Balance Impairment, Fall Risk, Frailty at Older Adults, Functional Decline, Sarcopenia in Elderly
Conditions
Keywords
multicomponent exercise, frailty, older adults, nursing homes, balance training, functional performance, fall prevention, physical therapy, institutionalizad elderly
Brief summary
Frailty is common among older adults living in nursing homes and increases the risk of falls, disability, and loss of independence. However, there is limited evidence on practical and feasible exercise programs adapted to this population. This study evaluated the effects of a multicomponent exercise program combining strength and balance training in residents aged 65 years and older. Participants were assigned to either an intervention group, which performed supervised exercise sessions twice a week for 8 weeks, or a control group, which continued their usual activities. The main outcome was frailty, measured using the Short Physical Performance Battery. Other outcomes included balance, functional independence, sarcopenia, fear of falling, and number of falls. This study was retrospectively registered.
Detailed description
Frailty is a multidimensional clinical condition highly prevalent among older adults living in institutional settings and is associated with increased risk of falls, disability, hospitalization, and mortality. Despite growing evidence supporting physical exercise interventions, there is still a need for structured, feasible, and clinically applicable programs specifically designed for nursing home residents. This study aimed to evaluate the effects of a multicomponent exercise program on frailty and related outcomes in institutionalized older adults. A multicenter, controlled, non-randomized design was used, including participants recruited from eight nursing homes. Participants aged 65 years and older were allocated by residential center to either an intervention group or a control group. The intervention group participated in the Balance and Strength Exercises (BASE) program, consisting of supervised sessions performed twice weekly for 8 weeks. Each session included a combination of strength and balance exercises with progressive levels adapted to individual capacity. The control group continued their usual care and routine activities. The primary outcome was frailty, assessed using the Short Physical Performance Battery (SPPB). Secondary outcomes included balance, measured with the Performance-Oriented Mobility Assessment (POMA); sarcopenia, measured with the Strength, Assistance with Walking, Rise from a Chair, Climb Stairs, and Falls Questionnaire (SARC-F); functional independence, measured with the Barthel Index; fear of falling, measured with the Short Falls Efficacy Scale-International (Short FES-I); and the number of falls occurring during the study period. Assessments were conducted at baseline, immediately after the intervention (8 weeks), and at follow-up (20 weeks). The study evaluated both the immediate effects of the intervention and the persistence of outcomes after cessation. This study was retrospectively registered following completion of data collection.
Interventions
BEHAVIORALMulticomponent Exercise Program (BASE)
A supervised multicomponent exercise program including strength and balance training, performed twice weekly for 8 weeks. Each session lasted 30-40 minutes and included warm-up, strength exercises, and progressively adapted balance tasks based on individual capacity.
OTHERUsual Care
Participants continued their usual care and routine physical activities provided by the nursing homes without additional structured intervention.
Sponsors
Escoles Universitaries Gimbernat
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
No blinding was used due to the nature of the intervention.
Intervention model description
Participants were allocated by residential center to either an intervention group or a control group in a non-randomized parallel design. The intervention group received a multicomponent exercise program, while the control group continued usual care.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged 65 years or older * Living in a nursing home * Ability to walk at least 10 meters (with or without assistive devices) * Mini-Mental State Examination (MMSE) score ≥19
Exclusion criteria
* Neurodegenerative diseases * Advanced dementia * Parkinson's disease * Hemodynamic instability * Lower limb fractures under rehabilitation within the past year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frailty assessed by the Short Physical Performance Battery (SPPB) | Baseline to 8 weeks | Frailty was measured using the Short Physical Performance Battery (SPPB), which includes assessments of balance, gait speed, and chair rise performance. Total scores range from 0 to 12, with higher scores indicating better physical performance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Balance assessed by the Performance-Oriented Mobility Assessment (POMA) | Baseline, 8 weeks, and 20 weeks | Balance was measured using the Performance-Oriented Mobility Assessment (POMA), which evaluates static and dynamic balance as well as gait performance. Total scores range from 0 to 28, with higher scores indicating better balance and mobility. |
| Sarcopenia assessed by SARC-F | Baseline, 8 weeks, and 20 weeks | Sarcopenia was measured using the Strength, Assistance with Walking, Rise from a Chair, Climb Stairs, and Falls Questionnaire (SARC-F), a self-reported screening tool for sarcopenia risk. Total scores range from 0 to 10, with higher scores indicating a greater risk of sarcopenia. |
| Functional independence assessed by the Barthel Index | Baseline, 8 weeks, and 20 weeks | Functional independence was measured using the Barthel Index, which assesses the ability to perform activities of daily living, including feeding, bathing, dressing, toileting, mobility, and stair climbing. Total scores range from 0 to 100, with higher scores indicating greater functional independence. |
| Fear of falling assessed by Short FES-I | Baseline, 8 weeks, and 20 weeks | Fear of falling was measured using the Short Falls Efficacy Scale-International (Short FES-I), which assesses concerns about falling during everyday activities. Total scores range from 7 to 28, with higher scores indicating greater fear of falling. |
| Number of falls | Throughout the 20-week study period | Falls were measured as the total number of falls recorded during the study period using incident reports from the participating nursing homes. Higher values indicate a greater frequency of falls. |
Countries
Spain
Outcome results
None listed