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RESEARCH PRODUCT
Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial
Katriina Kukkonen-harjulaMarkku HupliSara SuikkanenHannu KautiainenKaisu H. PitkäläSarianna SipiläSanna KääriäPaula K. SoukkioEeva Aartolahtisubject
Malemedicine.medical_specialtyActivities of daily livingFrail Elderlymedicine.medical_treatmentPoison controlPhysical Therapy Sports Therapy and RehabilitationPhysical exerciselaw.invention03 medical and health sciences0302 clinical medicineRandomized controlled triallawInterquartile rangeInjury preventionmedicineHumans030212 general & internal medicineAgedAged 80 and overRehabilitationFrailtybusiness.industryRehabilitationHome Care ServicesConfidence intervalExercise TherapyPhysical therapyAccidental FallsFemalebusinesshuman activities030217 neurology & neurosurgerydescription
To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty.A randomized controlled trial with a 1:1 allocation.Home-based.Home-dwelling persons aged 65 years or older meeting at least 1 frailty phenotype criteria (N=300). The mean age of the participants was 82.2±6.3 years, 75% were women, 61% met 1-2 frailty criteria, and 39% met ≥3 criteria.A 12-month, individually tailored, progressive, and physiotherapist-supervised physical exercise twice a week (n=150) vs usual care (n=149).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 4 times at home over 12 months.FIM deteriorated in both groups over 12 months, -4.1 points (95% confidence interval [CI], -5.6 to -2.5) in the exercise group and -6.9 (95% CI, -8.4 to -2.3) in the usual care group (group P=.014, time P.001, interaction P=.56). The mean improvement in SPPB was significantly greater in the exercise group (1.6 [95% CI, 1.3-2.0]) than in the usual care group (0.01 [95% CI, -0.3 to 0.3]) (group P.001, time P=.11, interaction P=.027). The exercise group reported significantly fewer falls per person-year than the usual care group (incidence rate ratio, 0.47 [95% CI, 0.40-0.55]; P.001). There was no significant difference between the groups over 12 months in terms of handgrip strength, IADL function, or self-reported physical activity.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.
year | journal | country | edition | language |
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2021-12-01 | Archives of Physical Medicine and Rehabilitation |