Effectiveness of a group functional power training program for frail older adults implemented through neighbourhood senior centres – a randomised controlled study

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Several trials have demonstrated the efficacy of resistance training to reduce frailty and improve function of older adults. To narrow the research-practice gap, we designed and evaluated the implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighbourhoods. Methods Two-arm, multicentre assessor-blind stratified randomised controlled trial at four local senior activity centres. Older adults (<jats:italic>n</jats:italic> = 61) with low handgrip strength (HGS) were randomised to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipments) delivered by a community provider. The 12-week program comprised 2 × 60 mins sessions/wk. CG continued usual activities at the centres. Functional performance (SPPB and TUG), HGS, knee extensor strength (KES), and frailty status were assessed at baseline and 3-month. Program implementation was evaluated using RE-AIM framework. Results The program was halted due to Coronavirus Disease 2019 related suspension of senior centre activities. Results are reported from four centres (n = 61), which completed the program. IG showed significant improvement of moderate effect sizes in frailty status (0.36 points, 95CI [0.09, 0.64], p = 0.011) and SPPB (0.51 points, 95CI [0.13, 0.89], p = 0.010). IG improvement in TUG (0.57 s, 95CI [-0.07, 1.20], p = 0.080) did not achieve significance and there were no effects for HGS and KES. Only SPPB showed greater improvement in IG than CG (p = 0.047). The community program exhibited good reach, effectiveness, adoption, and implementation. Conclusions FPT is superior to regular activities at local senior centres in improving physical function and can be successfully implemented for frail older adults in their neighbourhoods. Trial registration: ClinicalTrials.gov, NCT04438876. Registered 19 June 2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04438876?term=NCT04438876</jats:p>