Effects of the Mobility-Fit Physical Activity Program on Strength and Mobility in Older Adults in Assisted Living: A Feasibility Study

Abstract

Physical activity programs focusing on fall prevention often overlook upper-limb strength, which is important for transferring, balance recovery, and arresting a fall. We developed and evaluated a physical activity program, Mobility-Fit for older adults in Assisted Living (AL) that includes upper-limb strengthening, agility, coordination, and balance exercises. Thirty participants (85 ± 6 years) were recruited from two AL facilities; 15 were assigned to Mobility-Fit (three times/week, 45 min/session for 12 weeks) and 15 maintained usual care. Twenty-two participants (11 in each group) completed the study. We compared outcome changes between groups and interviewed participants and staff to explore the effectiveness and feasibility of the program. Among participants who attended Mobility-Fit, knee extension strength increased by 6%, reaction time decreased by 16%, and five-time sit-to-stand duration decreased by 15%. Conversely, participants in the usual care group had a 6% decrease in handgrip strength. Changes of these outcomes were significantly different between two groups (p < 0.05). Participants enjoyed the program and staff suggested some changes to improve attendance. Our results indicate that Mobility-Fit is feasible to deliver and beneficial for older adults in AL and may guide future clinical trials to evaluate the effectiveness of upper limb strengthening on safe mobility of older adults in care facilities.

Effects of a multicomponent physical activity programme, Mobility-Fit, compared with a standard care lower limb strengthening programme, to promote safe mobility among older adults in care facilities: protocol for a cluster randomised controlled trial

“…The 40 min main workout includes agility, postural coordination, balance and strength training (triceps, wrist, core and lower limb strength) (figure 2). Participants with mobility issues (eg, using a wheelchair or walker) can practice while holding/leaning on a chair or wheelchair 16. The selection of exercises and activities is based on the participants’ mobility ability, strength, stamina and cognitive function.…”

“…The sensors will be taken off in the evening and securely stored at the facility. This testing protocol has been previously employed in our pilot study16 and showed 100% adherence and reliability in measuring PA. For outcomes related to movement quantity (PA level), we will use average activity counts per day,3 30 upright time29 and sitting time during the day. Sedentary time will also be calculated.…”

“…The Mobility-Fit programme was designed for older adults residing in care facilities 16 to enhance their ADL performance. The session commences with a 5 min warm-up that includes joint range of motion exercises in all planes of movement.…”

“…Mobility-Fit specifically targets the strength and functional mobility aspects crucial for performing ADLs effectively. Importantly, the programme has shown promise in a pilot study conducted in care facilities, demonstrating its feasibility and ability to improve upper and lower limb strength, reaction time, and sit-to-stand performance, as well as in older adults with physical and cognitive impairment 16…”

“…This research protocol addresses important issues by introducing the ‘Mobility-Fit’ programme, a multicomponent PA programme designed to promote safe mobility for older adults in care facilities. 16 Adapted from the Osteofit programme, Mobility-Fit extends its focus beyond balance, quadriceps strength and coordination to incorporate upper limb and core strength training, aiming to enhance safe transferring and the ability to recover balance and prevent falls. 7 15 17 Mobility-Fit specifically targets the strength and functional mobility aspects crucial for performing ADLs effectively.…”