Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

Nien Xiang Tou, Shiou-Liang Wee, Wei Ting Seah, Daniella Hui Min Ng, Benedict Wei Jun Pang, Lay Khoon Lau, Tze Pin Ng, Nien Xiang Tou, Shiou-Liang Wee, Wei Ting Seah, Daniella Hui Min Ng, Benedict Wei Jun Pang, Lay Khoon Lau, Tze Pin Ng

Abstract

Translation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020-retrospectively registered.

Keywords: Exercise; Frailty; Physical function; Senior activity centers; Successful aging.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Study flow diagram. ITT, intention-to-treat
Fig. 2
Fig. 2
Outcome measures at baseline and 3-month follow-up across groups. a Frailty status; b handgrip strength; c knee extensor strength; d timed up and go performance; e short physical performance battery; f SPPB balance component; g SPPB gait speed component; h SPPB repeated chair stand component. *Significant group-time interaction (p < 0.05). Data presented in mean ± 95% CI

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