Frail Elderly Syndrome
Conditions
Keywords
frailty, exercise, resistance training, strength, older adults
Brief summary
After the age of 40-45 years muscle mass and function progressively decline, reducing older peoples' abilities to perform tasks of daily living and also increase the risk of falls. It is known that, across the life course, resistance exercise can be of benefit in increasing muscle mass and function, yet how hard the exercise should be performed has received little attention. Current recommendations are for older people to perform exercise at 70% of the maximum they can lift, quite a high intensity that often puts older people off participating. Recent evidence in younger people has suggested that such intensities are not required. The investigators aim to determine the feasibility of a study to investigate recruitment and adherence of older people to a study of exercise training at different intensities.
Detailed description
The cohort will comprise two sets of participants: frail older adults and non-frail older adults. Each participant will receive 8 weeks of twice weekly supervised resistance training. Both the frail and non-frail participants will be randomised into either receiving high load resistance training or low load resistance training. High load resistance training will be delivered at 70% of the participants maximal capacity and low load resistance training will be delivered at 30% of maximal capacity. All resistance training will focus on the lower limb and regardless of intensity each exercise will be done to failure (unable to complete another full repetition).
Interventions
OTHERresistance training
Moving muscles against loads with the purpose of increasing strength.
Sponsors
NHS Greater Glasgow and Clyde
University of Glasgow
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
RCT
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Non-frail - Over 65 years of age Frail - Over 65 years of age, Three or more of the following criteria: \>10lbs of weight loss unintentionally in previous year; grip strength in lowest 20% (by sex and BMI); self-reported exhaustion; walking time for 15 feet in slowest 20% (by sex and height); physical activity in the lowest 20%.
Exclusion criteria
Non-frail - Current participation in an exercise programme. Clinical team do not think resistance exercise would be safe or unable to consent. Any other reason that precludes participation in exercise, decision made by research team in consultation with a consultant in Geriatric Medicine where required. Frail - Current participation in an exercise programme. Clinical team do not think resistance exercise would be safe or unable to consent. Any other reason that precludes participation in exercise, decision made by research team in consultation with a consultant in Geriatric Medicine where required.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of training sessions attended | 8 weeks | Expressed as a percentage of number of sessions attended |
| Compliance with protocol | 8 weeks | Expressed as a percentage of number of sessions where training protocol was adhered to |
| Number of treatment-related adverse events as assessed by CTCAE v4.0 | 8 weeks | Number of adverse events that could be attributed to the intervention |
| Acceptability of intervention (qualitative) | 8 weeks | focus groups with semi-structured discussion plans will investigate the acceptability of the intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life | 8 weeks | Measured using the Euroqol EQ-5 Dimension- 5 Level self report measure. This scale measures quality of life in 5 dimensions and produces an index of quality of life rangin from a worst quality of life at -1 to best quality of life at 1. |
| Activities of daily living | 8 weeks | Measured using the Barthel index. This scale measures ten variables of activities of daily living and produces an overall score. This ranges from 0-20 with a higher score indicating greater independence. |
| Muscle power | 8 weeks | Maximum voluntary contraction of a muscle at a set angle to produce a torque (kg) |
| motion analysis | 8 weeks | biomechanical assessment using infr-red motion analysis cameras |
| Functional abilities | 8 weeks | Short performance battery test. This battery of tests assesses balance, gait speed and lower limb strength. Scores are awarded for each individual section and aggregated ranging from 0-12 with a higher score indicating greater physical capability. |
| Muscle strength | 8 weeks | Maximal load participant can lift (kg) |
| Muscle thickness | 8 weeks | Thickness of vastus lateralus using ultrasound (mm) |
| Frailty | 8 weeks | As measured by the Fried criteria. These are low energy expenditure, slow gait speed, weak grip strength, exhaustion, and unintentional weight loss. Fulfilling three of these criteria indicates clinical frailty. |
Countries
United Kingdom
Contacts
Primary ContactEvan Campbell, PhD
Outcome results
None listed