Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial

Abstract

A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0–3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1–2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01–7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons.

Effects of physical activity interventions in frail and prefrail community-dwelling people on frailty status, muscle strength, physical performance and muscle mass—a narrative review

“…A detailed overview is given in Table 2 . Of the studies five provided both PA and nutritional support interventions [ 26 , 28 , 30 – 32 ], with a study by Kwon et al. [ 26 ] having distinguished groups (one receiving only PA and one both PA and nutritional support).…”

“…With a total of 11 studies describing on some aspects of physical performance, this outcome was the most reported one. Most studies reported significant changes between groups and over time [ 22 , 23 , 25 , 27 , 30 – 32 , 34 ]. Interestingly, from the three studies reporting no change in physical activity performance, two were performed with female participants only, barring an unknown bias or gender specific factors.…”

“…A total of four studies included changes in muscle mass as outcome [ 23 , 28 , 30 , 34 ]. All these studies focused on strength training and nutritional support or supplementation, with one study including a special intervention group for muscle power [ 34 ].…”

Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial

“…In addition, further publications of this intervention demonstrated that home visits with physical training and nutritional support can significantly increase handgrip strength and physical performance, but not muscle mass [60]. There was no significant change in these parameters in participants receiving home visits with social support alone.…”

“…We demonstrated that home visits with physical training and nutritional support provided by lay volunteers can increase handgrip strength significantly, with no significant difference to home visits with social support alone [35]. Fat mass and appendicular muscle mass were neither affected by home visits with physical training and nutritional intervention nor by home visits with social support alone.…”