MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults
Publication: Applied Physiology, Nutrition, and Metabolism
15 November 2022
Abstract
Exercise and nutrition interventions are often recommended for frailty; however, effective strategies are required for real-world implementation. Our primary aim was to assess the feasibility and acceptability of telephone and virtual delivery of MoveStrong, an 8-week exercise and nutrition program with a 4-week follow-up for older pre-frail and frail adults. A priori criteria for success included: recruitment (≥25/12 weeks), retention at follow-up (≥80%), and adherence to exercise and nutrition sessions (≥70%). We recruited community-dwelling Ontario residents; ≥60 years, ≥1 chronic condition, ≥1 FRAIL scale score. Participants received mailed materials, a personalized exercise program, 11 remote one-on-one training sessions with an exercise physiologist and 3 online dietitian-led nutrition education sessions. We completed exploratory analyses of secondary outcomes including physical function and dietary protein intake. Semi-structured interviews supported program evaluation. In total, 30 participants were enrolled. 28 (93%) participants completed program and follow-up assessments. Adherence to exercise and nutrition sessions (CI) was 84% (77%–91%) and 82% (70%–93%) respectively. At program end and follow-up [mean change (CI)], significant improvements were measured in 30-second chair stand test [3.50 (1.12–5.86), 4.54 (1.94–7.13) chair stands] and dietary protein intake [12.9 (5.7–20.0), 9.2 (0.4–18.1) g]. Overall, participants were satisfied with program delivery. Trial registration number: NCT04663685.
Résumé
Les interventions d'exercice et de nutrition sont souvent recommandées pour ne pas être aux prises avec la fragilité. Cependant, des stratégies efficaces sont nécessaires pour une mise en œuvre dans le monde réel. Notre objectif principal était d'évaluer la faisabilité et l'acceptabilité de la prestation téléphonique et virtuelle de MoveStrong, d’un programme d'exercice et de nutrition de 8 semaines comportant un suivi de 4 semaines pour les adultes âgés préfragiles et fragiles. Les critères a priori de succès comprenaient : le recrutement (≥25/12 semaines), la rétention lors du suivi (≥80 %) et l'observance des séances d'exercice et de nutrition (≥70 %). Nous avons recruté des résidents de l'Ontario vivant dans la communauté; ≥60 ans, ≥1 maladie chronique, ≥1 score sur l'échelle FRAIL. Les participants ont reçu du matériel par la poste, un programme d'exercice personnalisé, onze séances de formation individuelles à distance avec un physiologiste de l'exercice et trois séances d'éducation nutritionnelle en ligne dirigées par une diététiste. Nous avons effectué des analyses exploratoires des critères de jugement secondaires, y compris la fonction physique et l'apport en protéines alimentaires. Des entrevues semi-structurées ont appuyé l'évaluation du programme. Au total, 30 participants ont été inscrits et 28 (93 %) ont terminé le programme et les évaluations de suivi. L'adhésion aux séances d'exercice et de nutrition (IC) était de 84 % (77–91 %) et 82 % (70–93 %) respectivement. À la fin du programme et au suivi (changement moyen [IC]), des améliorations significatives ont été mesurées dans le test assis-debout de 30 secondes [3.50 (1.12–5.86), 4.54 (1.94–7.13) et au sujet de l'apport en protéines alimentaires [12.9 (5.7–20.0), 9.2 (0.4–18.1) g]. Dans l'ensemble, les participants étaient satisfaits de la prestation du programme. Numéro d'enregistrement de l'essai: NCT04663685. [Traduit par la Rédaction]
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Published In
Applied Physiology, Nutrition, and Metabolism
Volume 47 • Number 12 • December 2022
Pages: 1172 - 1186
History
Received: 9 May 2022
Accepted: 31 August 2022
Accepted manuscript online: 15 September 2022
Version of record online: 15 November 2022
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© 2022 The Author(s). Permission for reuse (free in most cases) can be obtained from copyright.com.
Data Availability Statement
Data generated or analyzed during this study are available from the corresponding author upon reasonable request.
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Author Contributions
Ellen Wang: Project administration, investigation, formal analysis, data curation, writing—original draft, visualization. Heather Keller and Lora Giangregorio: Supervision, funding acquisition, conceptualization, methodology, writing—review and editing, resources. Isabel Rodrigues: Conceptualization, methodology, writing—review and editing. Alex Steinke: Project administration, investigation, writing—review and editing. Lehana Thabane: Formal analysis, methodology, writing—review and editing. All Authors: Methodology, writing—review and editing.
Competing Interests
Angela M. Cheung is the chair of the ISCD Canadian Panel, a member of then Endocrine Society Clinical Guidelines Committee and a member of the Osteoporosis Canada Guidelines Committee. All other authors declare that there are no competing interests.
Funding Information
This research was supported by the Network for Aging Research COVID-19 and Aging Grant, from the University of Waterloo. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Ellen Wang, Heather Keller, Marina Mourtzakis, Isabel B. Rodrigues, Alex Steinke, Maureen C. Ashe, Lehana Thabane, Sheila Brien, Larry Funnell, Angela M. Cheung, Jamie Milligan, Alexandra Papaioannou, Zachary J. Weston, Sharon Straus, and Lora Giangregorio. 2022. MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults. Applied Physiology, Nutrition, and Metabolism. 47(12): 1172-1186. https://doi.org/10.1139/apnm-2022-0195