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Clinical Efficacy of a Multicomponent Exercise and Comprehensive Geriatric Assessment Program (FRAIL+AP) in Frail Older Adults Within Primary Care: A Randomized Controlled Trial (FRAIL+AP)

7 giugno 2026 aggiornato da: Alberto Bermejo Franco, Universidad Europea de Madrid

Frailty is a multidimensional clinical syndrome associated with increased vulnerability to adverse health outcomes in older adults. Despite strong evidence supporting multicomponent exercise interventions, their implementation in primary care settings remains limited.

This randomized controlled trial aims to evaluate the efficacy of the FRAIL+AP program, which integrates Comprehensive Geriatric Assessment (CGA) with a 12-week multicomponent exercise intervention, including visual-spatial gait retraining using the Tapiz Fisior system.

The study will assess whether this intervention improves frailty status, physical performance, and functional independence, while reducing falls among community-dwelling older adults compared to standard care.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Frailty is a prevalent geriatric syndrome characterized by decreased physiological reserve and increased vulnerability to adverse health outcomes, including falls, disability, hospitalization, institutionalization, and mortality. The Canary Islands have one of the highest rates of frailty and pre-frailty among community-dwelling older adults in Spain, highlighting the need for effective and scalable interventions within primary care settings.

Comprehensive Geriatric Assessment (CGA) is considered the gold standard for identifying multidimensional health needs in older adults and for guiding individualized care plans. In parallel, multicomponent exercise programs incorporating strength, balance, endurance, and flexibility training have demonstrated effectiveness in improving physical function and reducing frailty-related impairments. However, challenges remain regarding the implementation of these interventions in routine primary care practice.

The FRAIL+AP study is a multicenter, randomized controlled trial designed to evaluate the clinical efficacy of a primary care-based intervention combining Comprehensive Geriatric Assessment, health education, and a supervised multicomponent exercise program in frail and pre-frail older adults. The intervention also incorporates visual-spatial gait retraining using the Tapiz Fisior system, a structured floor-grid tool aimed at improving gait control, balance, coordination, and fall prevention.

A total of 200 community-dwelling adults aged 70 years and older will be recruited from five primary care centers in Tenerife, Spain. Eligible participants will be randomly allocated in a 1:1 ratio to either the intervention group or a control group receiving usual care. The intervention will last 12 weeks and will consist of supervised and home-based exercise sessions, together with educational activities focused on healthy lifestyles, nutrition, frailty awareness, and fall prevention.

Primary outcomes include changes in frailty status assessed by the FRAIL Scale and physical performance measured using the Short Physical Performance Battery (SPPB). Secondary outcomes include incidence of falls, pain perception, mood, functional independence, nutritional status, handgrip strength, healthcare resource utilization, and comorbidity measures. Outcomes will be assessed at baseline and one week after completion of the intervention by blinded evaluators.

The study aims to determine whether the FRAIL+AP protocol can improve physical performance, reduce frailty, and support healthy aging through an integrated and scalable model that can be implemented within routine primary care services.

Tipo di studio

Interventistico

Iscrizione (Stimato)

200

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

  • Spagna
    • Santa Cruz de Tenerife
      • Tacoronte, Santa Cruz de Tenerife, Spagna, 38350
        • Reclutamento
        • Centro de Salud Tacoronte
        • Contatto:
        • Contatto:
        • Sub-investigatore:
          • Carlos Eusebio Esparza Ferrera, Physiotherapist

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Community-dwelling adults aged 70 years or older.
  • Ability and willingness to provide written informed consent.
  • Medical clearance to participate in low-to-moderate intensity physical exercise.
  • Presence of frailty or pre-frailty defined by meeting at least two of the following criteria:
  • Functional independence sufficient to participate in the intervention (Barthel Index >80.
  • FRAIL Scale score ≥ 1.
  • Short Physical Performance Battery (SPPB) score < 10.
  • Gait speed < 0.8 m/s.
  • Timed Up and Go (TUG) test > 12 seconds.
  • Registered at one of the participating primary care centers.

Exclusion Criteria:

  • Absolute contraindications to physical exercise, including recent acute myocardial infarction, unstable angina, severe uncontrolled cardiovascular disease, or severe uncorrected aortic stenosis.
  • Severe cognitive impairment preventing comprehension of study procedures or exercise instructions.
  • Severe psychiatric disorders interfering with participation.
  • Absence of a legally authorized representative when required.
  • Severe uncontrolled behavioral disturbances.
  • Any acute or chronic medical condition considered by the investigators to make participation unsafe.

Discontinuation Criteria:

  • Failure to attend the initial mandatory health education workshop.
  • Attendance at fewer than 6 of the 12 scheduled supervised exercise sessions.
  • Development of an acute medical condition that results in a temporary or permanent contraindication to physical activity.
  • Participant withdrawal of informed consent.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: FRAIL+AP Program
Participants receive a 12-week intervention consisting of a Comprehensive Geriatric Assessment (CGA), health education, and a multicomponent exercise program combining strength, balance, mobility, flexibility, and visual-spatial gait retraining using the Tapiz Fisior system. The intervention includes one supervised session and one home-based session per week.
Comportamentale: FRAIL+AP Program
A 12-week multicomponent intervention including Comprehensive Geriatric Assessment, health education, strength training, balance exercises, mobility training, flexibility exercises, and visual-spatial gait retraining using the Tapiz Fisior system. Participants attend one supervised session and perform one home-based session per week.
Comparatore attivo: Usual Care
Participants receive standard primary care follow-up according to the Canary Health Service guidelines, including routine medical care and general lifestyle recommendations, without participation in the FRAIL+AP structured exercise program.
Altro: Usual Care
Standard primary care management according to regional healthcare guidelines without structured exercise intervention.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in frailty status measured by the FRAIL Scale
Lasso di tempo: Baseline and 12 weeks
Change in FRAIL Scale score from baseline to the end of the 12-week intervention. The FRAIL Scale classifies participants as robust (0), pre-frail (1-2), or frail (3-5).
Baseline and 12 weeks
Change in physical performance measured by the Short Physical Performance Battery (SPPB)
Lasso di tempo: Baseline and 12 weeks
Change in SPPB score from baseline to the end of the 12-week intervention. The SPPB evaluates balance, gait speed, and lower-extremity strength, with higher scores indicating better physical performance.
Baseline and 12 weeks

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Incidence of Falls
Lasso di tempo: Baseline and 12 weeks
Number of falls recorded during the study period using participant diaries and verified through electronic medical records.
Baseline and 12 weeks
Musculoskeletal Pain Intensity
Lasso di tempo: Baseline and 12 weeks
Change in perceived musculoskeletal pain measured using a 10-cm Visual Analog Scale (VAS), with higher scores indicating greater pain intensity.
Baseline and 12 weeks
Mood and Affective Status
Lasso di tempo: Baseline and 12 weeks
Change in depressive symptoms measured using the 15-item Geriatric Depression Scale (GDS-15), with higher scores indicating greater depressive symptomatology.
Baseline and 12 weeks
Functional Independence
Lasso di tempo: Baseline and 12 weeks
Change in functional independence measured using the Barthel Index. Higher scores indicate greater independence in activities of daily living.
Baseline and 12 weeks
Nutritional Status
Lasso di tempo: Baseline and 12 weeks
Change in nutritional status measured using the Mini Nutritional Assessment (MNA), a validated tool for identifying malnutrition and risk of malnutrition in older adults.
Baseline and 12 weeks
Handgrip Strength
Lasso di tempo: Baseline and 12 weeks
Change in upper-limb muscle strength measured by handgrip dynamometry. The highest value obtained from standardized testing procedures will be recorded.
Baseline and 12 weeks
Comorbidity Burden
Lasso di tempo: Baseline and 12 weeks
Change in clinical comorbidity status assessed using the Charlson Comorbidity Index.
Baseline and 12 weeks
Healthcare Resource Utilization
Lasso di tempo: Baseline and 12 weeks
Healthcare utilization assessed through review of electronic medical records, including primary care visits, emergency department attendance, hospital admissions, and other healthcare contacts during the study period.
Baseline and 12 weeks

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Universidad Europea de Madrid

Investigatori

  • Investigatore principale: Ángel Moisés Reyes Abreu, Registered Nurse, Centro médico Tacoronte. Adress: Carr. Gral. del Nte., 5, 38350 Tacoronte, Santa Cruz de Tenerife
  • Direttore dello studio: Alberto Bermejo Franco, PhD (Physiotherapy), Universidad Europea de Madrid. Adress: C/ Tajo, S/N. 28670 Villaviciosa de Odón (Madrid)

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

28 maggio 2026

Completamento primario (Stimato)

31 dicembre 2026

Completamento dello studio (Stimato)

31 dicembre 2026

Date di iscrizione allo studio

Primo inviato

7 giugno 2026

Primo inviato che soddisfa i criteri di controllo qualità

7 giugno 2026

Primo Inserito (Effettivo)

11 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

11 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

7 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • CHUC_2026_19
  • PIFIISC 25/28 (Altro numero di sovvenzione/finanziamento: Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC))

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

INDECISO

Descrizione del piano IPD

Data sharing plans have not yet been finalized. Any future sharing of de-identified individual participant data will be considered in accordance with ethical, legal, and institutional requirements.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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