Integrated Care and Lower Extremity Strength Training Among Community-Dwelling Frail Older Adults in Taiwan

National Taiwan University

Status: Completed

Conditions: Frailty

Treatments: Behavioral: lower extremity strength training; Behavioral: integrated care

Study type: Interventional

Funder types: Other

Identifiers

NCT02214485

201101038RC

Details and patient eligibility

About

Objective: To determine the differential effectiveness of integrated care (IC) and lower extremity strength training (LEST) among community-dwelling frail older adults in Taiwan.

Method: The investigators randomize participants at Bei-Hu site from the "Intervention study of Geriatric Frailty, Osteoporosis, and Depression in a Community Based Randomized Trial" into 12 weeks of either IC or LEST. Outcome assessments are performed at baseline, 12 weeks and 6 months after initiation of the interventions.

Interventions:

1. IC: Participants visit the study site with health education, social activities, warm up, stretch, and low intensity resistance exercise for about 1 hour per week. If any medical problems or functional decline suspected during the visit, the case manager refers participants to their primary care physicians for further managements.
2. LEST: Participants receive 2 sessions of 30-minute lower extremity strength straining using isotonic strength training machines each week. The intensity is set at 60-80% of 1 repetition maximum (RM). Evaluation of the exercise protocol are repeated every 2 weeks for individualized adjustments

Enrollment: 98 patients

Sex: All

Ages: 65 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Canadian Study of Health and Aging Clinical Frailty Scale (CSHA- CFS) Chinese In-Person Interview Version score is 3-6
• frailty index ≧ 1 (Cardiovascular Health Study Phenotypical Classification)。

Exclusion criteria

• age ≧ 80 years
• live in the nursing home.
• can not speak Chinese,Taiwanese.
• communication or hearing disorders affect daily activities.
• visual impairment or daily activities affect communication.
• another reason can not Communication or finish Canadian Study of Health and Aging Clinical Frailty Scale (CSHA- CFS) Chinese In-Person Version
• study of Health and Aging Clinical Frailty Scale (CSHA- CFS) Chinese In-Person Interview [9, 10]Version score is 0-2 and 7.
• communication or cognitive impairments affect daily activities(Exclusion 3-Item Recall score is <=1)
• can not stand to walk (available walkers) 5 meters, or unsteady gait when walking five meters, it looks fast fall
• there is serious risk of suicide (defined as: Suicide risk assessment score> = 6 points)
• alcoholism (defined as: the problem of alcoholism Chinese people self-administered screening questionnaire CAGE have two questions (including) above answer is "yes"
• long-term epilepsy, brain tumor, brain surgery, schizophrenia or bipolar disorder

Trial design

98 participants in 2 patient groups

integrated care (IC)

Experimental group

Description:

Subjects will receive such care twice weekly for 12 weeks.

Treatment:

Behavioral: integrated care

lower extremity strength training (LEST)

Experimental group

Description:

Subjects will receive training twice weekly for 12 weeks

Treatment:

Behavioral: lower extremity strength training