Effectiveness of a multicomponent exercise program in the attenuation of frailty in long-term nursing home residents: study protocol for a randomized clinical controlled trial

Background: Myostatin has been proposed as a candidate biomarker for frailty and sarcopenia. However, the relationship of myostatin with these conditions remains inconclusive. Objective: To determine the association of serum myostatin concentration with body composition, physical fitness, physical activity level, and frailty in long-term nursing home residents. We also aimed to ascertain the effect of an exercise program on myostatin levels. Methods: We obtained study data on 112 participants from long-term nursing homes. Participants were randomly assigned to a control or an intervention group and performed a 6-month multicomponent exercise program. Serum myostatin levels were analyzed by ELISA. Assessments also included body composition (anthropometry and bioelectrical impedance), physical fitness (Senior Fitness Test), physical activity level (accelerometry), and frailty (Fried frailty criteria, Clinical Frailty Scale, and Tilburg frailty indicator). Results: The concentration of myostatin at baseline was positively correlated with: a leaner body composition (p < 0.05), and a higher number of steps per day and light and moderate-vigorous physical activity in women (p < 0.005); greater upper and lower limb strength, endurance, and poorer flexibility (p < 0.05) in men; and better performance (less time) in the 8-ft timed up-and-go test in both women (p < 0.01) and men (p < 0.005). We observed higher concentrations of serum myostatin in non-frail than in frail participants (p < 0.05). Additionally, we found that the implemented physical exercise intervention, which was effective to improve physical fitness, increased myostatin concentration in men (p < 0.05) but not in women. The improvements in physical condition were related with increases in serum myostatin only in men (p < 0.05–0.01). Conclusions: Higher serum levels of myostatin were found to be associated with better physical fitness. The improvements in physical fitness after the intervention were positively related to increases in myostatin concentrations in men. These results seem to rule out the idea that high serum myostatin levels are indicative of frailty in long-term nursing home residents. However, although the direction of association was opposite to that expected for the function of myostatin, the use of this protein as a biomarker for physical fitness, rather than frailty, merits further study.

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Effect of a High-Intensity Exercise Program on Physical Function and Mental Health in Nursing Home Residents with Dementia: An Assessor Blinded Randomized Controlled Trial

PLoS ONE ◽

10.1371/journal.pone.0126102 ◽

2015 ◽

Vol 10 (5) ◽

pp. e0126102 ◽

Cited By ~ 65

Author(s):

Elisabeth Wiken Telenius ◽

Knut Engedal ◽

Astrid Bergland

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Nursing Home ◽

Physical Function ◽

High Intensity ◽

Controlled Trial ◽

Nursing Home Residents ◽

Exercise Program ◽

High Intensity Exercise ◽

Randomized Controlled

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Acupressure for agitation in nursing home residents with dementia: study protocol for a randomized controlled trial

Trials ◽

10.1186/1745-6215-15-410 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 3

Author(s):

Rick Yiu Cho Kwan ◽

Mason Chin Pang Leung ◽

Claudia Kam Yuk Lai

Keyword(s):

Randomized Controlled Trial ◽

Nursing Home ◽

Study Protocol ◽

Controlled Trial ◽

Nursing Home Residents ◽

Randomized Controlled

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A multicomponent exercise intervention to improve physical functioning, cognition and psychosocial well-being in elderly nursing home residents: a study protocol of a randomized controlled trial in the PROCARE (prevention and occupational health in long-term care) project

BMC Geriatrics ◽

10.1186/s12877-019-1386-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Thomas Cordes ◽

Laura L. Bischoff ◽

Daniel Schoene ◽

Nadja Schott ◽

Claudia Voelcker-Rehage ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Physical Functioning ◽

Exercise Intervention ◽

Controlled Trial ◽

Nursing Home Residents ◽

Well Being ◽

Term Care

Abstract Background Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. Methods A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45–60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents’ capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). Discussion This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. Trial registration The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018.

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