Table 1.

Overview of home-based exercise research in frail older adults

Authors	Subjects	Inclusion criteria	Intervention	Outcomes
Clegg et al. [19] (2014)	N = 84 Men and women Ave age: 78.7 + 9.2 years Location: UK	1. Living at home 2. Housebound (unable to leave house W/o assistance of another person 3. Spectrum of frailty > 30 s = level I (simple chair ex) 20–29 s = level 2 intermediate level < 20 s = level 3 independently mobile 4. Edmonton Frail Scale (EFS) (> 8 = frail w/ max score of 17 = highest level of frailty)	Duration: 12 weeks Groups: 1. Physical activity (n = 45) 2. Control group: usual care form primary healthcare team (n = 39) Physical activity intervention details: Frequency: 3 times per day/5 days per week Mode: strengthening exercises Progression: 5 reps to 10 then 15 Delivery: exercise manual with 5 face-to-face home visits & 7 phone calls by trained physiotherapists)	Timed up and go Barthel Index of ADL (assess function/ADL) QOL (EQ-D5) Depression—Geriatric Depression Scale
Luger et al. [15] (2016)	N = 80 Men and women Ave age: 82.8 + 8.0 years Location: Austria	1. > 65 years 2. Live in own homes 3. Pre-frail or frail based on frailty instrument of the Survey of Health, Ageing, and Retirement Group (SHARE-FI) 4. Able to walk with or without walking aid	Duration: 12 weeks Groups: 1. Physical activity and nutrition program (PTN) (n = 39) 2. Control group: Social support (SoSu) (n = 41) PTN group: Exercise details: Frequency: 2 times per week (plus encouraged 1×/week. on own) Mode: Strength exercises 2 sets of 6 strength exercises, discussed nutritional topics, social support Progression: 2 × 15 until failure—if all reps could not be completed reps increased 1st then intensity progressed (stronger band) Each session: Warm up with mobilization, circuit of exercises (mini squats in front of a chair, chest press (res band), ab exerc, hip extensions standing, reverse flys and shoulder press with band) Delivery: Trained lay volunteers (“Buddies”) for all sessions Nutrition details: Focused on fluid, protein, and energy intake Control details: SoSu only	Nutrition (Mini Nutritional Assessment Long Form) Frailty status (SHARE-FI)
Takatori et al. [21] (2016)	N = 266 Women only Ave age: 75 + 5.0 yrs Location: Japan	1. Frail elderly based on Kibon Checklist 2. No dementia diagnosis	Duration: 6 months Groups: 1. Exercise (n = 148) 2. Control (n = 118) Exercise details: Frequency: At least 3 times per week Mode: Stretching, breathing, balance, and strength exercises Progression: No details provided Each session: 5-min long Delivery: One session with physical therapist to learn exercises Then self-lead with brochure and DVD of exercise program Control details: Advised to maintain or improve daily activity and attended lectures on health Duration: 6 months Group: 1. Physical activity Physical activity Intervention details: Frequency: 5 times per week Mode: Strength and balance exercises Progression: 10 min/day and progressed to 45 min/day Delivery: Tablet for exercise instruction and necklace worn for daily activity registration 1st 3 months: Supervised via weekly telephone for coaching 2nd 3 months: Not contacted at all, but could call coach if needed necklace worn sensory for daily activity registration Duration: 12 weeks Groups: 1. Physical activity and nutrition program (PTN) (n = 39) 2. Control group: Social support (SoSu) (n = 41) PTN group: Exercise details: Frequency: 2 times per week (plus encouraged 1×/week. on own) Mode: Strength exercises 2 sets of 6 strength exercises, discussed nutritional topics, social Progression: 2 × 15 until failure—if all reps could not be completed reps increased 1st then intensity progressed (stronger band) Each session: Warm up with mobilization, circuit of exercises (mini squats in front of a chair, chest press (res band), ab exerc, hip extensions standing, reverse flys and shoulder press with band) Delivery: Trained lay volunteers (“Buddies”) for all sessions Nutrition details: Focused on fluid, protein, and energy intake Control details: SoSu only	Swallow-related function: Voluntary peak cough flow (VPCF) Lip closure force Balance (static and dynamic) Static: Stabilometer with open and closed eyes Dynamic: 5 m walk, timed up and go, functional Reach test Lower limb strength (dynamometer, 30-s chair stands) Flexibility (sit-and-reach Test) Feasibility Adherence Retention Feasibility Adherence Technical and operational feasibility Determinants of participation Participant satisfaction Hand grip (dynamometer) Short physical performance battery Muscle mass (BIA) Dropout rate Adverse events Adherence freq/duration home visits # sets per home visit p#p oofr texercises done per visit # reps # of circuits completed between visits
Haider et al [17] (2017)	N = 53 Men and women Ave age: 82.4 + 8.2 years Location: Austria	1. > 65 years 2. Live in own homes 3. Pre-frail or frail based on SHARE-FI 4. Able to walk with or without walking aid	Duration: 12 weeks Groups: 1. Physical activity and nutrition program (PTN) (n = 35) 2. Control group: Social support (SoSu) (n = 23) PTN group: Exercise details: Frequency: 2 times per week (plus encouraged 1×/week. on own) Mode: Strength exercises 2 sets of 6 strength exercises, discussed nutritional topics, social support Progression: 2 × 15 until failure—if all reps could not be completed reps increased 1st then intensity progressed (stronger band) Each session: Warm up with mobilization, circuit of exercises (mini squats in front of a chair, chest press (res band), ab exerc, hip extensions standing, reverse flys and shoulder press with band) Delivery: Trained lay volunteers (“Buddies”) for all sessions Nutrition details: Focused on fluid, protein, and energy intake Control details: SoSu only
Kapan et al. [18] (2017)	N = 80 Men and women Ave age: 82.6 + 8.1 years Location: Austria	1. > 65 yrs 2. Live in own homes 3. Pre-frail or frail based on SHARE-FI 4. Able to walk with or without walking aid	Duration: 12 weeks Groups: 1. Physical activity and nutrition program (PTN) (n = 39) 2. Control group: Social support (SoSu) (n = 41) PTN group: Exercise details: Frequency: 2 times per week (plus encouraged 1×/week. on own) Mode: Strength exercises 2 sets of 6 strength exercises, discussed nutritional topics, social support Progression: 2 × 15 until failure—if all reps could not be completed reps increased 1st then intensity progressed (stronger band) Each session: Warm up with mobilization, circuit of exercises (mini squats in front of a chair, chest press (res band), ab exerc, hip extensions standing, reverse flys and shoulder press with band) Delivery: Trained lay volunteers (“Buddies”) for all sessions Nutrition details: Focused on fluid, protein, and energy intake Control details: SoSu only	Quality of life WHOQOL-OLD and WHOQOL-BREF)
Hsieh et al. [22] (2019)	N = 319 Men and women Ave age: 71.6 + 5.7 years Location: Taiwan	1. > 65 years 2. Cardiovascular Health Study criteria for frail and pre-frail (Fried) 3. Walk 14 m independently 4. Living in the home Exercise intervention details: Frequency: 3–7 sessions per week Mode: Strength, flexibility, balance, and endurance training Progression: 5 min to 60 min/session (repetitions based on participant’s capabilities) Delivery: Self-lead Nutrition intervention details: Weight maintenance with adequate food intake achieved with a designated number of servings of 6 major food groups (dairy, protein, vegetables, fruits, nuts, seeds, plant oils, grains/roots) Control group details: Regular medical care with telephone contact	Duration: 6 months (3-month intervention + 3-month follow-up) Groups: 1. Exercise only—individualized 2. Nutrition only 3. Exercise plus nutrition (combo) 4. Control group	Frailty (Primary; CHS) Physical performance (10 m, flex, lower ST, balance, handgrip, PA vol) Depression (Geriatric Depression Scale) Quality of life (Short Form Health Survey)