Effectiveness of a community-delivered pneumatic machine resistance training programme (Gym Tonic) for older adults at neighbourhood senior centres - a randomized controlled trial

Shuen Yee Lee, Alycia Goh, Ken Tan, Pei Ling Choo, Peck Hoon Ong, Wai Pong Wong, Shiou-Liang Wee, Shuen Yee Lee, Alycia Goh, Ken Tan, Pei Ling Choo, Peck Hoon Ong, Wai Pong Wong, Shiou-Liang Wee

Abstract

Background: Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults.

Methods: Three hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach.

Results: After 12 weeks, lower-extremity muscle strength improved by 11-26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0-12-weeks,90%(SD,13%); 12-24-weeks,89%(SD,17%)] and control [12-24-weeks,90%(SD,19%)] groups.

Conclusion: Community-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks.

Trial registration: ClinicalTrials.gov, NCT04661618 , Registered 10 December 2020 - Retrospectively registered.

Keywords: Community exercise program; Community-dwelling; Muscle strength; Physical function; Program evaluation; Technology.

Conflict of interest statement

AG and KT are employed by PulseSync, which was responsible for implementing the programme evaluated in the study. AG is the programme executive and KT is the managing director of PulseSync. None of the other authors had any other competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
CONSORT diagram of the randomized controlled trial with crossover of control group to intervention arm after 12 weeks. GT = Gym Tonic programme, ITT = intention-to-treat
Fig. 2
Fig. 2
Muscle strength outcomes including knee extension (a, b) and knee flexion (c, d), and hip abduction and adduction (e, f) at baseline, 12 weeks and 24 weeks between intervention (a, c, e) and control (b, d, f) groups. For panels a–d, black circle indicates left knee and grey triangle indicates right knee, while black circle represents hip abduction and grey triangle represents hip adduction in panels e–f. Data presented are mean and 95% CI. **p < 0.01, ***p < 0.001 compared to values at baseline; †††p < 0.001 compared to values at 12 weeks. RCT = randomized controlled trial phase, Crossover = crossover of control group to intervention arm. Intervention = Gym Tonic resistance training programme
Fig. 3
Fig. 3
Physical function outcomes including total short physical performance battery scores (a, b), five times repeated chair sit-to-stand time (c, d), and habitual (black circle) and fast gait speed (grey triangle) (e, f) at baseline, 12 weeks and 24 weeks between intervention (a, c, e) and control (b, d, f) groups. Data presented are mean and 95% CI. **p < 0.01, ***p < 0.001 compared to values at baseline; †p < 0.05, ††p < 0.01 compared to values at 12 weeks. RCT = randomized controlled trial phase, Crossover = crossover of control group to intervention arm. Intervention = Gym Tonic resistance training programme

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