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J Am Geriatr Soc. 2019 Mar 19. doi: 10.1111/jgs.15824. [Epub ahead of print]

Effects of Multicomponent Exercise on Frailty in Long-Term Nursing Homes: A Randomized Controlled Trial.

Author information

1
Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.
2
Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Donostia, Spain.
3
Matia Instituto, Donostia, Spain.
4
Matia Fundazioa, Donostia, Spain.
5
Caser Betharram, Hondarribia, Spain.

Abstract

OBJECTIVES:

To determine the effect of multicomponent exercise on frailty and related adverse outcomes in residents of long-term nursing homes (LTNHs).

DESIGN:

A single-blind randomized controlled trial.

SETTING:

Ten LTNHs in Gipuzkoa, Spain.

PARTICIPANTS:

The study sample comprised 112 men and women aged 70 years or older who scored 50 or higher on the Barthel Index, 20 or higher on the MEC-35 test (an adapted and validated version of the Mini-Mental State Examination in Spanish), and who were capable of standing up and walking independently for at least 10 m.

INTERVENTION:

Subjects in the control group (CG) participated in routine activities. The intervention group (IG) participated in a 6-month program of individualized and progressive multicomponent exercise at moderate intensity.

MEASUREMENTS:

Frailty was assessed by four different scales at baseline and at 6 months. The Barthel Index was measured at baseline and at 12 months. Frailty-related adverse outcomes were recorded from 12 months before to 12 months after starting the intervention.

RESULTS:

A lower prevalence of frailty was observed in the IG compared with the CG according to Fried's frailty phenotype, Short Physical Performance Battery, and Tilburg Frailty Indicator after 6 months (p < .05). There was a decline in the CG on the Barthel Index after 12 months (p < .05), whereas score was maintained in the IG. Both groups experienced a similar number of falls before and after the intervention (p > .05), but during the 6-month intervention period, fewer falls were observed in the IG than the CG (p < .05). Lower overall mortality was observed 12 months after starting the intervention for the IG than the CG (1 vs 6, respectively; p = .05).

CONCLUSION:

Individualized and progressive multicomponent exercise at moderate intensity seems to be effective to prevent falls and reduce frailty and mortality.

KEYWORDS:

falls; frailty; mortality; nursing home; physical exercise

PMID:
30891748
DOI:
10.1111/jgs.15824

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