Multicomponent physical exercise program among community-dwelling older adults who are users of home care services: a quasi-experimental pilot study

To analyze the feasibility and preliminary effectiveness of a multicomponent physical exercise program (MPEP) among community-dwelling older adults receiving home care services (HCS). A quasi-experimental pilot study was conducted with 44 participants allocated by preference for pragmatic considerations to MPEP or control group (NCT05726214, ClinicalTrails.gov). Over 16 weeks, the MPEP included strength, balance, flexibility, and aerobic exercises through one weekly physiotherapist-led face-to-face session plus two home-based Vivifrail (evidence-based multicomponent exercise program) sessions tailored to participants’ functional level. Feasibility was assessed through recruitment, adherence, safety and acceptability. Physical performance; nutritional, psycho-affective and cognitive status; and frailty were measured at baseline and post-intervention. The completion rate was 77%. Face-to-face session attendance and compliance were 83% and 73%, respectively. At-home compliance was 71%. No severe adverse events occurred. Satisfaction was 9/10. Group-by-time analyses suggested improvements in the MPEP group for the Short Physical Performance Battery (η2ₚ=0.154) and Fried Frailty Scale (η2ₚ=0.164). Frailty decreased on both scales (OR = 0.142 and 0.125). No further significant effects were observed. The assessed intervention is feasible and suggests benefits in improving physical function and reducing frailty among older adults receiving HCS. Further robust studies, including explanatory and pragmatic randomised controlled trials are needed. Exercise interventions are key to preserving functionality and delaying disability, supporting older adults’ preference to remain independent at home and in their communities.A multicomponent exercise programme combining supervised group and home-based sessions is feasible, safe and well-accepted by this population.The intervention improves physical function and reduces frailty after 16 weeks, showing promise as an early rehabilitation strategy. Exercise interventions are key to preserving functionality and delaying disability, supporting older adults’ preference to remain independent at home and in their communities. A multicomponent exercise programme combining supervised group and home-based sessions is feasible, safe and well-accepted by this population. The intervention improves physical function and reduces frailty after 16 weeks, showing promise as an early rehabilitation strategy.

本研究旨在分析多组分体育锻炼方案（multicomponent physical exercise program, MPEP）在接受居家照护服务（home care services, HCS）的社区居住老年人中的可行性与初步有效性。本研究采用类实验预试验（quasi-experimental pilot study）设计，基于实用性考量按偏好将44名参与者分配至多组分体育锻炼方案组或对照组（临床试验注册号：NCT05726214，ClinicalTrails.gov）。干预周期为16周，该方案涵盖力量、平衡、柔韧性与有氧运动，包含每周1次由物理治疗师主导的面对面授课，以及2次基于参与者功能水平定制的居家Vivifrail（循证多组分锻炼方案）训练。可行性通过招募情况、依从性、安全性与可接受性进行评估；于基线与干预后阶段测量参与者的躯体表现、营养、心理-情感及认知状态，以及衰弱程度。
本研究完成率为77%。面对面授课的出勤率与依从率分别为83%与73%，居家训练依从率为71%。未发生严重不良事件，参与者满意度为9/10分。组间-时间交互分析显示，多组分体育锻炼方案组在简短体能表现量表（Short Physical Performance Battery, SPPB）与弗里德衰弱量表（Fried Frailty Scale）上均有改善（偏η²值分别为0.154与0.164）；两项量表的衰弱程度均有所降低（优势比（Odds Ratio, OR）分别为0.142与0.125），未观察到其他显著效应。
本研究所评估的干预方案具备可行性，且提示可改善接受居家照护服务老年人的躯体功能、降低衰弱程度。后续需开展更严谨的研究，包括解释性与实用性随机对照试验（randomised controlled trial, RCT）。
锻炼干预是维持躯体功能、延缓失能的关键举措，有助于满足老年人居家与社区独立生活的意愿。结合监督式团体训练与居家训练的多组分锻炼方案，在该人群中具备可行性、安全性且接受度良好。该干预方案在16周干预后可改善躯体功能、降低衰弱程度，有望成为早期康复策略。
锻炼干预是维持躯体功能、延缓失能的关键举措，有助于满足老年人居家与社区独立生活的意愿。结合监督式团体训练与居家训练的多组分锻炼方案，在该人群中具备可行性、安全性且接受度良好。该干预方案在16周干预后可改善躯体功能、降低衰弱程度，有望成为早期康复策略。