-191 kJ/day). Measurements: Frailty was operationalized using three frailty indices (FI-lab, FI-self-report, FI-combined) and the frailty phenotype. Results: There were no significant differences in changes in frailty scores at either 6 or 12 months follow up between the two treatment groups for all scales. Participants at the intervention group were 4.8 times more likely to improve their FI-combined score at both time points compared to the placebo group. Conclusion: A testosterone and a high calorie nutritional supplement intervention did not improve the frailty levels of under-nourished older people. Even so, when frailty was measured using a frailty index combining self-reported and lab data we found that participants who received the intervention were more likely to show persistent improvement in their frailty scores.

Effects of a Low-Intensity Strength-Training Program on Knee-Extensor Strength and Functional Ability of Frail Older People

2000 ◽  
Vol 8 (4) ◽  
pp. 325-342 ◽  
Author(s):  
Marja H. Westhoff ◽  
Lysander Stemmerik ◽  
Hendriek C. Boshuizen
Keyword(s):  
Older People ◽  
Strength Training ◽  
Training Program ◽  
Functional Ability ◽  
Knee Extensor ◽  
Knee Extensors ◽  
Control Group ◽  
Frail Older People ◽  
Low Intensity ◽  
Knee Extensor Strength

This study’s purpose was to investigate whether a 10-week low-intensity strength-training program could improve strength of the knee extensors and functional ability. Participants 65 years and older with low knee-extensor muscle strength were randomized into an exercise (n = 11) and a control group (n = 10). Knee-extensor strength and functional ability were measured before and after the program and again 6 months later. Knee-extensor strength (Nm) increased by 54% (13% in the control) by the end of the training program (F = 13.02, p = .01), and most of this improvement was still present 6 months later. The program had a beneficial effect on functional tasks, especially the time taken to rise from a chair in combination with a 3-m walk (F = 3.99, p = .03) and self-reported ability related to lower extremity performance (F = 6.97, p = .02). It seems that this program could contribute to improving functional ability in frail older people.

scholarly journals The feasibility and effects of virtual-reality motor-cognitive training in community-dwelling older people with cognitive frailty: A pilot randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Rick Yiu Cho Kwan ◽  
Justina Yat Wa Liu ◽  
Kenneth Nai Kuen Fong ◽  
Harry Qin ◽  
Philip Kwok-Yuen Leung ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Cognitive Training ◽  
Walking Speed ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Physical Frailty ◽  
Cognitive Frailty

BACKGROUND Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment and is associated with many adverse health outcomes. While cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function We propose a virtual reality (VR) simultaneous motor-cognitive training program, which allows older people to practice performing daily activities in a virtual space mimicking real environments. OBJECTIVE We aimed 1) to explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and 2) to compare its effects with an existing motor-cognitive training program in the community on the cognitive function and physical function of older people with cognitive frailty. METHODS A two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for participants were: 1) age≥60 years, 2) community dwelling, and 3) with cognitive frailty. Those in the intervention group received cognitive training (i.e., cognitive games) and motor training (i.e., cycling on an ergometer) simultaneously on a VR platform, mimicking the daily living activities of older people. Those in the control group received cognitive training (i.e., cognitive games) on tablet computers and motor training (i.e., cycling on the ergometer) sequentially on a non-VR platform. Both groups received a 30-minute session twice a week for 8 weeks. Feasibility was measured by adherence, adverse outcomes, and successful learning. The outcomes were cognitive function, physical frailty level, and walking speed. RESULTS Seventeen participants were recruited and randomized into either the control group (n=8) or intervention group (n=9). At baseline, the median age was 74.0 years (IQR=9.5) and the median MoCA score was 20.0 (IQR=4.0). No significant between-group differences were found except in the number of chronic illnesses (P=0.043). At post-intervention, the intervention group (Z=-2.673, P=0.008) showed a significantly larger improvement in cognitive function than the control group (Z=-1.187, P=0.235). The reduction in physical frailty in the intervention group (Z=-1.730, P=0.084) was similar to that in the control group (Z=-1.890, P=0.059). The TUG-measured improvement in walking speed was moderate in the intervention group (Z=-0.159, P=0.110), and greater in the control group (Z=-2.521, P=0.012). The recruitment rate was acceptable (17/33, 51.5%). Both groups had a 100% attendance rate. The intervention group had a higher completion rate than the control group. Training was terminated for one participant (1/9, 11.1%) due to minimal VR sickness (VRSQ=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in both groups. CONCLUSIONS This study provides preliminary evidence that the VR simultaneous motor-cognitive training group experienced greater improvement in cognitive function than the control group, and reduced frailty and improved walking speed. VR training is feasible and safe for older people with cognitive frailty. CLINICALTRIAL ClinicalTrials.gov NCT0446726

scholarly journals Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

2019 ◽  
Author(s):  
Lynne Taylor ◽  
John Parsons ◽  
Denise Taylor ◽  
Elizabeth Binns ◽  
Sue Lord ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Long Term Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Community Dwelling ◽  
Control Group ◽  
Term Care

Abstract Background Falls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively. Methods/Design This is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018. Discussion This study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.

scholarly journals 206 Deprescribing in Frail Older People Transitioning to Long-term Care: a Randomized Controlled Trial Using STOPPFrail Criteria

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Denis Curtin ◽  
Emma Jennings ◽  
Ruth Daunt ◽  
Mary Randles ◽  
Paul Gallagher ◽  
...  
Keyword(s):  
Older People ◽  
Intervention Group ◽  
Nursing Home Care ◽  
Control Group ◽  
Frail Older People ◽  
Term Care ◽  
Emergency Hospital ◽  
Significant Difference ◽  
The Mean

Abstract Background Older people with advanced frailty are among the highest consumers of prescription medications. When life expectancy is limited, the use of multiple medications may be unnecessary or burdensome. STOPPFrail criteria were recently developed to assist clinicians with deprescribing decisions in frail older people approaching end-of-life. The aim of this study was to examine whether long-term medications could be safely discontinued in frail older people using STOPPFrail criteria. Methods We recruited hospitalized adults aged ≥75 years with polypharmacy (≥5 long-term medications) that were transitioning to nursing home care. Participants were eligible if their Clinical Frailty Scale score was ≥7 and if their attending physician indicated that he/she “would not be surprised if the patient died in the next 12 months”. Patients were randomized to single time point pre-discharge STOPPFrail-guided deprescribing or routine pharmaceutical care. The primary outcome was change in the number of regular medications at 3 months. Secondary outcomes included emergency hospital transfers, incident falls, fractures and mortality. Results Results are presented for the first 100 enrolled patients. The mean (±standard deviation [SD]) age of study participants was 85.1 (±5.7) and 61% were female. Intervention (n = 49) and control group (n = 51) participants were prescribed a mean (±SD) of 11.5 (±3.0) and 10.9 (±3.5) regular medications, respectively, at baseline. The mean (±SD) change in the number of regular medications at 3 months was -2.7 (±2.8) in the intervention group and -0.6 (±2.6) in the control group (estimated difference 2.1 ±0.6, 95% confidence interval 0.8 -3.3, p=0.001). Ten intervention participants and 14 control participants died within 3 months of randomization (20.4% vs 27.4%, p=0.49). There was no significant difference between groups for emergency hospital transfers, incident falls or fractures. Conclusion STOPPFrail-guided deprescribing significantly reduced medication burden in frail older people without adversely affecting clinical outcomes in the prospective 3 months.

scholarly journals Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 5 ◽  
Author(s):  
Katarina Wilhelmson ◽  
Isabelle Andersson Hammar ◽  
Anna Ehrenberg ◽  
Johan Niklasson ◽  
Jeanette Eckerblad ◽  
...  
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Study Design ◽  
Comprehensive Geriatric Assessment ◽  
Controlled Study ◽  
Control Group ◽  
Frail Older People ◽  
Positive Effects ◽  
Health And Social Care ◽  
Randomised Controlled

The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care.

scholarly journals Effectiveness of a Targeted Exercise Intervention in Reversing Older People's Mild Balance Dysfunction: A Randomized Controlled Trial

2012 ◽  
Vol 92 (1) ◽  
pp. 24-37 ◽  
Author(s):  
Xiao Jing Yang ◽  
Keith Hill ◽  
Kirsten Moore ◽  
Susan Williams ◽  
Leslie Dowson ◽  
...  
Keyword(s):  
Older People ◽  
Exercise Intervention ◽  
Physical Therapist ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Home Exercise ◽  
Control Group ◽  
Home Exercise Program ◽  
Randomized Controlled

Background Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored. Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balance dysfunction. Design This was a community-based, randomized controlled trial with assessors blinded to group allocation. Participants Study participants were older people who reported concerns about their balance but remained community ambulant (n=225). After a comprehensive balance assessment, those classified as having mild balance dysfunction (n=165) were randomized into the trial. Intervention Participants in the intervention group (n=83) received a 6-month physical therapist–prescribed balance and strength home exercise program, based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit. Participants in the control group (n=82) continued with their usual activities. Outcome Measures Laboratory and clinical measures of balance, mobility, and strength were assessed at baseline and at a 6-month reassessment. Results After 6 months, the intervention group (n=59) significantly improved relative to the control group (n=62) for: the Functional Reach Test (mean difference=2.95 cm, 95% confidence interval [CI]=1.75 to 4.15), the Step Test (2.10 steps/15 seconds, 95% CI=1.17 to 3.02), hip abductor strength (0.02, 95% CI=0.01 to 0.03), and gait step width (2.17 cm, 95% CI=1.23 to 3.11). There were nonsignificant trends for improvement on most other measures. Fourteen participants in the intervention group (23.7%) achieved balance performance within the normative range following the exercise program, compared with 3 participants (4.8%) in the control group. Limitations Loss to follow-up (26.6%) was slightly higher than in some similar studies but was unlikely to have biased the results. Conclusions A physical therapist–prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment.

scholarly journals Effect of an integrated care model for pre-frail and frail older people living in community

2020 ◽  
Vol 49 (6) ◽  
pp. 1048-1055
Author(s):  
Ruby Yu ◽  
Cecilia Tong ◽  
Jean Woo
Keyword(s):  
Health Services ◽  
Older People ◽  
Integrated Care ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Care Model ◽  
Health And Social Care ◽  
Community Dwelling Older People

Abstract Objectives to evaluate the effect of an integrated care model for pre-frail and frail community-dwelling older people. Design a quasi-experimental design. Setting and participants we enrolled people aged ≥60 years from a community care project. An inclusion criterion was pre-frailty/frailty, as measured by a simple frailty questionnaire (FRAIL) with a score of ≥1. Methods we assigned participants to an intervention group (n = 183) in which they received an integrated intervention (in-depth assessment, personalised care plans and coordinated care) or a control group (n = 270) in which they received a group education session on frailty prevention. The outcomes were changes in frailty, individual domains of frailty (‘fatigue’, ‘resistance’, ‘ambulation’, ‘illnesses’ and ‘loss of weight’) and health services utilisation over 12 months. Assessments were conducted at baseline and at the 12-month follow-up. Results the mean age of the participants (n = 453) at baseline was 76.1 ± 7.5 years, and 363 (80.1%) were women. At follow-up, the intervention group showed significantly greater reductions in FRAIL scores than the control group (P < 0.033). In addition, 22.4% of the intervention and 13.7% of the control participants had reverted from pre-frail/frail to robust status, with the difference reaching significance when the intervention was compared with the control group (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.0–2.4) after adjustments for age, sex, living arrangement/marital status and hypercholesterolemia. For individual domains of frailty, the adjusted OR for improved ‘resistance’ was 1.7 (95% CI 1.0–2.8). However, no effects were found on reducing use of health services. Conclusion the integrated health and social care model reduced FRAIL scores in a combined population of pre-frail/frail community-dwelling older people attending older people’s centres.

EFFECTS OF GAIT AND ACTIVITIES OF DAILY LIVING MODIFICATIONS FOR IMPROVING KNEE JOINT FUNCTION IN COMMUNITY-DWELLING MIDDLE-AGED AND OLDER PEOPLE: A RANDOMIZED CONTROL STUDY

2021 ◽  
pp. 2150007
Author(s):  
Susumu Ota ◽  
Remi Fujita ◽  
Hiroshi Ohko ◽  
Aiko Imai
Keyword(s):  
Quality Of Life ◽  
Knee Joint ◽  
Older People ◽  
Daily Living ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Middle Aged ◽  
Related Quality

Knee osteoarthritis is highly prevalent in middle-aged and older people, and biomechanical interventions include modifications of the gait and activities of daily living (ADL). This study investigated the effects of gait and ADL modifications compared with conventional exercise for improving knee function in community-dwelling middle-aged and older people. Fifty middle-aged and older people were randomly allocated to the control ([Formula: see text]) or intervention ([Formula: see text]) groups. The control group performed conventional straight leg raising and knee joint range of motion exercises, and the intervention group modified their gait by decreasing the knee adduction moment and increasing hip muscle activities, and performed range of motion exercises in a bathtub. In both groups, the program was implemented for 12 weeks. The Japan knee OA measure score, walking speed, and hip abduction strength significantly improved in both the control and intervention groups. The health-related quality of life (Short Form 8: SF-8) was significantly improved in the intervention group compared with the control group. Gait and ADL modifications achieved effects similar to those of conventional knee joint exercise, and might be more effective for improving physical function-related quality of life.

scholarly journals The Effect of Exercise and Learning Therapy on Cognitive Functions and Physical Activity of Older People with Dementia in Indonesia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Neti Juniarti ◽  
Ihda Al’Adawiyah MZ ◽  
Citra Windani Mambang Sari ◽  
Hartiah Haroen
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Cognitive Functions ◽  
Intervention Group ◽  
Exercise Program ◽  
Control Group ◽  
Control Groups ◽  
People With Dementia ◽  
The Mean ◽  
And Control

Background. This study aims to analyze the effect of exercise and learning therapy on the cognitive functions and daily physical activities of older people with dementia in Indonesia. Methods. This was an experimental study with a pretest-posttest design and a control group. Samples were selected using nonrandom sampling methods and were then randomly assigned to intervention and control groups. The study population was older people with mild-to-moderate dementia, and the sample number was 90 people. The intervention group received an Indonesian physical exercise program for older people and reading therapy through 12 sessions over four weeks. The intervention was led by a community health volunteer who has been trained and certified. Results. The mean score for cognitive function in the intervention group showed significant increase between pre- and postintervention, with p  value < 0. 001 , and there was no significant difference in the control group before and after intervention, with a p  value of 0. 198 . Further, the Mann–Whitney test showed that there were significant differences in the mean scores for cognitive function between the intervention and control groups with p  value < 0. 001 and a 95% confidence level. Conclusion. Based on the results, the Indonesian older people exercise program and reading aloud activity had a positive effect on the cognitive function of older people with dementia.

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