Impact of a Multicomponent Exercise Program on Physical Function and Quality of Life in Pre-frail and Frail Older Women

Arm 1 – Intervention Group: This intervention consists of a two-phase multicomponent exercise program Phase 1: Centre-based Multicomponent Exercise Program Duration & Frequency: 12 weeks 3 sessions per week Each session is 60 minutes Session Components: Warm-Up (10 minutes): Brisk walking for 5 minutes, static and dynamic stretching of the neck, shoulders, arms, hips, knees, and ankles Strength/Resistance Training (20 minutes): conducted in circuits, with each exercise performed for 3 sets of 7–10 repetitions. The intensity progressed according to the Borg CR10 scale, starting at 3–4 and progressing to 5–7 over the program. Balance Training (10 minutes) such as sideways walking along a straight line, and heel-to-toe standing for 10 seconds. The progression of exercise is based on participant's ability (e.g., holding onto support vs. no support). Aerobic Training (10 minutes): Performed at intensity levels 3–4 on CR10 scale and progressed every 2 weeks. Cool-Down (10 minutes): Deep breathing and static stretching for neck, shoulders, back, hips, thighs, calves, and ankles Intervention Setting: Intervention will be delivered in-person by certified exercise specialists in a group sessions of 5–8 participants in a community center Adherence Monitoring: Participants’ adherence to the intervention will be monitored using session attendance checklists completed by the exercise supervisor at each session. Phase 2: Home-based Multicomponent Exercise Program (VIVIFRAIL©) After completion of the 12-week centre-based program; participants will be assessed using Short Physical Performance Battery (SPPB) and according to the results will be assigned to the proper VIVIFRAIL© programs as following: Passport B corresponds to Category B: For frail individuals (SPPB 4–6) Passport B+ corresponds to Category B: Frail with fall risk Passport C corresponds to Category C: Pre-frail individuals (SPPB 7–9) Passport C+ corresponds to Category C: Pre-frail with fall risk A comprehensive description of the Vivifrail program is available at [http://vivifrail.com/resources/] Duration of VIVIFRAIL© home program : 12 weeks Participants are expected to perform their home exercise 3 to 5 times per week Printed exercise booklets tailored to their classification will be given to each participant with daily exercise diary to record adherence 1. Functional Category: Pre-frail / Low Risk (Category A) • Examples of Exercises: o Sit-to-stand repetitions o Biceps curls with light weights o Calf raises o Tandem stance o Heel-to-toe walk o Walking 5–10 minutes o Marching in place • Intensity: Low to moderate, tailored to participant’s capacity (using Borg CR-10) • Frequency & Duration: 3–5 sessions per week, ~45 minutes per session • Adherence Monitoring: exercise log; weekly phone check-in by study staff 2. Functional Category: Frail (Category B) • Examples of Exercises: o Sit-to-stand (fewer repetitions) o Knee extensions with ankle weights o Seated arm raises o Single-leg stance o Side stepping o Walking along a line o Short bouts of walking (3–5 minutes) o Step-ups • Intensity: Low to moderate, adjusted individually based on participant’s ability (using Borg CR-10) • Frequency & Duration: 3–5 sessions per week, 45–60 minutes per session • Adherence Monitoring: exercise log; weekly phone check-in by study staff 3. Functional Category: Very Frail / High Risk (Category C) • Examples of Exercises: o Seated knee extensions o Seated biceps curls o Heel raises while holding a chair o Sit-to-stand with support o Mini squats holding a chair o Weight shifts while seated o Short walking with assistance o Marching in place (seated or standing with support) • Intensity: Low, according to participant’s ability (using Borg CR-10) • Frequency & Duration: 3 sessions per week, 30–45 minutes per session • Adherence Monitoring: exercise log; weekly phone check-in by study staff