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

2026. augusztus 24. frissítette: 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.

A tanulmány áttekintése

Állapot

Befejezve

Körülmények

Beavatkozás / kezelés

Részletes leírás

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.

Tanulmány típusa

Beavatkozó

Beiratkozás (Tényleges)

256

Fázis

  • Nem alkalmazható

Kapcsolatok és helyek

Ez a rész a vizsgálatot végzők elérhetőségeit, valamint a vizsgálat lefolytatásának helyére vonatkozó információkat tartalmazza.

Tanulmányi helyek

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

Részvételi kritériumok

A kutatók olyan embereket keresnek, akik megfelelnek egy bizonyos leírásnak, az úgynevezett jogosultsági kritériumoknak. Néhány példa ezekre a kritériumokra a személy általános egészségi állapota vagy a korábbi kezelések.

Jogosultsági kritériumok

Tanulmányozható életkorok

  • Idősebb felnőtt

Egészséges önkénteseket fogad

Igen

Leírás

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

Tanulási terv

Ez a rész a vizsgálati terv részleteit tartalmazza, beleértve a vizsgálat megtervezését és a vizsgálat mérését.

Hogyan készül a tanulmány?

Tervezési részletek

  • Elsődleges cél: Megelőzés
  • Kiosztás: Nem véletlenszerű
  • Beavatkozó modell: Párhuzamos hozzárendelés
  • Maszkolás: Nincs (Open Label)

Fegyverek és beavatkozások

Résztvevő csoport / kar
Beavatkozás / kezelés
Kísérleti: 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)
Viselkedési: 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.
Nincs beavatkozás: 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)
Kísérleti: 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)
Viselkedési: 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.

Mit mér a tanulmány?

Elsődleges eredményintézkedések

Eredménymérő
Intézkedés leírása
Időkeret
Change in Time-Domain Heart Rate Variability
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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

Másodlagos eredményintézkedések

Eredménymérő
Intézkedés leírása
Időkeret
Change in Skeletal Muscle Mass and Body Fat Mass
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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
Időkeret: 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

Együttműködők és nyomozók

Itt találhatja meg a tanulmányban érintett személyeket és szervezeteket.

Szponzor

Chang Gung Memorial Hospital

Nyomozók

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

Publikációk és hasznos linkek

A vizsgálattal kapcsolatos információk beviteléért felelős személy önkéntesen bocsátja rendelkezésre ezeket a kiadványokat. Ezek bármiről szólhatnak, ami a tanulmányhoz kapcsolódik.

Általános kiadványok

Tanulmányi rekorddátumok

Ezek a dátumok nyomon követik a ClinicalTrials.gov webhelyre benyújtott vizsgálati rekordok és összefoglaló eredmények benyújtásának folyamatát. A vizsgálati feljegyzéseket és a jelentett eredményeket a Nemzeti Orvostudományi Könyvtár (NLM) felülvizsgálja, hogy megbizonyosodjon arról, hogy megfelelnek-e az adott minőség-ellenőrzési szabványoknak, mielőtt közzéteszik őket a nyilvános weboldalon.

Tanulmány főbb dátumok

Tanulmány kezdete (Tényleges)

2024. május 10.

Elsődleges befejezés (Tényleges)

2026. február 27.

A tanulmány befejezése (Tényleges)

2026. február 28.

Tanulmányi regisztráció dátumai

Először benyújtva

2026. augusztus 20.

Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak

2026. augusztus 24.

Első közzététel (Tényleges)

2026. augusztus 27.

Tanulmányi rekordok frissítései

Utolsó frissítés közzétéve (Tényleges)

2026. augusztus 27.

Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak

2026. augusztus 24.

Utolsó ellenőrzés

2026. augusztus 1.

Több információ

A tanulmányhoz kapcsolódó kifejezések

Kulcsszavak

Egyéb vizsgálati azonosító számok

  • 202601236B0
  • FCRPD1P0021 (Egyéb támogatási/finanszírozási szám: Wang Chang-Gung Charitable Trust Fund)

Terv az egyéni résztvevői adatokhoz (IPD)

Tervezi megosztani az egyéni résztvevői adatokat (IPD)?

IGEN

IPD terv leírása

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.

IPD megosztási időkeret

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

IPD-megosztási hozzáférési feltételek

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

Az IPD megosztását támogató információ típusa

  • STUDY_PROTOCOL

Gyógyszer- és eszközinformációk, tanulmányi dokumentumok

Egy amerikai FDA által szabályozott gyógyszerkészítményt tanulmányoz

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Nem

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