None listed
Conditions
Brief summary
With population ageing, a progressive increase in the absolute number of individuals with frailty will inevitably occur unless we can change the likelihood of these events occurring, otherwise, the high prevalence of frailty conditions will place a significant burden on the health and social care systems. The objective of this study is to evaluate the effectiveness of a frailty intervention program in improving frailty status among community-dwelling Chinese older people. We hypothesized that there will be improvements in frailty status in the intervention group. A randomized controlled trial will be conducted. 120 people aged 50 years and older who are pre-frail or frail will be recruited from community. Subjects will be randomly assigned to the intervention group or the wait-list control group. The intervention group will receive 24 2-hour group sessions of exercise and game training in 12 weeks. If this frailty intervention of this proposed study is shown to be effective, there are major potential benefits to the pre-frail and frail older population generally in terms of decreased disability and cognitive decline. Significant cost savings could be flow to government and broader society if hospitalization or institutionalization can be avoided or postponed. The interventions being examined are low-cost, readily transferable to routine clinical practice and can potentially be applied routinely in aged care services and other settings.
Interventions
Subjects assigned to the intervention group will be invited to participate in a frailty intervention 2 sessions/week over a 12 week period. The duration of each session will be 2 hours. Each session consists of exercise training (1 hour/session) provided by a personal trainer and game training (1 hour/session) provided by a trained research assistant, which will be conducted in groups (6-10 subjects/group). Each exercise session will begin and end with a 5-10 minute warm-up and cool-down routine
Subjects assigned to the intervention group will be invited to participate in a frailty intervention 2 sessions/week over a 12 week period. The duration of each session will be 2 hours. Each session consists of exercise training (1 hour/session) provided by a personal trainer and game training (1 hour/session) provided by a trained research assistant, which will be conducted in groups (6-10 subjects/group). Each exercise session will begin and end with a 5-10 minute warm-up and cool-down routine that consists of stretching of the main muscle groups being trained. The first part of the exercise program consists of 20-30 minute aerobic exercises, which include movements of the main muscle groups. These exercises include swinging legs, walking on the spot, stepping, circling shoulders, touching toes, clapping hands, stamping feet etc. The intensity of the aerobic training stimulus will be set at approximately 40% of one’s age specific target heart rate (i.e., heart rate reserve; HRR) and be progressed to the range of 70-80% of HRR. Exercise intensity will be monitored through heart rate monitors. Subjects will be asked to aim for 13-15 on the Rating of Perceived Exertion (RPE) during the aerobic sessions. The aerobic component will last for 20-30 minutes. A 5-minute rest period will be given prior to the start of the second part of the exercise program that consists of 20-30 minute resistance exercises using Thera-Bands, dumbbells, or other resistance training equipment. for muscle groups in both the upper (chest, back, biceps, triceps) and lower body (knee extension/flexion, heel raises, side leg lifts). Initial strength assessment will be conducted by trained research personnel on the first day of exercise intervention to estimate each individual’s one-repetition maximum (1RM, the maximal load that could be lifted fully one time only) using a submaximal 8-12RM test for each set of exercise. For the actual training, subjects will be instructed to perform each movement against 60-80% of the estimated 1RM load. Higher resistance will be added progressively based on their subjective ratings of muscle effort during the exercise. Number of repetitions (up to 12) and sets (1 to 4 sets) will also increase progressively throughout the entire intervention period. Overall, the exercises are easy to learn and are designed to include variations and gradual progression to higher intensity. For the game training, a selection of video games, board games, and card games will be used according to subject's choice. Subjects will also be invited to share their attitudes and expectations toward doing exercise and game training in focus groups. Six focus groups will be held. Each focus group will have around 6 subjects, resulting in a total of 36 subjects
Sponsors
Jean Woo
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
People aged 50 years or older will be identified in community facilities (e.g., neighbourhood elderly centre, social centre for the elderly). They will be invited for a brief screening using the FRAIL scale. Those meeting the criteria for potentially pre-frail / frail according to the FRAIL score (score >= 1) will be invited for further assessment. To be eligible for the study, the subjects should further fulfill the following inclusion and exclusion criteria: Inclusion criteria - People aged 50 years or older; - FRAIL score >= 1, and thus are considered pre-frail / frail; - Chinese origin; - Normally reside in Hong Kong; - Could speak and understand Chinese; - Willing to follow the study procedures.
Exclusion criteria
Exclusion criteria - Live in a residential aged care facility; - Recent (i.e. past 3 months) or concurrent participation in any clinical trial or exercise and/or cognitive and/or dietary intervention program; - With medical advice or conditions prohibiting exercise or medical conditions that precluded safe participation in an exercise program; - With any other indication of a major medical or psychological illness, as judged by the investigators as ineligible to participate the study.
Outcome results
None listed