Changes in physical performance and frailty-associated risk associated with participation in a community exercise programme: Findings from the ExWell cohort.

Abstract

Introduction: Exercise can improve physical function and reduce disability in older adults living with frailty. ExWell Medical is a national, community-based, medically supported group exercise program for people living with chronic conditions in Ireland.

Study aims/objectives: We aimed to evaluate the longitudinal association between baseline frailty status and outcomes including gait speed in ExWell programme participants.

Methods: This is a secondary data analysis of a prospective cohort study. All participants attending an ExWell Medical induction in the Dublin/Kildare regions January-September 2023 were invited to participate. At baseline, 12, and 24 weeks we collected data on socio-demographics; health behaviours; measures of physical function; patient-reported outcomes. The cohort were stratified by Clinical Frailty Scale category at baseline.

Results: We recruited 1290 participants (mean age 69 (SD:10.9) years; 60% female. At baseline 15% of participants were classified as frail, 23% prefrail, 62% robust. Baseline frailty was associated with a higher chronic condition count, higher health service use, poorer scores on measures of physical function, EQVAS, EQ5D5L index scores. There was an inverse association between frailty and class attendance (p < 0.001). Attrition increased with increasing baseline frailty status (p = 0.006). Participants who were frail at baseline had improvements between baseline and 24-week reassessment in gait speed, timed up and go, six-minute time trial, EQVAS; prefrail participants in the sit to stand test, six-minute time trial, EQVAS, but no improvement in timed up and go. Robust participants recorded improvements in all measures.

Conclusion: Participation in the ExWell programme was associated with improvements across frailty groups in community-dwelling adults living with chronic conditions.