Barros Duarte, Johansson Jonas, Wilsgaard Tom, Magalhães José, Carvalho Joana, Marques Elisa A
CIAFEL-Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
Geroscience. 2025 Jul 16. doi: 10.1007/s11357-025-01770-y.
This parallel two-arm pragmatic controlled trial aimed to examine the effectiveness of a 12-month exercise intervention on physical performance, handgrip strength, independence in basic activities of daily living (BADL), and falls in real-world settings. Ninety-five older residents of nursing homes (mean age 81.9 ± 8.0 years) were allocated to either an exercise (n = 43) or usual care only (n = 52) group. The 12-month exercise training consisted of resistance and aerobic exercises (2 days/week), while the usual care consisted of everyday routine and standard care. The primary endpoint was the change in physical performance measured by the short physical performance battery (SPPB, score range 0-12). The secondary endpoints were changes in handgrip strength, independence in BADL measured by the Barthel index (BI), and the rate of falls. The exercise intervention significantly provided benefits over usual care on SPPB score by 2.59 points (95% CI: 1.75, 3.43) and handgrip strength by 1.85 kgf (95% CI: 0.56, 3.14). No significant between-group differences were observed for the BI or the rate of falls. However, within-group analysis revealed a significant decline in the BI score (- 11.8) and an increase in the rate of falls (+ 31.5 falls per 100 person-years) in the usual care group. Long-term concurrent exercise programme significantly improved physical performance and handgrip strength, but not independence in BADL and rate of falls in mostly frail nursing home residents. These findings support the integration of exercise physiologists and exercise programmes into standard care practices in nursing homes to help preserve physical function among residents.
这项平行双臂实用性对照试验旨在研究为期12个月的运动干预对实际生活环境中身体机能、握力、基本日常生活活动（BADL）独立性及跌倒情况的有效性。95名养老院老年居民（平均年龄81.9±8.0岁）被分配至运动组（n = 43）或仅接受常规护理组（n = 52）。为期12个月的运动训练包括阻力训练和有氧运动（每周2天），而常规护理包括日常活动和标准护理。主要终点是通过简短身体机能测试（SPPB，评分范围0 - 12）测量的身体机能变化。次要终点是握力变化、通过巴氏指数（BI）测量的BADL独立性变化以及跌倒发生率。运动干预在SPPB评分上比常规护理显著高出2.59分（95%CI：1.75，3.43），在握力上高出1.85千克力（95%CI：0.56，3.14）。在BI或跌倒发生率方面未观察到显著的组间差异。然而，组内分析显示常规护理组的BI评分显著下降（-11.8），跌倒发生率增加（每100人年增加31.5次跌倒）。长期同时进行的运动计划显著改善了身体机能和握力，但对于大多数身体虚弱的养老院居民，并未改善BADL独立性和跌倒发生率。这些发现支持将运动生理学家和运动计划纳入养老院的标准护理实践中，以帮助维持居民的身体功能。
