Travers John, Romero-Ortuno Roman, Cooney Marie-Therese
School of Medicine, University College Dublin, Dublin.
Trinity College Dublin HSE Specialist Training Programme in General Practice, Dublin.
EClinicalMedicine. 2022 Mar 22;46:101355. doi: 10.1016/j.eclinm.2022.101355. eCollection 2022 Apr.
Resistance exercises have been shown to prevent and reverse frailty but their application in clinical practice is low. We wished to test the feasibility of an optimised exercise intervention for mild or pre-frailty in a primary-care setting and inform the design of a definitive randomised control trial.
The intervention was co-designed with eighteen older adults in two group workshops, informed by systematic review and meta-analysis. Eligible patients aged 65+, mildly frail or less, presenting to an Irish primary-care centre over 6 months from January 2020 were invited to participate. They were offered an exercise guide and educational discussion. Demographics, health indicators and frailty scores were recorded. Feasibility was assessed using the Bowen model for acceptability; participation; demand; implementation; practicality; adaptation; integration; expansion; and limited-efficacy. Half of the randomly selected participants were telephoned after one month, and all the participants were called after two to measure effects on adherence.
94 of 107 eligible people (88%) participated (average age 77, 59 women (63%)). Only 15% had previously considered resistance exercises. The intervention satisfied all Bowen feasibility criteria. At one month, 65% of participants were exercising. At two months, adherence amongst those previously called was higher: 78%. 87% described exercises as 'very easy' or 'somewhat easy'. 66% felt 'much better' or 'slightly better'.
Frailty intervention uptake and adherence were high. A single telephone call appeared to help increase adherence. Participants reported meaningful physical and mental health benefits.
Roman Romero-Ortuno is funded by a grant from Science Foundation Ireland (SFI), grant number 18/FRL/6188.
抗阻运动已被证明可预防和逆转身体虚弱，但在临床实践中的应用率较低。我们希望在初级保健环境中测试针对轻度虚弱或虚弱前期的优化运动干预措施的可行性，并为确定性随机对照试验的设计提供信息。
该干预措施是在系统评价和荟萃分析的基础上，与18名老年人在两个小组研讨会上共同设计的。邀请了2020年1月起6个月内到爱尔兰初级保健中心就诊的65岁及以上、轻度虚弱或更轻的符合条件的患者参与。为他们提供了运动指南和教育讨论。记录了人口统计学、健康指标和虚弱评分。使用鲍恩模型评估可行性，包括可接受性、参与度、需求、实施、实用性、适应性、整合性、扩展性和有限效果。随机选择的参与者中有一半在一个月后接到电话，所有参与者在两个月后接到电话以测量对依从性的影响。
107名符合条件的人中，94人（88%）参与（平均年龄77岁，59名女性（63%））。只有15%的人之前考虑过抗阻运动。该干预措施满足了所有鲍恩可行性标准。在一个月时，65%的参与者在进行运动。在两个月时，之前接到电话的参与者的依从性更高：78%。87%的人将运动描述为“非常容易”或“有点容易”。66%的人感觉“好多了”或“稍微好一点”。
虚弱干预措施的接受度和依从性很高。一次电话回访似乎有助于提高依从性。参与者报告了对身心健康有显著益处。
罗曼·罗梅罗 - 奥图诺由爱尔兰科学基金会（SFI）的一项拨款资助，拨款编号为18/FRL/6188。
