MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults

Abstract

Exercise and nutrition interventions are often recommended for frailty; however, effective strategies are required for real-world implementation. Our primary aim was to assess the feasibility and acceptability of telephone and virtual delivery of MoveStrong, an 8-week exercise and nutrition program with a 4-week follow-up for older pre-frail and frail adults. A priori criteria for success included: recruitment (≥25/12 weeks), retention at follow-up (≥80%), and adherence to exercise and nutrition sessions (≥70%). We recruited community-dwelling Ontario residents; ≥60 years, ≥1 chronic condition, ≥1 FRAIL scale score. Participants received mailed materials, a personalized exercise program, 11 remote one-on-one training sessions with an exercise physiologist and 3 online dietitian-led nutrition education sessions. We completed exploratory analyses of secondary outcomes including physical function and dietary protein intake. Semi-structured interviews supported program evaluation. In total, 30 participants were enrolled. 28 (93%) participants completed program and follow-up assessments. Adherence to exercise and nutrition sessions (CI) was 84% (77%–91%) and 82% (70%–93%) respectively. At program end and follow-up [mean change (CI)], significant improvements were measured in 30-second chair stand test [3.50 (1.12–5.86), 4.54 (1.94–7.13) chair stands] and dietary protein intake [12.9 (5.7–20.0), 9.2 (0.4–18.1) g]. Overall, participants were satisfied with program delivery. Trial registration number: NCT04663685.

Facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia: A qualitative meta-synthesis

“…Four of the included studies were nutrition care-based interventions, and the interventions in six studies included mixed dietary nutrition and exercise guidance. The detailed characteristics of all included studies [ [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] ] are shown in Table 1 .…”

“… Rattray et al., 2022 [ 42 ] Australia and New Zealand Qualitative study Dietitians from clinical, community, and residential aged-care ( n = 18) Nutrition care Semi-structured interviews Exploring the barriers and enablers to providing coordinated nutrition care to malnourished or frail clients in the community. Wang et al., 2022 [ 43 ] Canada Feasibility study Older pre-frail and frail adults ( n = 28) Nutrition and exercise Semi-structured interviews Reasons for joining, perceived benefits facilitators of and barriers to behaviour maintenance, and suggestions for future studies. Van Dongen et al., 2020 [ 44 ] Netherlands Process evaluation study Community-dwelling older adults (65 years or older, n = 16); Health care professionals ( n = 37) Support intervention including diet counselling and exercise Semi-structured interviews Acceptability and applicability of ProMuscle in Practice interventions in the community.…”

“…[ 40 ] Wang et al. [ 43 ] Van Dongen et al. [ 45 ] Socio-economic None Costs: potentially high product costs for protein-rich dairy products, cost of nutritional preparations.…”

“…[ 42 ] Wang et al. [ 43 ] Intervention-related factors level Intervention protocols Tailored interventions—respect for participants’ opinions and dietary preferences. Prior to the intervention, the participants’ profile needs to be taken into account.…”

“…[ 41 ] Wang et al. [ 43 ] Van Dongen et al. [ 44 ] Implementers of interventions Advantages of a multidisciplinary team.…”