Effect of 12-month supervised, home-based physical exercise on functioning among persons with signs of frailty : Randomized Controlled Trial
Suikkanen, S., Soukkio, P., Aartolahti, E., Kääriä, S., Kautiainen, H., Hupli, M. T., Pitkälä, K., Sipilä, S., & Kukkonen-Harjula, K. (2021). Effect of 12-month supervised, home-based physical exercise on functioning among persons with signs of frailty : Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 102(12), 2283-2290. https://doi.org/10.1016/j.apmr.2021.06.017
Published inArchives of Physical Medicine and Rehabilitation
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© 2021 The American Congress of Rehabilitation Medicine
Objectives To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty. Design A randomized controlled trial with a 1:1 allocation Setting Home-based Participants Home-dwelling persons aged ≥65 years meeting at least one frailty phenotype criteria (n=300). Intervention 12-month, individually tailored, progressive and physiotherapist-supervised, physical exercise twice a week (n=150) vs. usual care (n=149). Main outcome Measures Functional Independence Measure (FIM), Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and physical activity (other than intervention). Assessed four times at home over 12 months. Results The mean age of the participants was 82.2 (SD 6.3), 75% were women, 61% met 1–2 frailty criteria and 39% ≥3 criteria. FIM deteriorated in both groups over 12 months, -4.1 points (95% CI: -5.6 to -2.5) in the exercise group and -6.9 (-8.4 to -2.3) in the usual care group (group p=0.014, time p<0.001, interaction p=0.56). The mean improvement in SPPB was significantly greater in the exercise group [1.6 (1.3 to 2.0)] than in the usual care group [0.01 (-0.3 to 0.3)] (group p<0.001, time p=0.11, interaction p=0.027). The exercise group reported significantly fewer falls per person-year compared to the usual care group (incidence rate ratio, IRR 0.47 [95% CI 0.40 to 0.55]; p<0.001). There was no significant difference between the groups over 12 months in terms of handgrip strength, IADL function or self-reported physical activity. Conclusions One year of physical exercise improved physical performance and decreased the number of falls among people with signs of frailty. FIM differed between the groups at 12 months, but exercise did not prevent deterioration of FIM, IADL or handgrip strength. ...
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Additional information about fundingThis work was supported by the South Karelia Social and Health Care District (Eksote; register number 1236/00.01.05.01/2013); The Social Insurance Institution of Finland (SII; register number 94/331/2013); and the Finland State Research Funding for Academic Health Research (Ministry of Social Affairs and Health). The funders played no role in the design, collection, analysis, or interpretation of the data, nor in writing the manuscript. ...
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