Community-Dwelling Older Adults, Frailty, Functional Decline
Conditions
Keywords
Exercise, Gezaixi (Taiwanese Opera), Resistance Exercise, Strength Training, Community-Dwelling Older Adults
Brief summary
This interventional study evaluates a 12-week, once-weekly group exercise program combining 60 minutes of progressive strength training and 60 minutes of Taiwanese opera-based activities for community-dwelling adults aged ≥65 in Taipei. The primary aim is to delay frailty and functional decline by improving physical fitness and independence. Primary outcomes are muscle strength, calf circumference, and SOF frailty score; secondary outcomes are BSRS-5, GGDS-5, and SARC-F. The study uses a non-randomized, parallel two-arm design (exercise vs. usual activity), open-label, with assessments at baseline and week 12.
Detailed description
Participants attend weekly 120-minute sessions for 12 consecutive weeks at community centers. Strength training targets major muscle groups using body weight, elastic bands, or light dumbbells at moderate intensity (Borg RPE 11-13) with progressive overload. The Taiwanese opera-based segment integrates singing, reciting, acting, and martial arts elements to promote balance, coordination, posture, and endurance. Sessions include warm-up and cool-down. Certified C-level instructors lead classes; adherence and adverse events are monitored each session. Statistical analysis will compare pre-post changes within groups (paired t-tests) and between-group differences in change scores (independent t-tests or ANCOVA adjusting for baseline values). Missing data will be handled primarily using complete case analysis, with sensitivity analyses using linear mixed-effects models under a MAR assumption or multiple imputation as appropriate.
Interventions
BEHAVIORALStrength Training plus Taiwanese Opera-based Activities
Group-based exercise delivered at community centers for community-dwelling adults aged ≥65 years. Frequency: once per week. Session length: 120 minutes per session (60 minutes progressive strength training + 60 minutes Taiwanese opera-based activities integrating singing, reciting, acting, and martial arts). Total duration: 12 consecutive weeks. * Content and progression: Strength training targets major muscle groups (e.g., sit-to-stand, rowing/pulling with elastic bands, hip abduction, calf raises) using body weight, elastic bands, or light dumbbells; intensity targeted at moderate level (Borg RPE 11-13) and progressed by resistance/repetitions as tolerated. The opera-based segment includes rhythmic movement, balance drills, upper-/lower-limb coordination, posture and breathing, and simple choreographed sequences adapted from Taiwanese opera elements. Each session includes \~10 minutes warm-up and \~10 minutes cool-down with flexibility and breathing exercises. Approximate group size:
Sponsors
National Taipei University of Nursing and Health Sciences
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* Age ≥65 years. * Community-dwelling older adults residing in Taipei. * Able to ambulate independently (with or without assistive device). * Able to communicate and provide informed consent.
Exclusion criteria
* Unstable cardiopulmonary disease or uncontrolled hypertension. * Severe cognitive impairment affecting participation. * Recent major surgery or fracture within the past 3 months. * Any contraindication to moderate-intensity exercise as assessed by the study team.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Strength | From enrollment to the end of intervention at 12 week | Change in muscle strength from baseline to week 12, measured using standardized tests (e.g., handgrip strength with a dynamometer in kilograms, or 30-second chair stand repetitions). Higher values indicate better strength. |
| Calf Circumference | rom enrollment to the end of treatment at 12 weeks | Change in calf circumference (centimeters) measured at the widest point of the non-dominant calf using a non-stretchable tape. Larger circumference generally indicates better muscle mass. |
| Study of Osteoporotic Fractures (SOF) frailty score | From enrollment to the end of treatment at 12 week | Change in Study of Osteoporotic Fractures (SOF) frailty score (range 0-3; higher scores indicate greater frailty) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Brief Symptom Rating Scale 5-item (BSRS-5) | From enrollment to the end of treatment at 12 weeks | Change in the total score on the 5-item Brief Symptom Rating Scale (BSRS-5); higher scores indicate greater psychological distress. Scores range from 0 to 20. |
| Geriatric Depression Scale score 5-item(GGDS-5) | From enrollment to the end of treatment at 12 weeks | Change in the 5-item Geriatric Depression Scale (GDS-5) score; higher scores indicate more depressive symptoms. Scores range from 0 to 5. |
| SARC-F | From enrollment to the end of treatment at 12 weeks | Description: Change in SARC-F questionnaire score for sarcopenia risk (range 0-10; higher scores indicate higher risk). |
Countries
Taiwan
Outcome results
None listed