Encouraging older adults with pre-frailty and frailty to “MoveStrong”: an analysis of secondary outcomes for a pilot randomized controlled trial

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.

A review of frailty instruments in human medicine and proposal of a frailty instrument for dogs

“…The first step in the ability to make frailty-specific protocol adjustments to improve frail patients’ outcomes is the ability to identify those patients. The identification of frail dogs would also allow for direct intervention in the frailty state as is seen in human medicine ( 2 , 13 , 14 , 51 , 52 , 54 ). For instance, programs to target strength, balance, or maintenance of muscle mass could be implemented in veterinary medicine to directly improve the lives of geriatric companion dogs.…”

“…This finding suggests that specific interventions such as increasing life-space, may preferentially benefit frail individuals compared to their potential benefit on the greater geriatric population overall. An exploratory analysis of the MoveStrong exercises suggested improvement in frailty indicators (gait speed, balance, sit-to-stand functioning) and health-related quality of life in both frail and pre-frail individuals who used these exercises ( 54 ).…”