Eccentric Exercise in Community-dwelling Older Adults (HEX:AGEUK)

Eccentric exercise programme

Participants will undertake a 12-month supervised eccentric-biased strengthening programme delivered in a community setting, with the option of performing this at home. The intervention will consist of 6x 1-minute progressive lower-limb strengthening exercises emphasising the eccentric phase of movement, including functional tasks relevant to activities of daily living. Exercise difficulty will be progressively increased throughout the programme according to participant performance and tolerance. Community sessions will be led by staff at the community setting who will have been educated and trained by developers of the exercise programme in a group-based format. The intervention is designed to improve lower-limb strength, mobility, balance confidence, and physical function in community-dwelling older adults.

Feasibility of recruitment will be assessed through participant recruitment capacity, calculated as the number of participants enrolled on the study relative to total number of people invited to take part.

Feasibility of delivery will be assessed through participant partiicpant adherence to the intervention, calculated as the number of sessions attended relative to the total number of sessions presrcibed.

Timed Up and Go test wil require participants to rise from a chair, walk three metres, turn around, return to the chair, and sit down. The time taken to complete the test will be recorded in seconds.

Lower-limb strength will be assessed using the Five Times Sit-to-Stand test. Participants will be asked to stand up and sit down five times as quickly as possible from a standard chair without using their arms for assistance. Time to completion will be recorded in seconds.

The Falls Efficacy Scale International (FES-I) will be used to assess the fear of falling. The FES-I is a validated self-report questionnaire that evaluates an individual's concern about falling during a range of everyday activities. Higher scores indicate greater concern about falling.

Health-related quality of life will be assessed using the EQ-5D-5L questionnaire. The instrument evaluates mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, alongside a self-rated health visual analogue scale.

Participant acceptability of the eccentric-biased strengthening programme will be assessed through post-intervention feedback. Information regarding participant satisfaction, perceived benefits, barriers to participation, and willingness to continue exercise following programme completion will be collected.