Effectiveness of RPT With Elastic Band in Tx of Sarcopenia in LTCFs

April 3, 2026 updated by: Sheng-Hui Tuan, Cishan Hospital, Ministry of Health and Welfare

The Clinical Effectiveness of Progressive Resistance Training With Elastic Band in Postponing and Preventing Sarcopenia Among Older Adults in Rural Long-Term Care Facilities

The goal of this clinical trial is to evaluate the effectiveness of progressive resistance training using elastic bands in treating and delaying the progression of sarcopenia among older adults in long-term care facilities. Sarcopenia, characterized by a progressive decline in muscle mass and strength, affects more than 20% of individuals aged over 65 in Taiwan and is a significant risk factor for impaired daily functioning, falls, and increased mortality in older adults. While resistance or aerobic exercises are known to improve muscle strength and function in the elderly, such interventions are challenging to implement long-term in rural care facilities due to limited resources.

The study aims to determine:

Whether elastic band progressive resistance training can achieve clinical benefits in treating and delaying sarcopenia with minimal rehabilitation personnel.

Whether this training model can be adapted to rural care facilities and other resource-limited settings, aligning with the goals of Taiwan's Long-Term Care 2.0 program.

Participants will engage in a 12-week program, involving twice-weekly, 30-minute sessions of upper and lower limb resistance training using elastic bands. The training incorporates major muscle groups and proprioceptive neuromuscular facilitation (PNF) techniques.

Primary outcomes:

Skeletal muscle mass index of the limbs Dominant hand grip strength Walking speed SARC-F questionnaire scores

Secondary outcomes:

Maximal voluntary isometric contraction (MVIC) of the dominant hand Muscle thickness assessed via ultrasound Functional activities of the dominant upper limb Calf circumference Quality of life indicators

The study will be conducted in long-term care facilities affiliated with or contracted by the Ministry of Health and Welfare Qishan Hospital. The findings aim to provide evidence for scalable, low-resource sarcopenia interventions suitable for rural and underserved populations.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Study Objectives Sarcopenia is a progressive condition characterized by the loss of muscle mass and decline in muscle function. The prevalence of sarcopenia in the elderly population aged over 65 years in Taiwan exceeds 20%. Sarcopenia is an independent risk factor for impaired daily functioning, falls, and increased mortality among older adults. Previous studies have demonstrated that resistance or aerobic exercise can improve muscle strength and functionality in the elderly. However, due to manpower constraints, such exercise programs are challenging to implement long-term in rural care facilities. Therefore, a simple and safe resistance training model that minimizes the risk of exercise-related injuries in older populations is needed.

Previous research has shown that progressive resistance training using elastic bands can effectively enhance muscle strength in older adults under safe conditions while reducing the risk of bone and joint injuries associated with traditional resistance training. However, the efficacy of elastic band training in delaying the progression of sarcopenia and determining the optimal exercise prescription for the elderly remain contentious.

This study aims to implement progressive resistance training using elastic bands for the upper and lower limbs of older adults in long-term care facilities to achieve the following expected outcomes:

Demonstrate that progressive resistance training using elastic bands can provide clinical benefits in treating and delaying sarcopenia with minimal rehabilitation personnel, while minimizing the risk of exercise-related injuries.

Apply the findings to rural daycare centers and other facilities with limited manpower resources, aligning with the goals of Taiwan's current Long-Term Care 2.0 program.

Study Methods This study will be conducted in long-term care facilities affiliated with or contracted by the Ministry of Health and Welfare Qishan Hospital, including nursing homes and daycare centers. Older adults with sufficient cognitive function to participate in rehabilitation exercises will undergo a 12-week intervention of progressive resistance training using elastic bands, performed twice per week. The training will target major muscle groups of the upper and lower limbs and incorporate proprioceptive neuromuscular facilitation (PNF) techniques. Each session will last 30 minutes.

The differences in primary and secondary outcomes will be compared before and after the intervention.

Primary outcomes include diagnostic criteria for sarcopenia: appendicular skeletal muscle mass index, dominant hand grip strength, walking speed, and SARC-F questionnaire scores.

Secondary outcomes include maximal voluntary isometric contraction (MVIC) of the dominant hand, muscle thickness assessed via ultrasound, functional activities of the dominant upper limb, calf circumference, and quality of life indicators.

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Kaohsiung City, Taiwan, 842
        • CiShan hospital, MOHW

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Older adults aged 60 years or above who are either receiving daycare services at long-term care facilities affiliated with or contracted by this hospital, or residents living in the hospital-affiliated nursing home.
  2. Individuals with sufficient cognitive and physical capacity to participate in a progressive resistance training program incorporating elastic bands, with each session lasting at least 30 minutes. -

Exclusion Criteria:

  1. Inability to maintain a seated position for more than one hour.
  2. Presence of uncontrolled hypertension, recent infections, major cardiovascular diseases, or other contraindications to exercise training as defined by the American College of Sports Medicine (ACSM).
  3. Long-term bedridden individuals unable to participate in the progressive resistance training program incorporating elastic bands.
  4. Individuals with respiratory diseases requiring regular oxygen support in daily life.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PRT with EB
LTCFs users who receive standard care plus progressive resistance training with elastic band
Device: elastic band

Participants in the experimental group will receive standard care plus progressive resistance training with elastic band (PRT-EB). The PRT-EB is planned to last for 12 weeks, with at least two sessions per week and a minimum interval of one day between sessions.

Before each training session, participants will perform a 5-15-minute warm-up exercise led by the research staff. This will be followed by a 30-minute main rehabilitation exercise program and a subsequent 5-15-minute cool-down session. The elastic bands used in this study are Thera-Bands. The resistance increases by 25% with each successive color, except for silver and gold, which increase by 40%. This study will utilize six different colors of Thera-Bands-yellow, red, green, blue, black, and silver-following the principle of progression, with resistance levels increasing every two weeks. The resistance training program targets major muscle groups of both the upper and lower body, focusing on three muscle groups per section.
No Intervention: Standard care group
LTCFs users who receive only standard care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Appendicular Skeletal Muscle Mass Index
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
ASMMI is defined as appendicular skeletal muscle mass(kg)/height (m^2). This study utilizes BIA for body muscle mass measurement, considering the accessibility of the equipment and budget constraints.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Handgrip strength of dominant hand
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
In this study, grip strength is measured using a JAMAR electronic dynamometer, with a minimum scale of 0.1 pounds. The testing procedure is as follows: The participant is seated with the shoulder in a neutral position, the upper arm relaxed alongside the body, and the elbow flexed at a 90-degree angle. The participant holds the JAMAR dynamometer with their dominant hand. They are instructed to gradually apply force, reaching their maximum grip strength within 3 seconds. Before the test, a practice trial is provided to ensure the participant understands the procedure. The grip strength is tested twice, with a 30-second rest between trials. The average of the two trials is recorded as the final result
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Gait speed
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
The testing procedure is as follows: A stopwatch is used to measure the time (in seconds) from the command "Ready, go" until the participant crosses a 6-meter distance marked on the floor. Two trials are conducted, with a 10-minute rest between each trial. Walking speed (m/s) is calculated for each trial, and the average of the two trials is used for data analysis.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
SARC-F questionnaire
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
The SARC-F questionnaire consists of five questions, each scored based on the participant's self-reported responses, with a total score ranging from 0 to 10. Higher scores indicate a higher risk of sarcopenia. The questionnaire is designed for use in various clinical and community settings without requiring specialized equipment or professional expertise, making it suitable for large-scale screening.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
maximal voluntary isometric contraction of biceps brachii/ triceps brachii/ quadriceps muscle
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
In this study, the maximal voluntary isometric contraction (MVIC) strength of the dominant biceps brachii, triceps brachii, and quadriceps muscle are measured using the MicroFET3 device (Hoggan, Health Industrial, UT, USA) under standardized posture. The average of two measurements of each muscle is recorded as the participant's MVIC strength.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Sonographic thickness of biceps brachii muscle
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
In this study, a portable ultrasound device, equipped with a 12 MHz linear probe, is used for measurements. All measurements are performed under the same parameter settings by a physician with years of clinical ultrasound experience. The measurement of the biceps brachii muscle is conducted with the participant in a supine position, the upper limb extended and fully relaxed. The probe is positioned at two-thirds of the distance from the acromion to the anterior elbow crease along the line connecting these two points. The probe is placed gently in a transverse orientation, and the measurement range is defined as the distance between the lower edge of the subcutaneous fat and the most prominent point of the humerus.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Sonographic thickness of quadriceps muscle
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
In this study, a portable ultrasound device, equipped with a 12 MHz linear probe, is used for measurements. All measurements are performed under the same parameter settings by a physician with years of clinical ultrasound experience. The measurement of the quadriceps muscle is conducted with participants in a supine position, with both lower limbs extended and fully relaxed. The probe is placed at the midpoint of the line connecting the anterior superior iliac spine (ASIS) and the superior border of the patella (see illustration on the left). The thickness of the quadriceps muscle is defined as the sum of the thickness of the rectus femoris and vastus intermedius muscles, measured in a transverse scan.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Sonographic thickness of gastrocnemius muscle
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
In this study, a portable ultrasound device, equipped with a 12 MHz linear probe, is used for measurements. All measurements are performed under the same parameter settings by a physician with years of clinical ultrasound experience. The measurement of the gastrocnemius muscle is performed with participants in a prone position, both legs extended and relaxed, with the feet hanging off the edge of the examination table. The examiner places the ultrasound probe close to the skin, ensuring the probe beam is perpendicular to the skin surface. The medial cross-sectional area of the medial head of the gastrocnemius muscle is identified, with the largest cross-sectional area selected as the standard imaging plane, and the corresponding skin surface location is marked. Measurements include: 1. Fat thickness (FT): The distance from the superficial fascia to the skin. 2. Muscle thickness (MT): The distance from the superficial fascia to the deep fascia.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
hand dexterity
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
This study utilizes the Box and Block Test (BBT) for the objective assessment of hand dexterity. Participants are instructed to use their dominant hand to transfer blocks, one at a time, from a box on the same side, across a central partition, and into a box on the opposite side. During the test, participants must ensure that only one block is moved at a time and that all blocks must cross the partition. The number of blocks successfully transferred within 1 minute is recorded, with a higher count indicating better hand function.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Calf Circumference
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
The measurement of calf circumference (CC) is conducted bilaterally, including the paretic and non-paretic sides of stroke patients. Participants are positioned in either a seated or supine posture, with the knees and hips flexed at 90°, and the feet naturally placed on the floor or bed, with the ankles relaxed. The examiner faces the participant and identifies the largest circumference of the calf on both sides. A flexible tape measure is used to measure CC, ensuring it is positioned perpendicular to the axis of the calf. The measurement error is kept below 0.1 cm. To minimize the influence of edema, measurements are performed in the morning. Each leg is measured twice, and the highest value is recorded.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
EQ-5D questionnaire
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
The EQ-5D is a widely used health-related quality of life assessment tool suitable for evaluating functional outcomes in stroke patients. It covers five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension includes three to five response options, reflecting varying levels of health status.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
Mini Nutritional Assessment
Time Frame: From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.
The Mini Nutritional Assessment (MNA) is a comprehensive nutritional evaluation tool designed to assess various aspects of a patient's condition over the past three months, including dietary intake, mobility, upper arm circumference, and calf circumference. The MNA consists of 18 items divided into two main sections: nutritional screening and general assessment. The total score ranges from 0 to 30.
From enrollment (baseline) to the mid-term (at the 6th week) and the end (at the 12th week) of the intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cishan Hospital, Ministry of Health and Welfare

Investigators

  • Principal Investigator: Sheng-Hui Tuan, M.D.;Ph.D., Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 5, 2025

Primary Completion (Actual)

September 5, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

March 20, 2026

First Submitted That Met QC Criteria

April 3, 2026

First Posted (Actual)

April 6, 2026

Study Record Updates

Last Update Posted (Actual)

April 6, 2026

Last Update Submitted That Met QC Criteria

April 3, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CHIS11403

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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