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Effects of a Smart Circuit Exercise Program on Health Outcomes in Community-Dwelling Older Adults

24 août 2026 mis à jour par: Chang Gung Memorial Hospital

Intelligent Precision Exercise Integrated Health Management: Construction of Innovative Technology and Management Models and Clinical Evidence Research in Elderly Communities.

This study was conducted in collaboration with a community-based retirement facility to evaluate the clinical effectiveness of a smart, technology-assisted circuit exercise intervention for community-dwelling older adults. Traditional exercise prescriptions for older adults often lack real-time monitoring of individual physiological responses, which can increase the risk associated with exercise participation. This program integrated real-time physiological monitoring (including heart rate reserve, HRR) to guide individualized exercise intensity within a moderate-intensity range (50%-60% HRR).

The study was conducted in two stages with different allocation designs:

Stage 1 (Randomized Controlled Design): Participants were randomly assigned to either an intervention group or a control group. The intervention group received the smart circuit exercise program, while the control group did not receive the exercise intervention and underwent pre- and post-assessment only. This stage allowed for between-group comparison of intervention effects.

Stage 2 (Single-Group Extension): Following completion of Stage 1, the facility extended the exercise program to a broader group of community residents as part of a real-world implementation and scale-up initiative, in order to evaluate the program under routine practice conditions and to provide equitable access to the intervention across the community. A concurrent control group was not maintained during this stage, consistent with its focus on real-world effectiveness evaluation rather than efficacy comparison.

Participants in both stages received circuit-based exercise training three times per week (24 sessions total over approximately 8 weeks), with intensity controlled at 50%-60% heart rate reserve (HRR).

Outcome measures assessed before and after the intervention period included: cardiac autonomic activity and hemodynamic function (including blood pressure and heart rate variability), arterial stiffness, body composition (including skeletal muscle mass, body fat mass, and body fat percentage), functional fitness (including lower limb muscle strength and dynamic balance), clinical blood biochemistry indicators (including HbA1c), depressive symptoms (CESD-10), and sleep quality (Pittsburgh Sleep Quality Index, PSQI).

Statistical analyses varied by stage and publication. For Stage 1 between-group comparisons, linear mixed models (LMM) with participant as a random intercept were used to test Time × Group interactions, adjusting for age, sex, and height. For broader cohort analyses, two-way mixed-design analysis of variance and paired-samples t-tests were used. Statistical significance was set at alpha = .05 for all analyses.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

This study was conducted in collaboration with a community-based retirement facility to evaluate the clinical effectiveness of a smart, technology-assisted circuit exercise intervention for community-dwelling older adults. Traditional exercise prescriptions for older adults often lack real-time monitoring of individual physiological responses, which can increase the risk associated with exercise participation. This program integrated real-time physiological monitoring (including heart rate reserve, HRR) to guide individualized exercise intensity within a moderate-intensity range (50%-60% HRR).

The study was conducted in two stages with different allocation designs:

Stage 1 (Randomized Controlled Design): Participants were randomly assigned to either an intervention group or a control group. The intervention group received the smart circuit exercise program, while the control group did not receive the exercise intervention and underwent pre- and post-assessment only. This stage allowed for between-group comparison of intervention effects.

Stage 2 (Single-Group Extension): Following the completion and analysis of Stage 1, which demonstrated the safety and preliminary effectiveness of the smart circuit exercise program, the facility extended the program to a broader group of community residents as part of a real-world implementation and scale-up initiative, in order to evaluate the program's effectiveness under routine practice conditions and to provide equitable access to the intervention across the community. A concurrent control group was not maintained during this stage, consistent with its focus on real-world effectiveness evaluation rather than efficacy comparison.

Participants in both stages received circuit-based exercise training three times per week (24 sessions total across approximately 8 weeks), with intensity controlled at 50%-60% heart rate reserve (HRR).

Outcome measures assessed before and after the intervention period included: body composition (including skeletal muscle mass, body fat mass, and body fat percentage), blood pressure, functional fitness (lower limb muscle strength and dynamic balance), clinical blood biochemistry indicators (including HbA1c), depressive symptoms (CESD-10), and sleep quality (Pittsburgh Sleep Quality Index, PSQI).

Statistical analyses included two-way mixed-design analysis of variance and paired-samples t-tests, with statistical significance set at alpha = .05. Stage 1 data were analyzed as a between-group comparison. Stage 2 data were analyzed independently as a within-group pre-post comparison and were not statistically compared to the Stage 1 control group, given the non-concurrent recruitment timing between stages.

Note: This trial is being registered retrospectively. The study was conducted and closed under IRB approval prior to the decision to pursue publication in international peer-reviewed journals, at which point trial registration was completed.

Type d'étude

Interventionnel

Inscription (Réel)

256

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Taïwan
    • Guishan
      • Taoyuan, Guishan, Taïwan, 33371
        • Chang Gung University

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte plus âgé

Accepte les volontaires sains

Oui

La description

Inclusion Criteria:

  • Age 65 to 85 years, community-dwelling
  • Able to walk independently, without assistance
  • Able to understand study procedures in Mandarin or Taiwanese and voluntarily provide informed consent
  • Willing to undergo health examinations and testing, and to provide historical health examination records
  • Completed a health status questionnaire covering medical history, medication use, and comorbidities
  • Physical Activity Readiness Questionnaire Plus (PAR-Q+) results indicating suitability for exercise training (or written physician clearance obtained if any positive response)
  • Completed the International Physical Activity Questionnaire (IPAQ), with results not meeting the criterion for regular exercise within the past 6 months (i.e., fewer than 2 sessions/week or less than 30 minutes/session of moderate-intensity aerobic exercise)

Exclusion Criteria:

  • Cognitive impairment or dementia precluding understanding of study procedures or compliance with test instructions
  • Lower-extremity fracture, joint surgery, or joint replacement within the past 3 months precluding safe completion of sit-to-stand or walking tasks
  • Severe joint pain precluding safe completion of baseline test movements, as assessed by study personnel
  • Unexplained syncope or fall history within the past 3 months, or safety concerns as assessed by study personnel
  • Acute illness (e.g., fever, acute infection)
  • Cardiac pacemaker or incompatible metal implants affecting bioelectrical impedance analysis (BIA) measurement safety
  • Meeting the criterion for regular exercise within the past 6 months per the International Physical Activity Questionnaire (IPAQ) (≥2 sessions/week, ≥30 minutes/session of moderate-intensity aerobic exercise)
  • Physical Activity Readiness Questionnaire Plus (PAR-Q+) screening results indicating unsuitability for exercise training, without written physician clearance
  • Unstable cardiovascular disease, including unstable angina, uncontrolled atrial or ventricular arrhythmia, uncontrolled resting sinus tachycardia (>120 beats/min), decompensated congestive heart failure, third-degree atrioventricular block without a pacemaker, acute pericarditis or myocarditis, or recent thrombosis/thrombophlebitis
  • Uncontrolled diabetes (HbA1c > 9%, resting blood glucose > 300 mg/dL, or > 250 mg/dL with ketosis) or poorly controlled hypertension (systolic blood pressure > 180 mmHg or diastolic blood pressure > 100 mmHg)
  • Use of medications that may interfere with muscle metabolism (e.g., high-dose corticosteroids, immunosuppressants)
  • Symptomatic orthostatic hypotension (blood pressure drop > 20 mmHg)
  • Resting ST-segment depression > 2 mm
  • Severe neurological or musculoskeletal disease precluding safe performance of study procedures, as assessed by study personnel
  • Currently participating in another clinical trial involving an exercise intervention
  • Severe anemia, acute infectious disease, or other physiological conditions deemed unsuitable for exercise training by the investigator

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: La prévention
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Arm 1_Stage 1 - Intervention Group
Participants randomly assigned to receive the smart circuit exercise program during Stage 1. Sessions were held 3 times per week (24 sessions total over approximately 8 weeks), with exercise intensity controlled at 50%-60% heart rate reserve (HRR) using real-time physiological monitoring. (n=50 enrolled, n=50 completed)
Comportemental: Smart Circuit Exercise Program
A moderate-intensity circuit-based exercise program incorporating real-time physiological monitoring (including heart rate reserve, HRR) to guide individualized exercise intensity. Sessions were held 3 times per week (24 sessions total over approximately 8 weeks), with intensity controlled at 50%-60% HRR.
Aucune intervention: Arm 2_Stage 1 - Control Group
Participants randomly assigned to the control group during Stage 1. Participants did not receive the exercise intervention and underwent pre- and post-assessment only. (n=50 enrolled, n=46 completed)
Expérimental: Arm 3_Stage 2 - Intervention Extension (Single-Group)
Following completion and analysis of Stage 1, additional community residents were enrolled to receive the same smart circuit exercise program as part of a real-world implementation and scale-up initiative. No concurrent control group was maintained during this stage. (n=156 enrolled, n=142 completed)
Comportemental: Smart Circuit Exercise Program
A moderate-intensity circuit-based exercise program incorporating real-time physiological monitoring (including heart rate reserve, HRR) to guide individualized exercise intensity. Sessions were held 3 times per week (24 sessions total over approximately 8 weeks), with intensity controlled at 50%-60% HRR.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Time-Domain Heart Rate Variability
Délai: Baseline and up to 12 weeks
Standard deviation of NN intervals (SDNN) and root mean square of successive differences (RMSSD), derived from 4-minute seated ECG recording, reported in milliseconds.
Baseline and up to 12 weeks
Change in Frequency-Domain Heart Rate Variability
Délai: Baseline and up to 12 weeks
Normalized low-frequency (nLF) and high-frequency (nHF) power, derived from 4-minute seated ECG recording, reported in normalized units.
Baseline and up to 12 weeks
Change in Dynamic Heart Rate Variability Reactivity
Délai: Baseline and up to 12 weeks
E/I ratio (from 2-minute deep breathing), Valsalva ratio (from 2-minute Valsalva maneuver), and 30:15 ratio (from 2-minute standing), each reported as a ratio.
Baseline and up to 12 weeks
Change in Blood Pressure
Délai: Baseline and up to 12 weeks
Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP), measured via upper-arm automatic blood pressure monitor, average of 3 consecutive readings, reported in mmHg.
Baseline and up to 12 weeks
Change in Rate-Pressure Product
Délai: Baseline and up to 12 weeks
Cardiac load index calculated as heart rate multiplied by systolic blood pressure, reported in bpm·mmHg.
Baseline and up to 12 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in Skeletal Muscle Mass and Body Fat Mass
Délai: Baseline and up to 12 weeks
Skeletal muscle mass (SMM) and body fat mass (BFM), reported in kg.
Baseline and up to 12 weeks
Change in Percent Body Fat
Délai: Baseline and up to 12 weeks
Percent body fat (PBF), reported as a percentage.
Baseline and up to 12 weeks
Change in Body Mass Index
Délai: Baseline and up to 12 weeks
Body mass index (BMI), calculated from body composition analysis, reported in kg/m^2.
Baseline and up to 12 weeks
Change in Waist-Hip Ratio
Délai: Baseline and up to 12 weeks
Waist-hip ratio (WHR), reported as a ratio.
Baseline and up to 12 weeks
Change in Visceral Fat Area
Délai: Baseline and up to 12 weeks
Visceral fat area (VFA), reported in cm^2.
Baseline and up to 12 weeks
Change in Digital Volume Pulse Stiffness Index
Délai: Baseline and up to 12 weeks
Stiffness Index (SI), derived from photoplethysmography-based digital volume pulse (DVP) pulse contour analysis, reported in m/s.
Baseline and up to 12 weeks
Change in Digital Volume Pulse Contour Reflection Index
Délai: Baseline and up to 12 weeks
Reflection Index (RI), derived from pulse contour analysis of the digital volume pulse (DVP) waveform, reported as a ratio.
Baseline and up to 12 weeks
Change in Second-Derivative Photoplethysmogram Amplitude Ratios
Délai: Baseline and up to 12 weeks
Second-derivative photoplethysmogram (SDPTG) amplitude ratios (b/a, c/a, d/a, e/a), derived from second-derivative analysis of the digital volume pulse (DVP) waveform, reported as a ratio.
Baseline and up to 12 weeks
Change in Augmentation Index
Délai: Baseline and up to 12 weeks
Augmentation Index (AIx) and heart-rate-normalized Augmentation Index (AIx@75), derived from DVP pulse contour analysis, reported as a percentage.
Baseline and up to 12 weeks
Change in Aging Index
Délai: Baseline and up to 12 weeks
Aging Index (AGI), derived from second-derivative photoplethysmogram (SDPTG) analysis, reported in arbitrary units.
Baseline and up to 12 weeks
Change in Lower- and Upper-Limb Muscular Strength
Délai: Baseline and up to 12 weeks
Lower-limb strength (LowerStr), assessed using the 30-Second Chair Stand Test, and upper-limb strength (UpperStr), assessed using the 30-Second Arm Curl Test, reported in repetitions.
Baseline and up to 12 weeks
Change in Lower- and Upper-Limb Flexibility
Délai: Baseline and up to 12 weeks
Lower-limb flexibility (LowerFlex), assessed using the Chair Sit-and-Reach Test, and upper-limb flexibility (UpperFlex), assessed using the Back Scratch Test, reported in cm.
Baseline and up to 12 weeks
Change in Cardiorespiratory Endurance
Délai: Baseline and up to 12 weeks
Cardiorespiratory endurance assessed using a 2-minute step test, reported in number of steps.
Baseline and up to 12 weeks
Change in Dynamic and Static Balance
Délai: Baseline and up to 12 weeks
Dynamic balance (DynBal), assessed using the Timed Up-and-Go Test, and static balance (StatBal), assessed using the Single-Leg Stance Test (eyes open), reported in seconds.
Baseline and up to 12 weeks
Change in HbA1c
Délai: Baseline and up to 12 months following study completion
Glycated hemoglobin (HbA1c), based on voluntary submission of participants' individual routine health examination reports. Assessment timing and laboratory were not standardized by the study protocol, as this measure relied on participant-provided documentation rather than investigator-administered blood collection. Reported as a percentage.
Baseline and up to 12 months following study completion
Change in Lipid Profile
Délai: Baseline and up to 12 months following study completion
Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG), based on voluntary submission of participants' individual routine health examination reports at any point up to 12 months following study completion. Assessment timing and laboratory were not standardized by the study protocol, as this measure relied on participant-provided documentation rather than investigator-administered blood collection. Reported in mg/dL.
Baseline and up to 12 months following study completion

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Chang Gung Memorial Hospital

Les enquêteurs

  • Chercheur principal: Jong-Shyan WANG, Ph.D., Chang Gung University, Guishan, Taoyuan 333

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

10 mai 2024

Achèvement primaire (Réel)

27 février 2026

Achèvement de l'étude (Réel)

28 février 2026

Dates d'inscription aux études

Première soumission

20 août 2026

Première soumission répondant aux critères de contrôle qualité

24 août 2026

Première publication (Réel)

27 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

27 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

24 août 2026

Dernière vérification

1 août 2026

Plus d'information

Termes liés à cette étude

Mots clés

Autres numéros d'identification d'étude

  • 202601236B0
  • FCRPD1P0021 (Autre subvention/numéro de financement: Wang Chang-Gung Charitable Trust Fund)

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

OUI

Description du régime IPD

De-identified individual participant data that underlie the results reported in publications arising from this study may be made available to other researchers upon reasonable request to the corresponding author, subject to appropriate institutional and ethics committee approvals.

Délai de partage IPD

Beginning after publication, with no defined end date, upon reasonable request.

Critères d'accès au partage IPD

Requests will be reviewed by the corresponding author and require institutional/ethics approval where applicable.

Type d'informations de prise en charge du partage d'IPD

  • PROTOCOLE D'ÉTUDE

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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