Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

Chiung-Ju Liu, Huiping Xu, NiCole R Keith, Daniel O Clark, Chiung-Ju Liu, Huiping Xu, NiCole R Keith, Daniel O Clark

Abstract

Background: Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone.

Methods: A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50-60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.

Results: At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =-0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01).

Conclusion: Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.

Keywords: activities of daily living; aging in place; disablement process; functional exercise; resistance exercise.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The study CONSORT flow diagram. Abbreviation: CONSORT, Consolidated Standards of Reporting Trials.
Figure 2
Figure 2
Estimated means and 95% confidence intervals by outcomes and groups at postintervention and 6-month follow-up. Notes: Outcome of the Box and Blocks Test dominant hand by groups and time points (A). Outcome of the Box and Blocks Test non-dominant hand by groups and time points (B). Outcome of the Timed Up and Go Test by groups and time points (C). Outcome of the AMPS Motor Skills by groups and time points (D). Solid line: 3-Step Workout for Life Group. Dashed line: Resistance Exercise Only Group. Estimates were based on the constrained longitudinal data analysis. Abbreviation: AMPS, Assessment of Motor and Process Skills.

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