Effectiveness of exercise interventions on physical function in community-dwelling frail older people

Jadczak, Agathe Daria; Makwana, Naresh; Luscombe-Marsh, Natalie D.; Visvanathan, Renuka; Schultz, Tim

doi:10.11124/jbisrir-2016-003081

Cited by 28 publications

(30 citation statements)

References 36 publications

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“…Of the KCL items, 13 items (Q3, 6,7,8,9,10,11,18,20,21,22,23,25) were signi cantly different among the groups (p < 0.05), as well as social activities of Qvii (p = 0.02).…”

Section: Resultsmentioning

confidence: 98%

Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

Kume

Takahashi

Itakura

et al. 2020

Preprint

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Background: A gradually increasing prevalence of frailty is recognized in the super-aging society that Japan faces, and early detection and intervention of frailty in community-dwellers are critical issues to prevent frailty. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of this study was to clarify the association and predictors of frail status in northen Japan community-dwellers aged 65 or more.Methods: The investigation was conducted from 2018 to 2020. After obtaining informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. Participants were recruited from Akita community-dwellers in northern Japan. We applied the frailty index of Gerontology - the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status, collecting data of demographics and psycho-social status using the Kihon checklist and cognitive domains including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT).Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail and 12 frail. For statistical analysis, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were the main predictors of frail status.Conclusions: Reducing medications and finding fun in your life are important to prevent frailty.

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“…Of the KCL items, 13 items (Q3, 6,7,8,9,10,11,18,20,21,22,23,25) were signi cantly different among the groups (p < 0.05), as well as social activities of Qvii (p = 0.02).…”

Section: Resultsmentioning

confidence: 98%

Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

Kume

Takahashi

Itakura

et al. 2020

Preprint

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“…Also, the intervention proposed may not be suitable for all patients, and it is worth considering stratifying patients to different interventions according to their mobility difficulties. Accordingly, a recent umbrella review [90] investigating the effect of exercise interventions in pre-frail community-dwelling older adults found inconclusive results regarding the effect on mobility of both multi-component exercises and resistance exercises and suggested that only personalized exercises are effective in improving mobility.…”

Section: Discussionmentioning

confidence: 99%

“…Jadczak et al recommend interventions with a duration of at least 2.5 months[90]. Accordingly, a systematic review by Valenzuela et al[36] concludes that progressive resistance training in older nursing home residents is efficient in improving strength and functional performance despite advanced age, chronic diseases, sedentary habits, and functional disabilities.…”

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confidence: 99%

A randomized controlled trial of the effect of supervised progressive cross-continuum strength training and protein supplementation in older medical patients: the STAND-Cph trial

Pedersen

Petersen

Beyer

et al. 2019

Preprint

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Background: During hospitalization, older adults (+65) are inactive, which puts them at risk of functional decline and loss of independence. Systematic strength training can prevent loss of functional performance and combining strength training with protein supplementation may enhance the response on muscle mass and strength . However, we lack knowledge about the effect of strength training commenced during hospitalization and continued after discharge in older medical patients. This assessor-blinded, randomized study investigated the effect of a simple, supervised strength training program for the lower extremities, combined with post-training protein supplementation during hospitalization and in the home setting for 4 weeks after discharge on change in mobility in older medical patients. Methods: Older medical patients (≥65 yrs) admitted acutely from their home to the Emergency Department were randomized to either standard care or supervised progressive strength training and an oral protein supplement during hospitalization and at home 3 days/week for 4 weeks after discharge. The primary outcome was between-group difference in change in mobility from baseline to 4 weeks after discharge assessed by the De Morton Mobility Index, which assesses bed mobility, chair mobility, static and dynamic balance, and walking. Secondary outcomes were 24-hour mobility, lower extremity strength, gait speed, grip strength and Activities of Daily Living. Results: Eighty-five patients were randomized to an intervention group (N=43) or a control group (N=42). In the intervention group, 43% were highly compliant with the intervention. Our intention to treat analysis revealed no between-group difference in mobility (mean difference in change from baseline to 4 weeks: -4.17 (95 % CI: -11.09;2.74; p=0.24) nor in any of the secondary outcomes. The per protocol analysis showed that the intervention group increased significantly more in the daily number of steps taken compared to the control group (mean difference in change from baseline to 4 weeks: 1033.4 steps (95 % CI: 4.1;2062.7), p=0.049, adjusted for mobility at baseline and length of stay; 1032.8 steps (95% CI: 3.6;2061.9), p=0.049, adjusted for mobility at baseline, length of stay and steps at baseline). Conclusions: Simple supervised strength training for the lower extremities, combined with protein supplementation initiated during hospitalization and continued at home for 4 weeks after discharge was not superior to usual care on change in mobility at 4 weeks in older medical patients. For the secondary outcome, daily number of steps, high compliance with the intervention resulted in a higher daily number of steps. Less than half of the patients were compliant with the intervention indicating that a simpler intervention might be needed. Trial registration: NCT01964482, https://clinicaltrials.gov/ct2/show/NCT01964482 , registration date: October 14, 2013, trial protocol: PubMed ID (PMID): 27039381.

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“…Most components of physical activity (i.e., strength, balance, coordination, flexibility and endurance exercises) and their combination with each other and prehabilitation interventions were found to be effective (33,34). Systematic reviews and meta-analyses evaluating multicomponent physical activities showed positive effects on frailty (33)(34)(35)(36), physical functioning and daily activities of living (37)(38)(39)(40) and reduction on falls by improving walking, balance, and strength (39,41). Positive effects of physical activity on cognition, emotion and social network were found (42,43).…”

Section: Evidence-based Interventions Against Frailtymentioning

confidence: 99%

Frailty in family practice/primary health care: Care and management

Yaman¹

2021

VOJNOSANIT PREGL

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Frailty as a geriatric syndrome has been rediscovered in recent years and has been added to the mainstream literature of medicine. Even this condition is more managed by geriatric teams in well-equipped rehabilitation hospitals; the primary care team could contribute very well to frailty as an important stakeholder. Recent pro-active experimental models at the community level are promising, and in the future, the involvement of primary health care teams will be inevitable. The development of valid, reliable, and easy applicable diagnostic tools; recommendation on evidence-based treatment; innovative casemanagement and care models; and new work/professional definitions will improve health outcomes of ageing people and their caregivers in the community. This will be primarily an essential issue for industrialising and developing countries, who are aging at high locity.

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Effectiveness of exercise interventions on physical function in community-dwelling frail older people

Cited by 28 publications

References 36 publications

Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

A randomized controlled trial of the effect of supervised progressive cross-continuum strength training and protein supplementation in older medical patients: the STAND-Cph trial

Frailty in family practice/primary health care: Care and management

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