Isabel B Rodrigues1, Justin B Wagler1, Heather Keller1,2, Lehana Thabane3, Zachary J Weston4,5, Sharon E Straus6,7, Alexandra Papaioannou3,8, Marina Mourtzakis1, Jamie Milligan8, Wanrudee Isaranuwatchai6,9, Desmond Loong6,9, Ravi Jain10, Larry Funnell10, Angela M Cheung11, Sheila Brien10, Maureen C Ashe12,13, Lora M Giangregorio1,2. 1. Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada. 2. Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada. 3. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 4. Waterloo Wellington Local Health Integration Network, Waterloo, Ontario, Canada. 5. Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada. 6. CLEAR Health Economics, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada. 7. Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada. 8. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. 9. Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. 10. Canadian Osteoporosis Patient Network, Osteoporosis Canada, Toronto, Ontario, Canada. 11. Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada. 12. Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada. 13. Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: This 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility. METHODS: We recruited individuals aged 60 years and over, with a FRAIL scale score of 1 or higher and at least one chronic condition, who were not currently strength training. The program included 16 exercise physiologist-led hour-long group sessions and two dietitian-led hour-long nutrition sessions. We analyzed secondary outcomes-weight, gait speed, grip strength, physical capacity (fatigue levels), sit-to-stand functioning, dynamic balance, health-related quality of life (HRQoL), physical activity levels and protein intake-using a paired t test and a generalized estimating equation (GEE). RESULTS: Of 44 participants (mean [SD] age 79 [9.82] years), 35 were pre-frail and 9 were frail. At follow-up, participants had significantly improved grip strength (1.63 kg, 95% CI: 0.62 to 2.63); sit-to-stand functioning (2 sit-to-stands, 95% CI: 1 to 3); and dynamic balance (1.68 s, 95% CI: 0.47 to 2.89). There were no significant improvements in gait speed, HRQoL index scores, self-rated health, physical activity levels (aerobic activity and strength training) or protein intake. GEE analysis revealed an interaction between exposure to MoveStrong and gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores. The total cost to administer the program and purchase equipment was CAD 14 700, equivalent to CAD 377 per participant. CONCLUSION: Exploratory analyses suggest MoveStrong exercises may improve gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores in older individuals who are frail and pre-frail.
BACKGROUND: This 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility. METHODS: We recruited individuals aged 60 years and over, with a FRAIL scale score of 1 or higher and at least one chronic condition, who were not currently strength training. The program included 16 exercise physiologist-led hour-long group sessions and two dietitian-led hour-long nutrition sessions. We analyzed secondary outcomes-weight, gait speed, grip strength, physical capacity (fatigue levels), sit-to-stand functioning, dynamic balance, health-related quality of life (HRQoL), physical activity levels and protein intake-using a paired t test and a generalized estimating equation (GEE). RESULTS: Of 44 participants (mean [SD] age 79 [9.82] years), 35 were pre-frail and 9 were frail. At follow-up, participants had significantly improved grip strength (1.63 kg, 95% CI: 0.62 to 2.63); sit-to-stand functioning (2 sit-to-stands, 95% CI: 1 to 3); and dynamic balance (1.68 s, 95% CI: 0.47 to 2.89). There were no significant improvements in gait speed, HRQoL index scores, self-rated health, physical activity levels (aerobic activity and strength training) or protein intake. GEE analysis revealed an interaction between exposure to MoveStrong and gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores. The total cost to administer the program and purchase equipment was CAD 14 700, equivalent to CAD 377 per participant. CONCLUSION: Exploratory analyses suggest MoveStrong exercises may improve gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores in older individuals who are frail and pre-frail.
Authors: Matteo Ponzano; Isabel B Rodrigues; Zeinab Hosseini; Maureen C Ashe; Debra A Butt; Philip D Chilibeck; Jackie Stapleton; Lehana Thabane; John D Wark; Lora M Giangregorio Journal: Phys Ther Date: 2021-02-04
Authors: Benedetta Bartali; Edward A Frongillo; Stefania Bandinelli; Fulvio Lauretani; Richard D Semba; Linda P Fried; Luigi Ferrucci Journal: J Gerontol A Biol Sci Med Sci Date: 2006-06 Impact factor: 6.053
Authors: S Hassan; S J Seung; R E Clark; J C Gibbs; C McArthur; N Mittmann; L Thabane; D Kendler; A Papaioannou; J D Wark; M C Ashe; J D Adachi; J A Templeton; L M Giangregorio Journal: Osteoporos Int Date: 2020-03-26 Impact factor: 4.507
Authors: Sandra M Eldridge; Claire L Chan; Michael J Campbell; Christine M Bond; Sally Hopewell; Lehana Thabane; Gillian A Lancaster Journal: BMJ Date: 2016-10-24
Authors: Robert W Morton; Kevin T Murphy; Sean R McKellar; Brad J Schoenfeld; Menno Henselmans; Eric Helms; Alan A Aragon; Michaela C Devries; Laura Banfield; James W Krieger; Stuart M Phillips Journal: Br J Sports Med Date: 2017-07-11 Impact factor: 13.800