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Wang WX, Kong LN, Zeng L, Chen L, Qiu J, Zhao Y. Exercise interventions for frail older adults with diabetes: A scoping review. Geriatr Nurs 2024; 58:200-207. [PMID: 38824882 DOI: 10.1016/j.gerinurse.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024]
Abstract
There is a paucity of evidence on exercise interventions for frail older adults with diabetes. This scoping review aims to identify the scope of the current literature on the characteristics and effects of exercise interventions for frail older adults with diabetes. A search without time limitation was conducted in eight databases. 14 studies were finally included. Resistance exercise and multicomponent exercise were the most common types of exercise. There was considerable variation in the frequency, duration and intensity of exercise interventions. Studies reported improvements in frailty status, physical function, blood glucose and lipid levels and economic effectiveness. The most frequent combined interventions involved nutrition and education. Although evidence was limited, the potential benefits of exercise interventions for frail older adults with diabetes were substantial. Further high-quality studies are needed to explore the most effective and cost-saving exercise interventions for frail older adults with diabetes.
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Affiliation(s)
- Wen-Xin Wang
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China.
| | - Lin Zeng
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lu Chen
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ju Qiu
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Endocrinology and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Zhao
- School of Nursing, Chongqing Medical University, Chongqing, China
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Yao A, Gao L, Zhang J, Cheng JM, Kim DH. Frailty as an Effect Modifier in Randomized Controlled Trials: A Systematic Review. J Gen Intern Med 2024; 39:1452-1473. [PMID: 38592606 PMCID: PMC11169165 DOI: 10.1007/s11606-024-08732-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The effect of clinical interventions may vary by patients' frailty status. Understanding treatment effect heterogeneity by frailty could lead to frailty-guided treatment strategies and reduce overtreatment and undertreatment. This systematic review aimed to examine the effect modification by frailty in randomized controlled trials (RCTs) that evaluate pharmacological, non-pharmacological, and multicomponent interventions. METHODS We searched PubMed, Web of Science, EMBASE, and ClinicalTrial.gov, from their inception to 8 December 2023. Two reviewers independently extracted trial data and examined the study quality with senior authors. RESULTS Sixty-one RCTs that evaluated the interaction between frailty and treatment effects in older adults were included. Frailty was evaluated using different tools such as the deficit accumulation frailty index, frailty phenotype, and other methods. The effect of several pharmacological interventions (e.g., edoxaban, sacubitril/valsartan, prasugrel, and chemotherapy) varied according to the degree of frailty, whereas other treatments (e.g., antihypertensives, vaccinations, osteoporosis medications, and androgen medications) demonstrated consistent benefits across different frailty levels. Some non-pharmacological interventions had greater benefits in patients with higher (e.g., chair yoga, functional walking, physical rehabilitation, and higher dose exercise program) or lower (e.g., intensive lifestyle intervention, psychosocial intervention) levels of frailty, while others (e.g., resistance-type exercise training, moderate-intensive physical activity, walking and nutrition or walking) produced similar intervention effects. Specific combined interventions (e.g., hospital-based disease management programs) demonstrated inconsistent effects across different frailty levels. DISCUSSION The efficacy of clinical interventions often varied by frailty levels, suggesting that frailty is an important factor to consider in recommending clinical interventions in older adults. REGISTRATION PROSPERO registration number CRD42021283051.
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Affiliation(s)
- Aaron Yao
- VillageMD Research Institute, Chicago, IL, USA.
- Virginia Commonwealth University, Richmond, VA, USA.
| | | | - Jiajun Zhang
- Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Joyce M Cheng
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dae Hyun Kim
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Yoon KI, Jeong TS, Kim SC, Lim SC. Anonymizing at-home fitness: enhancing privacy and motivation with virtual reality and try-on. Front Public Health 2023; 11:1333776. [PMID: 38192556 PMCID: PMC10773911 DOI: 10.3389/fpubh.2023.1333776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction This study aimed to address privacy concerns associated with video conferencing tools used in home-based exercise training. To that end, a method that could anonymize participants' appearances and exercise environments during at-home fitness sessions was proposed. Methods This method combines virtual reality for 3-D human-model rendering using key-points tracking with a virtual try-on system enhanced by UV mapping and instance segmentation. To validate the proposed method, we conducted a user study by recruiting participants to assess effectiveness of virtual reality and virtual try-on in terms of privacy protection, self-confidence, and coaching satisfaction. Results Experimental results demonstrated the effectiveness and improved user experience of using virtual reality or virtual try-on in remote fitness, particularly in enhancing privacy protection and self-confidence with statistical significance. However, no significant differences were noted in coaching satisfaction. Discussion These findings confirmed the efficacy of our proposed approach. We believe that the proposed approach can significantly contribute to the future of remote fitness training, offering a more secure and engaging environment for users, thereby potentially increasing adherence to fitness regimens and overall physical wellbeing.
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Affiliation(s)
- Kang-Il Yoon
- Department of Mechanical, Robotics, and Energy Engineering, Dongguk University, Seoul, Republic of Korea
| | - Tae-Soo Jeong
- Department of Mechanical, Robotics, and Energy Engineering, Dongguk University, Seoul, Republic of Korea
| | - Seung-Chan Kim
- Machine Learning Systems Lab, College of Sports Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - Soo-Chul Lim
- Department of Mechanical, Robotics, and Energy Engineering, Dongguk University, Seoul, Republic of Korea
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Dent E, Hanlon P, Sim M, Jylhävä J, Liu Z, Vetrano DL, Stolz E, Pérez-Zepeda MU, Crabtree DR, Nicholson C, Job J, Ambagtsheer RC, Ward PR, Shi SM, Huynh Q, Hoogendijk EO. Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology. Ageing Res Rev 2023; 91:102082. [PMID: 37797723 DOI: 10.1016/j.arr.2023.102082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Frailty is an age-related clinical condition characterised by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population ageing, the prevalence of frailty is expected to soar in coming decades. This narrative review provides critical insights into recent developments and emerging practices in frailty research regarding identification, management, risk factors, and prevention. We searched journals in the top two quartiles of geriatrics and gerontology (from Clarivate Journal Citation Reports) for articles published between 01 January 2018 and 20 December 2022. Several recent developments were identified, including new biomarkers and biomarker panels for frailty screening and diagnosis, using artificial intelligence to identify frailty, and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included exercise (including technology-based exercise), multidimensional interventions, person-centred and integrated care, assistive technologies, analysis of frailty transitions, risk-factors, clinical guidelines, COVID-19, and potential future treatments. This review identified a strong need for the implementation and evaluation of cost-effective, community-based interventions to manage and prevent frailty. Our findings highlight the need to better identify and support older adults with frailty and involve those with frailty in shared decision-making regarding their care.
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Affiliation(s)
- Elsa Dent
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Juulia Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, University of Tampere, Tampere, Finland
| | - Zuyun Liu
- Second Affiliated Hospital and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Dirección de Investigación, ciudad de México, Mexico; Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de México
| | | | - Caroline Nicholson
- Centre for Health System Reform & Integration, Mater Research Institute-University of Queensland, Brisbane, Australia
| | - Jenny Job
- Centre for Health System Reform & Integration, Mater Research Institute-University of Queensland, Brisbane, Australia
| | - Rachel C Ambagtsheer
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Paul R Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Sandra M Shi
- Hinda and Arthur Marcus Institute for Aging, Hebrew Senior Life, Boston, Massachusetts, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Quan Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science and Department of General Practice, Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands; Amsterdam Public Health research institute, Ageing & Later Life Research Program, Amsterdam UMC, Amsterdam, the Netherlands.
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Suikkanen S, Soukkio P, Kautiainen H, Kääriä S, Hupli MT, Sipilä S, Pitkälä K, Aartolahti E, Kukkonen-Harjula K. Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial. J Am Med Dir Assoc 2022; 23:1717.e9-1717.e15. [PMID: 35985418 DOI: 10.1016/j.jamda.2022.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To investigate the effects of 12 months of physiotherapist-supervised, home-based physical exercise on the severity of frailty and on the prevalence of the 5 frailty phenotype criteria, using secondary analyses. DESIGN Randomized clinical trial, with 1:1 allocation into 12-month home-based physical exercise, or usual care. The multicomponent exercise sessions (60 minutes) were supervised by the physiotherapist and included strength, balance, functional, and flexibility exercises twice a week at participants' homes. SETTING AND PARTICIPANTS Home-dwelling older adults aged ≥65 years who were frail (meeting 3-5 criteria) or prefrail (1-2 criteria) according to frailty phenotype criteria. METHODS The severity of frailty (nonfrail, prefrail, or frail) was assessed using frailty phenotype criteria, and the prevalence of each frailty criterion (weight loss, low physical activity, exhaustion, weakness, and slowness) were assessed at baseline and at 12 months. RESULTS Two hundred ninety-nine persons were included in the analyses, of whom 184 were prefrail and 115 were frail at baseline. Their mean age was 82.5 (SD 6.3) years, and 75% were women. There was a significant difference between the exercise and usual care groups' transitions to different frailty states from baseline to 12 months among those who at baseline were prefrail (P = .032) and frail (P = .009). At 12 months, the mean number of frailty criteria had decreased in the exercise group (-0.27, 95% CI -0.47, -0.08) and remained unchanged in the usual care group (0.01, 95% CI -0.16, 0.18; P = .042). The prevalence of the exhaustion (P = .009) and the low physical activity (P < .001) criteria were lower at 12 months in the exercise group than in the usual care group. CONCLUSIONS AND IMPLICATIONS The severity of frailty can be reduced through 12-month supervised home-based exercise training. Exercise should be included in the care of older adults with signs of frailty.
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Affiliation(s)
- Sara Suikkanen
- Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
| | - Paula Soukkio
- Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | | | - Markku T Hupli
- Rehabilitation, South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Sarianna Sipilä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland; Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisu Pitkälä
- Department of General Practice, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Eeva Aartolahti
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
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Gao S, Yu L, Yi G, Li T, Chen Z, Ding J. Exercise Intervention as a Therapy in Patients with Diabetes Mellitus and Sarcopenia: A Meta-Analysis. Diabetes Ther 2022; 13:1311-1325. [PMID: 35648376 PMCID: PMC9240178 DOI: 10.1007/s13300-022-01275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Sarcopenia is defined as a progressive and generalized muscle disorder that involves accelerated loss of muscle mass and impaired function. It is believed to influence the ability to carry out daily activities, muscle strength, and physical capacity in the elderly. Studies have shown that sarcopenia has been implicated as both a cause and a consequence of diabetes mellitus. In this analysis, we aimed to systematically show the impact of exercise intervention as a therapy for patients with diabetes mellitus and sarcopenia. METHODS Electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane database, were searched from November to December 2021 for publications based on exercise intervention in patients with sarcopenia. After the selection of studies for this analysis, patients with diabetes mellitus were retrieved. Since dichotomous data including mean and standard deviation were reported, weighted mean difference (MD) with 95% confidence intervals (CI) were used to represent the data following analysis. RESULTS A total of 431 participants with diabetes mellitus and sarcopenia were included in this meta-analysis. A statistical analysis was carried out on patients with diabetes mellitus who were assigned to the exercise intervention group. Our analysis showed that "sit-to-stand test" and "timed up and go" were significantly in favor of exercise intervention: MD -1.57, 95% confidence interval (CI) -2.26 to -0.87 (P = 0.0001) versus MD -0.61, 95% CI -1.21 to -0.01 (P = 0.05), respectively. Handgrip strength, walking speed and leg strength were also assessed. Another statistical analysis was carried out, this time on patients with diabetes mellitus and sarcopenia who were not assigned to an exercise intervention. The results showed no significant difference among sit-to-stand test, timed up and go, handgrip strength, and leg strength. CONCLUSION Exercise intervention significantly improved the time taken to stand up from a sitting position, and to "stand up and go" in patients with diabetes mellitus and sarcopenia. Therefore, exercise intervention should be considered a relevant therapy for such patients.
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Affiliation(s)
- Siyao Gao
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Ling Yu
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Guozhong Yi
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Tong Li
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Zhenyin Chen
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Jiawang Ding
- Department of Internal Medicine, Beijing Chaoyang Hospital, Chaoyang, Beijing, 100020 People’s Republic of China
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Qiao X, Ji L, Jin Y, Si H, Bian Y, Wang W, Liu Q, Yu J, Wang C. A theory-driven exercise intervention among community-dwelling (pre)frail older adults: Protocol for a stepped-wedge cluster-randomized trial. J Adv Nurs 2022; 78:2634-2645. [PMID: 35621366 DOI: 10.1111/jan.15303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
AIM This study is aimed to evaluate the effectiveness of a theory-driven exercise intervention for Chinese community-dwelling (pre)frail older adults, and to clarify the underlying mechanisms of the exercise intervention in this population. DESIGN A stepped-wedge cluster-randomized trial. METHODS A stepped-wedge cluster-randomized trial will be conducted among (pre)frail older adults at six communities in a county of central China. A 12-week multicomponent exercise intervention based on the integration of the Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) will be implemented to all participants during the study period. The primary outcomes are frailty, muscle mass, muscle strength and physical performance. Secondary outcomes include beliefs in exercise, exercise behaviours and other physical, mental and social functioning. Assessments will be conducted at baseline and at week 12, 24 and 36. A multilevel regression model will be used to evaluate the effectiveness of exercise interventions. A multilevel mediation model will be used to clarify the underlying mechanisms of this exercise intervention. DISCUSSION This study is expected to provide an effective and practical mode for exercise interventions among Chinese community-dwelling (pre)frail older adults, and contribute to the existing evidence in this field. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100041981.
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Affiliation(s)
- Xiaoxia Qiao
- School of Nursing, Peking University, Beijing, China
| | - Lili Ji
- School of Nursing, Peking University, Beijing, China
| | - Yaru Jin
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Bian
- School of Nursing, Peking University, Beijing, China
| | - Wenyu Wang
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Health economic evaluation of exercise interventions in people over 60 years old: A systematic review. Exp Gerontol 2022; 161:111713. [DOI: 10.1016/j.exger.2022.111713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/21/2022]
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Defining Pooled' Place-Based' Budgets for Health and Social Care: A Scoping Review. Int J Integr Care 2022; 22:16. [PMID: 36186513 PMCID: PMC9479665 DOI: 10.5334/ijic.6507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/23/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Current descriptions of pooled budgets in the literature pose challenges to good quality evaluation of their contribution to integrated care. Addressing this gap is increasingly important given the shift from early models of integrated care targeting segments of the population, to more recent approaches that aim to target 'places', broader geographically defined populations. This review draws on the current international evidence to describe practical examples of pooled health and social care budgets, highlighting specific place-based approaches. Methods We initially conducted a scoping review, a systematic database search ('Medline', 'Embase', 'Econ Lit' and 'Google Scholar') complemented by further snowballing for academic and 'grey literature' publications (1995 - 2020). Results were analysed thematically according to budget characteristics and macro-environment, with additional specific case studies. Results Thirty-six primary studies were included, describing ten broad models of pooled budgets across seven countries. Most budgets targeted specific sub-populations rather than an entire geographically defined population. Specific budget structures varied and were generally under-described. The closest place-based models were for small populations and implemented in a national health system, or insurance-based with natural geographical boundaries. Conclusion Despite their increasing relevance in the current political debate, pooled place-based budgets are still at an early stage of implementation and research. Adequate description is required for future meta-analysis of effectiveness on outcomes.
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Suikkanen S, Soukkio P, Aartolahti E, Kääriä S, Kautiainen H, Hupli MT, Pitkälä K, Sipilä S, Kukkonen-Harjula K. Effect of 12-month supervised, home-based physical exercise on functioning among persons with signs of frailty - Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:2283-2290. [PMID: 34283997 DOI: 10.1016/j.apmr.2021.06.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty. DESIGN A randomized controlled trial with a 1:1 allocation SETTING: Home-based PARTICIPANTS: Home-dwelling persons aged ≥65 years meeting at least one frailty phenotype criteria (n=300). INTERVENTION 12-month, individually tailored, progressive and physiotherapist-supervised, physical exercise twice a week (n=150) vs. usual care (n=149). MAIN OUTCOME MEASURES Functional Independence Measure (FIM), Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and physical activity (other than intervention). Assessed four times at home over 12 months. RESULTS The mean age of the participants was 82.2 (SD 6.3), 75% were women, 61% met 1-2 frailty criteria and 39% ≥3 criteria. FIM deteriorated in both groups over 12 months, -4.1 points (95% CI: -5.6 to -2.5) in the exercise group and -6.9 (-8.4 to -2.3) in the usual care group (group p=0.014, time p<0.001, interaction p=0.56). The mean improvement in SPPB was significantly greater in the exercise group [1.6 (1.3 to 2.0)] than in the usual care group [0.01 (-0.3 to 0.3)] (group p<0.001, time p=0.11, interaction p=0.027). The exercise group reported significantly fewer falls per person-year compared to the usual care group (incidence rate ratio, IRR 0.47 [95% CI 0.40 to 0.55]; p<0.001). There was no significant difference between the groups over 12 months in terms of handgrip strength, IADL function or self-reported physical activity. CONCLUSIONS One year of physical exercise improved physical performance and decreased the number of falls among people with signs of frailty. FIM differed between the groups at 12 months, but exercise did not prevent deterioration of FIM, IADL or handgrip strength.
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Affiliation(s)
- Sara Suikkanen
- South Karelia Social and Health Care District, Rehabilitation, Valto Käkelän katu 3, FI-53130 Lappeenranta, FINLAND; University of Jyväskylä, Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, FINLAND.
| | - Paula Soukkio
- South Karelia Social and Health Care District, Rehabilitation, Valto Käkelän katu 3, FI-53130 Lappeenranta, FINLAND; University of Jyväskylä, Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, FINLAND.
| | - Eeva Aartolahti
- University of Jyväskylä, Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, FINLAND.
| | - Sanna Kääriä
- Raatimiehet Oy, Raatimiehenkatu 18, FI-53100, Lappeenranta, FINLAND.
| | - Hannu Kautiainen
- University of Helsinki, Department of General Practice, and Helsinki University Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, FI-00290 Helsinki, FINLAND.
| | - Markku T Hupli
- South Karelia Social and Health Care District, Rehabilitation, Valto Käkelän katu 3, FI-53130 Lappeenranta, FINLAND.
| | - Kaisu Pitkälä
- University of Helsinki, Department of General Practice, and Helsinki University Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, FI-00290 Helsinki, FINLAND.
| | - Sarianna Sipilä
- University of Jyväskylä, Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, FINLAND; University of Jyväskylä, Gerontology Research Center, Faculty of Sport and Health Sciences, Rautpohjankatu 8, FI-40700 Jyväskylä, FINLAND.
| | - Katriina Kukkonen-Harjula
- South Karelia Social and Health Care District, Rehabilitation, Valto Käkelän katu 3, FI-53130 Lappeenranta, FINLAND.
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Cameron I. Exercise with Older People who have Activity Limitations. J Am Med Dir Assoc 2021; 22:731-732. [PMID: 33832712 DOI: 10.1016/j.jamda.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ian Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, Australia.
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