Mind-body training – a single-arm feasibility study of community-delivered Baduanjin training for frail older adults

Abstract

Background Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. Our study examined the feasibility and effects of a community-delivered BDJ training program among pre-frail/frail community-dwelling older people in preparation for a randomised control implementation study.Methods Our study was a single arm feasibility study in community setting. Eleven participants (aged 77 ± 6 years; 2 frail, 9 prefrail at baseline) completed the program. Sixteen week group BDJ training co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation resulting in 12 older adults enrolled in the program. One participant was hospitalized (unrelated to BDJ training) and the other 11 completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance > 80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n = 2) or maintained (n = 9) their frailty statuses. There were significant within-group post-training improvements in hand grip strength (p = 0.013), knee extension strength (p = 0.048), TUG (p = 0.018), MQ (p = 0.001), FES (p = 0.022), MoCA (p = 0.014), GDS (p = 0.028), EQ-5D-5L index score (p = 0.029). The reduction of frailty score and PPA fall risk score showed moderate-to-large effect size.Conclusions Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.