Effects of Multicomponent Exercise on Frailty in Long-Term Nursing Homes: A Randomized Controlled Trial.

OBJECTIVES: To determine the effect of multicomponent exercise on frailty and related adverse outcomes in residents of long-term nursing homes (LTNHs).

DESIGN: A single-blind randomized controlled trial.

SETTING: Ten LTNHs in Gipuzkoa, Spain.

PARTICIPANTS: The study sample comprised 112 men and women aged 70 years or older who scored 50 or higher on the Barthel Index, 20 or higher on the MEC-35 test (an adapted and validated version of the Mini-Mental State Examination in Spanish), and who were capable of standing up and walking independently for at least 10 m.

INTERVENTION: Subjects in the control group (CG) participated in routine activities. The intervention group (IG) participated in a 6-month program of individualized and progressive multicomponent exercise at moderate intensity.

MEASUREMENTS: Frailty was assessed by four different scales at baseline and at 6 months. The Barthel Index was measured at baseline and at 12 months. Frailty-related adverse outcomes were recorded from 12 months before to 12 months after starting the intervention.

RESULTS: A lower prevalence of frailty was observed in the IG compared with the CG according to Fried's frailty phenotype, Short Physical Performance Battery, and Tilburg Frailty Indicator after 6 months (p < .05). There was a decline in the CG on the Barthel Index after 12 months (p < .05), whereas score was maintained in the IG. Both groups experienced a similar number of falls before and after the intervention (p > .05), but during the 6-month intervention period, fewer falls were observed in the IG than the CG (p < .05). Lower overall mortality was observed 12 months after starting the intervention for the IG than the CG (1 vs 6, respectively; p = .05).

CONCLUSION: Individualized and progressive multicomponent exercise at moderate intensity seems to be effective to prevent falls and reduce frailty and mortality.