Enhancing the physical activity levels of frail older adults with a wearable activity tracker‐based exercise intervention: A pilot cluster randomized controlled trial

A wearable activity tracker (WAT) incorporated with behavioral change techniques (BCTs) increases physical activity in younger adults; however, its effectiveness with frail older adults is unknown. The feasibility and preliminary effects of a WAT‐based exercise intervention to increase physical activity levels in frail older adults was investigated in this pilot study involving 40 community‐dwelling frail older adults. The experimental group received a 14‐week WAT‐based group exercise intervention and a 3‐month follow‐up, while the control group only received similar physical training and all BCTs. The recruitment rate was 93%, and the average attendance rate was 85.2% and 82.2% in the WAT and control groups, respectively, establishing feasibility. Adherence to wearing the WAT was 94.2% and 92% during the intervention and follow‐up periods, respec-tively. A significant interaction effect between time and group was found in all physical assess-ments, possibly lasting for 3 months post‐intervention. However, no significant difference between groups was observed in any daily activity level by the ActiGraph measurement. The majority of the WAT group’s ActiGraph measurements reverted to baseline levels at the 1‐month follow‐up. Thus, the WAT‐based exercise program has potential for employment among community‐dwelling frail older adults, but sustaining the effects after the intervention remains a major challenge

Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial

Background: To the best of our knowledge, although ageing-induced fatigue could cause adverse outcomes such as frailty, there is currently no intervention for it. This study evaluated the effects of an individualised exercise programme with/without BCE strategies on reducing fatigue in older adults. Methods: A three-armed cluster-randomised controlled trial (RCT) was conducted with 184 participants (mean age: 79.1 ± 6.4; mean frailty score: 2.8 + 0.8) from 21 community centres (ClinicalTrials.gov: NCT03394495). They were randomised into either: the COMB group (n = 64), receiving 16 weeks of exercise training plus the BCE programme; the EXER group (n = 65), receiving exercise training and health talks; or the control group (n = 55), receiving only health talks. Fatigue was assessed using the Multi-dimensional Fatigue Inventory (range: 20 to 100, with higher scores indicating higher fatigue levels) at baseline, and immediately, 6 months, and 12 months post-intervention. Results: The GEE analyses showed significant interaction (time x group) between the COMB and control groups immediately (p &lt; 0.001), 6 months (p &lt; 0.001), and 12 months (p &lt; 0.001) post-intervention. Comparing the COMB and EXER groups, there was a significant interaction immediately (p = 0.013) and at 12 months post-intervention (p = 0.007). However, no significant difference was seen between the EXER group and control group at any time point. Conclusions: The COMB intervention showed better immediate and sustainable effects (i.e., 12 months after the intervention) on reducing fatigue in frail older adults than exercise training or health education alone. Trial registration: ClinicalTrials.gov (NCT03394495), registered on 09/01/2018.</p

Play activities program to relieve chronic pain and enhance functional mobility and psychological well-being for frail older adults: a pilot cluster randomized controlled trial

Chronic pain is common in frail older adults. Pain can alter psychological status, causing higher levels of loneliness and depression and lower levels of happiness and life satisfaction. Pain hinders functional mobility and activities of daily living, and frail older adults consequently participate less in social activities, resulting in a deterioration of physical health and quality of life. Play activities are widely used in children, and their therapeutic effects are well established. Benefits include better communication skills, social skills, and cognitive ability.Play activities are also effective in reducing fear and anxiety for hospitalized children4 and postsurgical pain in children.5The social effects of play activities may help to reduce pain.6Older adults living in nursing homes tend to be lonelier and more socially isolated than individuals of other ages, which places them at greater risk of negative consequences of pain. The literature on play activities for older adults is scanty, but the potential beneficial effects of play activities in this age group warrant investigation. It was therefore the aim of this study to explore the therapeutic effects of play activities on the physical and psychological health of frail older adults

Play Activities Program to Relieve Chronic Pain and Enhance Functional Mobility and Psychological Well-Being for Frail Older Adults: A Pilot Cluster Randomized Controlled Trial

School of NursingDepartment of Rehabilitation SciencesDepartment of Applied Social Science