Table 2.
Description of studies that included community-dwelling older adults.
|
N (%F) Mean age |
Inclusion criteria | Intervention characteristics | Outcome measurese | Quality | Reference |
|---|---|---|---|---|---|
| 188 (80) 83 |
Moderate and severe physical frail (walking test and chair stand test), >75b | Multicomponent training (resistance, balance, and flexibility), 24 weeks, 3/week, up to 60 min/session, 2 × 10 rep at three levels of difficulty | Walking speed (3 meters test); chair rises (3 times); test batteries (POMA, PPT); ADL disability (8 ADL scale, IADL scale); falls (fear of falling); utilization of resources (admission and days spent in nursing home) | 5 | [34–37] |
| 161 (71) 79 |
Frail (reduced physical activity and weight loss)b | Supervised group functional multicomponent training (aerobic, resistance, flexibility, speed, coordination, and skills training), 17 weeks, 2/week, 45 min/session, intensity 6–8 on a 10-point perceived exertion scale | Body composition (weight, muscle mass, fat mass, and bone mass); nutrition (energy and carbohydrate intake, fat and protein intake, haematological indicators, sensory performance, and appetite); biochemical (cellular immune response); neurological (visual stimulus reaction time, coordination); psychosocial state (social involvement); Groningen fitness test for the elderly (strength, flexibility, balance, block transfer, and reaction time); test batteries (functional performance based on six performance tests); ADL disability (self-reported ability to perform 16 ADL); QOL (Dutch scale of subjective wellbeing for older persons, self-rated health) | 4 | [22–29] |
| 155 (79) 77 |
Frail (SPPB and the indication of difficulty with ADL), >70b | Class-based multicomponent training (functional aerobic, resistance, and flexibility), 72 weeks, 3/week, 75 min/session | Only exercise compliance | 5 | [60] |
| 115 (52) 83 |
Mild-to-moderate physical frail (PPT, difficulty with ADL, and reduced peak aerobic power), >78b | Multicomponent (physical therapy, aerobic, and resistance), 36 weeks, 3/week, 20–60 min/session, 3 × 8–12 rep at 85–100% 1RM, 15 min at 65–70% VO2max and 3–5 min 85–90% VO2max | Body composition (weight, muscle mass, fat mass, and bone mass); nutrition (energy intake); cardio (VO2max, cardiac output, exercise HR and peak BP, resting HR and BP,and left ventricular stroke work); muscle function (lower and upper strength); balance (one leg stance, BBS); test batteries (PPT, functional status questionnaire); ADL disability (The Older American Resources and Services Instrument); QOL (SF-36) | 5 | [30–33] |
| 96 (60) 83 |
Frail (reduced physical activity and weight loss), >75, receiving home service, age under 75, body mass index <30 kg/m2 b | Multicomponent training (aerobic, resistance, and Qigong), 12 weeks, 2/week, 60 min/session, 60–80% intensity | Body composition (weight, muscle mass); nutrition (energy intake); psychosocial state (health belief model); muscle function (lower and upper strength); walking speed (10 meters test); chair rises (30 sec); TUG; stair climb (30 sec); balance (one leg and tandem stance, modified figure 8); ADL disability (FIM, IAM) | 3 | [74] |
| 84 (57) 83 |
Mild-to-moderate physical frail (PPT), >78, sedentary, living independently but with difficultyb | Low-intensity supervised multicomponent training (resistance, balance, flexibility, body handling skills, speed of reaction, and coordination), 12 weeks, 3/week, three levels of difficulty for each exercise | Neurological (visual stimulus reaction time, light touch and pressure sensation and proprioception, coordination); muscle function (lower and upper strength); flexibility (shoulder, hip, knee, trunk ROM); walking speed; balance (one leg stance, obstacle course, BBS); test batteries (PPT) | 2 | [64] |
| 77 (81) 81 |
Physical frail (at least one fall during the last year and used some kind of walking aid either indoors or outdoors), >75b | Functional multicomponent training (resistance, balance), 12 weeks, 2/week, 40 min/session | Psychosocial state (satisfaction); PA (interview, frequency and duration of outdoor walks); walking speed (3 meters test); QOL (SF-36) | 5 | [75] |
| 53 (100) 82 |
Frail (reduced physical activity and unable to get outdoors without walking aids or help from another person and/or subjective functional ability), >75, receiving practical and/or personal public home careb | Home-based multicomponent training (aerobic, resistance, flexibility, and dynamic balance), 20 weeks, 3/week, 26 min/session | Psychosocial state (mobility-tiredness scale); muscle function (lower power and upper strength); walking speed (10 meters test); chair rises (5 times); balance (stance); test batteries (PPT); QOL (EQ-5D questionnaire, self-rated health status) | 3 | [77] |
| 424 (69) 77 |
70–89, inactivity, risk for major mobility disability as indicated by a summary score of ≤9 on the SPPB (balance, mobility, strength)c | Multicomponent training (aerobic, resistance, balance, flexibility, and walking), 48 weeks, 1–3/week, 60 min/session, intensity based on Borg's RPE scale | Psychosocial state (self-efficacy for the 400-m walk, satisfaction with physical function); PA (CHAMPS questionnaire) | 5 | [66] |
| 13 (0) 75 |
>70, at risk for fall (history of fall past year, muscle weakness, measurable gait or balance impairment)c | Multicomponent training (resistance, balance, and walking), 12 weeks, 3/week, 60 min/session | Biochemical status (immune) | 3 | [61] |
| 46 (59) 81 |
Referred by their general practitioner and patients who could not leave their home by themselvesd | Multicomponent and comprehensive training (aerobic, resistance, balance, flexibility, rhythm, and reaction), 12 weeks, 2/week, 60 min/session | Body composition (muscle and fat mass), cardio (VO2max); muscle function (upper strength); walking speed (10 meters test); balance (BBS); QOL (SF-36) | 2 | [41, 42] |
| 100 (50) 78 |
Frail (inability to descend stairs step over step without holding the railing)b | Home-based resistance training, 10 weeks, 3/week | Muscle function (lower strength); walking speed (10 meters test); mobility endurance (6-minute walk test); chair rises (lowest height someone stands); balance (postural sway, functional reach); test batteries (mobility skills protocol); QOL (SF-36); falls (fear of falling) | 5 | [65] |
| 31 (35) 71 |
Moderate frail (PPT)c | Resistance training, 24 weeks, 3/week, 60 min/session, 3 × 8 rep based on 1RM | Body composition (muscle mass, muscle fiber distribution); biochemical (IGF-I); muscle function (KE strength) | 2 | [62] |
| 21 (100) 78 |
>70, SPPB score 4–10 (balance, mobility, strength)c | Progressive resistance training (mobility task specific and one component at the fastest possible velocity), 12 weeks, 3/week, 30 min/session, 3 sets | Muscle function (lower power); walking speed (2.4 meters test); chair rises (5 times); balance (one leg stance); test batteries (SPPB) | 4 | [63] |
| 17 (71) 82 |
mild to moderate physical frail (PPT and difficulty with ADL)b | Resistance training, 24 weeks, 3/week, initially 1–2 × 6–8 rep at 65–75% 1RM and progressed to 3 × 8–12 rep at 85–100% 1RM | Body composition (weight, muscle mass); biochemical status (muscle protein synthesis, TNF-α, LPL protein content); muscle function (lower and upper strength) | 2 | [38–40] |
| 21 (48) 80 |
>65, Using the day care facility 2 or more times per weekd | Horse riding simulator training, 12 weeks, 2/week, 10–30 min/session, speed of the simulator based on the physical activity of participants | Walking Speed (5 meters test); TUG; Balance (stance, spinal alignment, and functional reach) | 2 | [86] |
bNonvalidated operational definition of frailty.
cAt least one frailty indicator in the inclusion criteria.
dNo frailty indicators on the inclusion criteria.
eSignificant between-group differences are shown in bold.
1RM: one repetition maximum; ADL: activities of daily living; BBS: Berg balance scale; BP: blood pressure; FIM: functional independence measure; HR: heart rate; IADL: instrumental activities of daily living; IAM: instrumental activity measure; IGF-I: insulin-like growth factor I; KE: knee extension; LPL: lipoprotein lipase; PA: physical activity; POMA: Tinetti performance-oriented mobility assessment; PPT: physical performance test; QOL: quality of life; rep: repetitions; ROM: range of motion; RPE: rating of perceived exertion; SF-36: medical outcomes survey short-form 36; SPPB: short physical performance battery; TNF-α: tumor necrosis factor alpha; TUG: timed up-and-go test; VO2max: maximal oxygen uptake.