Effectiveness of a theory-underpinning exercise intervention among community-dwelling (pre)frail older adults: A stepped-wedge cluster-randomized trial

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-10-23 DOI:10.1016/j.ijnurstu.2024.104933

Xiaoxia Qiao , Lili Ji , Yaru Jin , Huaxin Si , Yanhui Bian , Wenyu Wang , Qinqin Liu , Jiaqi Yu , Wendie Zhou , Cuili Wang

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引用次数: 0

Abstract

Objectives

To evaluate the effectiveness of a theory-underpinning exercise intervention among Chinese community-dwelling (pre)frail older adults, and the impacts of intervening late as opposed to intervening early.

Methods

This was a stepped-wedge cluster-randomized trial. Participants were enrolled from six communities in a county of central China from January to November in 2021 (n = 149). A 12-week exercise intervention based on the integration of Health Belief Model, Theory of Planned Behavior and Health Action Process Approach was implemented among 149 community-dwelling (pre)frail older adults during the study period. The primary outcomes were frailty and muscle mass, muscle strength and physical performance. Secondary outcomes included physical disability, fear of falling, cognitive function, depressive symptoms, social support and quality of life. Assessments were conducted at baseline and at 12, 24 and 36 weeks. A multilevel regression model was used for statistical analysis.

Results

The positive effects were statistically significant on frailty (β = − 1.166, p = 0.016), muscle mass (β = 1.499, p = 0.005), handgrip strength (β = 14.758, p < 0.001), physical performance (Short Physical Performance Battery, β = 6.043, p < 0.001), physical disability (Activities of Daily Living: β = 0.462, p = 0.043; Instrumental Activities of Daily Living: β = 0.693, p = 0.049;) and fear of falling (β = − 1.490, p = 0.003), cognitive function (β = − 0.466, p = 0.011), depressive symptoms (β = − 0.541, p < 0.001), social support (β = 27.661, p < 0.001), physical (β = 2.413, p = 0.013) and mental (β = 7.837, p < 0.001) components of quality of life at 0-week postintervention, and most of them persisted at 12- and 24-week postintervention. The effectiveness significantly differed by the time of interventions on muscle mass (β = − 1.217, p = 0.002), 5-time chair stand test (β = − 1.172, p = 0.018), cognitive function (β = 0.600, p = 0.014) and mental component of quality of life (β = − 12.679, p = 0.002).

Conclusion

The theory-underpinning exercise intervention has positive immediate and persistent effects on frailty, frailty-related characteristics as well as physical, mental and social functioning among Chinese community-dwelling (pre)frail older adults. Late intervention attenuated the significant intervention effect.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100041981.

查看原文本刊更多论文

在社区居住的（前期）体弱老年人中开展理论基础运动干预的效果：阶梯式楔形分组随机试验

目标评估在中国社区居住的（前期）体弱老年人中开展理论基础运动干预的效果，以及晚干预与早干预的影响。方法这是一项阶梯式分组随机试验。参与者于2021年1月至11月在中国中部某县的6个社区登记（n = 149）。在研究期间，根据健康信念模式、计划行为理论和健康行动过程方法，对149名社区（前期）体弱老年人进行了为期12周的运动干预。主要结果是虚弱程度、肌肉质量、肌肉力量和身体表现。次要结果包括身体残疾、跌倒恐惧、认知功能、抑郁症状、社会支持和生活质量。评估在基线、12 周、24 周和 36 周时进行。结果对虚弱（β = - 1.166，p = 0.016）、肌肉质量（β = 1.499，p = 0.005）、手握力（β = 14.758, p < 0.001）、体能（短期体能测试，β = 6.043, p < 0.001）、肢体残疾（日常生活活动：β = 0.462, p = 0.043；器质性日常生活活动：β = 0.693，p = 0.049；）和跌倒恐惧（β = - 1.490，p = 0.003）、认知功能（β = - 0.466，p = 0.011）、抑郁症状（β = - 0.541，p < 0.001）、社会支持（β = 27.661，p < 0.在干预后 0 周，生活质量的身体（β = 2.413，p = 0.013）、心理（β = 7.837，p <0.001）、社会支持（β = 27.661，p <0.001）、生理（β = 2.413，p = 0.013）和精神（β = 7.837，p <0.001）组成部分均有显著改善，其中大部分在干预后 12 周和 24 周仍有改善。不同干预时间对肌肉质量（β = - 1.217，p = 0.002）、5 次椅子站立测试（β = - 1.172，p = 0.018）、认知功能（β = 0.600，p = 0.014）和生活质量的心理部分（β = - 12.结论以理论为基础的运动干预对中国社区（前）体弱老年人的体弱、体弱相关特征以及身体、精神和社会功能具有积极的直接和持续影响。试验注册中国临床试验注册中心ChiCTR2100041981.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).