Effects of Exercise Snacking on Physical Fitness, Cognition, and Pain in Institutionalized Older Adults (EXSNAKS)

The Effects of Exercise Snacking on Physical Fitness, Cognitive Function, and Chronic Pain in Institutionalized Older Adults: A Randomized Controlled Trial

This study aims to compare the effects of two different exercise approaches on health and well-being in older adults living in residential care facilities. One approach, called "exercise snacking," consists of short and frequent bouts of physical activity spread throughout the day, while the other involves longer, structured exercise sessions performed a few times per week.

Approximately 75 adults aged 65 years and older will be randomly assigned to one of the two exercise programs and will participate for 12 weeks. The study will examine whether exercise snacking is as effective as conventional exercise in improving physical fitness, cognitive function, chronic pain intensity, quality of life, and symptoms of anxiety and depression.

The researchers hypothesize that short, intermittent exercise sessions may provide similar or greater health benefits compared to traditional exercise programs and may represent a practical and accessible strategy to promote physical activity in older adults living in institutional settings.

Study Overview

• Status: Active, not recruiting
• Conditions: Chronic Pain; Cognition Disorders in Old Age; Physical Fitness in Older Adults
• Intervention / Treatment: Behavioral: Exercise Snacks; Behavioral: Conventional Exercise

• Study Type: Interventional
• Enrollment (Estimated): 75
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Portugal
  • Lisbon, Portugal, 1500-661
    • Associação Casapiana de Solidariedade

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age ≥ 65 years
• Residence in Associação Casapiana de Solidariedade

Exclusion Criteria:

• Severe cognitive impairment (MMSE 0-10)
• Unstable medical conditions (e.g., decompensated heart failure)
• Refusal of consent
• Total inability to walk/move.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise Snacks; The Exercise Snacks intervention comprises two daily sessions of approximately ten minutes each, five days per week (total ≈ 100 minutes/week). Each ten-minute session consists largely of alternating one-minute bouts of activity and one-minute rest. The exercises followed a structured three-month progression. Intensity targeted at a 4 on Borg CR10 Scale "somewhat hard" with progression rules (increase repetitions, range of motion and exercise difficulty).	Behavioral: Exercise Snacks; Exercise snacks, defined as short bouts of gentle intermittent exercise performed twice a day
Active Comparator: Conventional Exercise; Conventional Exercise comprises two supervised 50 minutes sessions per week (total ≈ 100 minutes/week). Organized in one-minute exercise/one-minute rest intervals equal in content to the snacks but performed in longer continuous practice. The exercises followed a structured three-month progression. Intensity targeted at a 4 on Borg CR10 Scale "somewhat hard" with progression rules (increase repetitions, range of motion and exercise difficulty).	Behavioral: Conventional Exercise; Conventional exercise consists of longer continuous practice of structured physical activity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical Fitness Assessed by the Short Physical Performance Battery (SPPB)	The Short Physical Performance Battery (SPPB) is a test of lower extremity functioning that combines scores from usual gait speed, standing balance, and chair stand tests. Scores range from 0 to 12, with higher scores indicating better physical functioning.	Baseline and 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nordic Musculoskeletal Questionnaire (NMQ)	Pain will be assessed using the Nordic Musculoskeletal Questionnaire. Participants will report as yes/no the presence of chronic pain (pain that persists or recurs more than three months) in nine body regions (neck, shoulders, elbows, wrists/hands, upper back, lower back, hips/thighs, knees, and ankles/feet). Symptom intensity in the last 7 days will be rated on a numeric scale from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain.	From baseline to 3 months
The 12-Item Short-Form Health Survey (SF-12)	The SF-12 includes 12 items covering eight health domains (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health). Responses will be scored using standard algorithms to generate two summary measures: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Scores will range from 0 to 100, with higher scores indicating better health-related quality of life. Outcomes will be reported as mean PCS and MCS scores.	From baseline to 3 months
Mini-Mental State Examination (MMSE)	Cognitive function will be assessed using the MMSE, a standardized interviewer-administered screening tool. The MMSE will evaluate orientation, attention, memory, language, and visuospatial abilities. Total scores will range from 0 to 30, with higher scores indicating better cognitive function. Cognitive impairment will be defined according to education-adjusted cut-off scores, as follows: illiterate participants ≤15 points; participants with 1 to 11 years of education ≤22 points; and participants with more than 11 years of education ≤27 points.	From baseline to 3 months
Anxiety and depression assessed by Hospital Anxiety and Depression Scale (HADS) subscale scores	HADS consists of two subscales, one measuring anxiety, with seven items, and one measuring depression, with seven items, which are scored separately. Each item was answered by the participant on a 4-point (0-3) response category so the possible scores ranged from 0 to 21 for anxiety and 0 to 21 for depression. The HADS manual indicates that a score between 0 and 7 is ''normal'', between 8 and 10 ''mild'', between 11 and 14 ''moderate'' and between 15 and 21 ''severe''.	From baseline to 3 months

Collaborators and Investigators

• Sponsor: Ivan Patrício
• Collaborators: CIDEFES - Universidade Lusofona; Associação Casapiana de Solidariedade

Study record dates

Study Major Dates

• Study Start (Actual): January 5, 2026
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): April 1, 2026

Study Registration Dates

• First Submitted: January 4, 2026
• First Submitted That Met QC Criteria: January 4, 2026
• First Posted (Actual): January 12, 2026

Study Record Updates

• Last Update Posted (Actual): March 4, 2026
• Last Update Submitted That Met QC Criteria: March 3, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Chronic Pain
• Other Study ID Numbers: D1025B

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No