Development of an Exercise Program for the Frail Elderly

2001 ◽  
Vol 9 (4) ◽  
pp. 452-465 ◽  
Author(s):  
Marijke J.M. Chin A Paw ◽  
Nynke de Jong ◽  
Martin Stevens ◽  
Petrus Bult ◽  
Evert G. Schouten
Keyword(s):  
Older Adults ◽  
Frail Elderly ◽  
Motor Behavior ◽  
Exercise Program ◽  
Community Dwelling ◽  
Daily Activities ◽  
Preliminary Evaluation ◽  
Elderly Adults ◽  
Frail Older Adults ◽  
And Performance

The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength, speed, endurance, flexibility, and coordination were trained by walking, kneeling, and chair stands, performed in the context of motor behavior such as games and daily activities. The acceptability of the exercise program was evaluated in a population of community-dwelling, frail older adults (mean age 77.6 ± 5.4 years). Eighty-one percent completed the program. Program appreciation and attendance were high. Seventy-three percent reported wanting to continue participating if possible—although most only once a week. At follow-up (1–1.5 years afterward) 30% were still participating in an exercise program. The exercise program was enjoyed and accepted by a population of frail, previously sedentary elderly adults. Widespread implementation of this program could increase physical activity among frail older adults.

Effects of a Group Exercise Program on Risk Factors for Falls in Frail Older Adults

1994 ◽  
Vol 2 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Ellen F. Binder ◽  
Marybeth Brown ◽  
Suzanne Craft ◽  
Kenneth B. Schechtman ◽  
Stanley J. Birge
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Exercise Program ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Moderate Intensity ◽  
Group Exercise ◽  
Frail Older Adults ◽  
The Mean ◽  
Risk Factors For Falls

Fifteen community dwelling older adults, ages 66 to 97 years, with at least one risk factor for recurrent falls, attended a thrice weekly group exercise class for 8 weeks. In post- versus preexercise comparisons, knee extensor torque at 0°/sec increased by 16.5% (p= 0.055); time to perform the stand-up test once, and five times consecutively, improved by 29.4 and 27.4%, respectively (p= 0.05,p= 0.01); gait speed for 24 feet increased by 16.5% (p< 0.001); and performance of the progressive Romberg test of balance improved with a mean increase of 1.1 ± 0.9 positions (p= 0.001). Participants reported a significant increase in the mean number of times per week that they went out of their apartment/home independent of exercising, and a significant increase in the mean number of city blocks they could walk. Performance data for nine exercise participants at 1-yr postintervention are presented. A low- to moderate-intensity groups exercise program can effect improvements in lower extremity strength, gait speed, balance, and self-reported mobility function in frail older adults.

The Effect of Functional Circuit Training on Physical Frailty in Frail Older Adults: A Randomized Controlled Trial

2010 ◽  
Vol 18 (4) ◽  
pp. 401-424 ◽  
Author(s):  
Maria Giné-Garriga ◽  
Míriam Guerra ◽  
Esther Pagès ◽  
Todd M. Manini ◽  
Rosario Jiménez ◽  
...  
Keyword(s):  
Older Adults ◽  
Controlled Trial ◽  
Exercise Program ◽  
Community Dwelling ◽  
Control Group ◽  
Physical Frailty ◽  
Circuit Training ◽  
Frail Older Adults ◽  
Randomized Controlled ◽  
Frailty Criteria

The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (±SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p< .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.

scholarly journals Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

2021 ◽  
Author(s):  
Nien Xiang Tou ◽  
Shiou-Liang Wee ◽  
Wei Ting Seah ◽  
Daniella Hui Min Ng ◽  
Benedict Wei Jun Pang ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Controlled Study ◽  
Power Training ◽  
Frail Older Adults ◽  
Frailty Status ◽  
Randomized Controlled ◽  
Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

Physical Exercise Interventions For Improving Performance-Based Measures of Physical Function in Community-Dwelling Frail Older Adults

2014 ◽  
Vol 46 ◽  
pp. 134
Author(s):  
Maria Giné-Garriga ◽  
Marta Roqué-Fíguls ◽  
Laura Coll-Planas ◽  
Mercè Sitjà-Rabert ◽  
Carme Martin-Borràs
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Physical Function ◽  
Community Dwelling ◽  
Exercise Interventions ◽  
Frail Older Adults

scholarly journals Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

2021 ◽  
Author(s):  
Jacqueline Giovanna De Roza ◽  
David Wei Liang Ng ◽  
Blessy Koottappal Mathew ◽  
Teena Jose ◽  
Ling Jia Goh ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Clinical Factors ◽  
Cross Sectional ◽  
Frail Older Adults ◽  
History Of ◽  
The Mean ◽  
Community Dwelling Older Adults

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

PREDICTING THE EFFICACY OF PROTEIN-ENERGY SUPPLEMENTATION IN FRAIL OLDER ADULTS LIVING IN COMMUNITY

2014 ◽  
pp. 1-6
Author(s):  
C.O. KIM
Keyword(s):  
Older Adults ◽  
Nutritional Assessment ◽  
Linear Regression Analysis ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Home Healthcare ◽  
Post Intervention ◽  
Frail Older Adults ◽  
Protein Energy ◽  
Energy Supplementation

Background:Protein-energy malnutrition is a major cause of functional decline in the elderly and isclearly an important component of frailty. However, limited evidence is available about how to select frailindividuals most benefiting from protein-energy supplementation. Objectives:1) To investigate factors associatedwith stronger benefits from protein-energy supplementation, and 2) to test the hypothesis that the severity offrailty is associated with the efficacy of protein-energy supplementation. Design:Secondary analysis of data froma pre-post-intervention study and a clinical trial. Setting:National Home Healthcare Services in Gangbuk-gu,Seoul, South Korea. Participants:123 community-dwelling frail older adults [usual gait speed (UGS) <0.6m/secand Mini Nutritional Assessment (MNA) <24]. Intervention:Each participant was received with two 200 mL perday of commercial liquid formula (providing additional 400 kcal of energy and 25 g of protein per day) for 12weeks. Measurements:Relative change in the Physical Functioning (PF) and Short Physical Performance Battery(SPPB) score between the baseline and 12-week follow-up assessments were measured. Results:Multilevelmixed-effect linear regression analysis showed that a lower level of baseline UGS was associated with a greaterimprovement in PF and SPPB score after adjustment for age, gender, education, living status, beneficiary ofpublic assistance, number of chronic diseases, compliance, and type of dataset (p<0.001). A lower level ofbaseline MNA score was associated with greater change in PF and SPPB score after adjustment for multiplecovariates (p<0.045). Participants with severe frailty (UGS <0.3 m/sec + MNA <17) showed 52.4% and 44.6%more relevant improvements in PF and SPPB score, respectively, than those with mild frailty (UGS 0.3-0.6 m/sec+ MNA 17-24) (p<0.001). Conclusion:Slower UGS and lower MNA score are independently associated with thegreater efficacy of protein-energy supplementation on functional status.

Tai Chi–Based Exercise for Older Adults with Parkinson’s Disease: A Pilot-Program Evaluation

2007 ◽  
Vol 15 (2) ◽  
pp. 139-151 ◽  
Author(s):  
Fuzhong Li ◽  
Peter Harmer ◽  
K. John Fisher ◽  
Junheng Xu ◽  
Kathleen Fitzgerald ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Performance ◽  
Tai Chi ◽  
Exercise Adherence ◽  
Primary Objective ◽  
Community Dwelling ◽  
Preliminary Evaluation ◽  
Exit Interviews

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson’s disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p< .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.

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