We sought to investigate the trajectory of physical functions during the use of exercise facilities to prevent long-term care admissions among community-dwelling adults.
The study recruited 334 participants (mean age: 78.2, male: 43.6%) who use three exercise facilities in the long-term care insurance system to prevent the need for long-term care. They performed goal-setting based exercise for 2.5 hours per session, including resistance, aerobics, balance, multi-component, and task-oriented training. Every three months (for one year) we measured physical function parameters, including quadriceps isometric strength per body weight, comfortable and maximum gait speed, skeletal muscle index, one leg standing, muscle quality score identified by bioimpedance method, short physical performance battery (SPPB), grip strength, and five times sit to stand time. We analyzed longitudinal changes in physical functions using a mixed-effects model with random effects for participants.
The total number of measurements was 1,287, with an average of 3.85. Using the Fried phenotypic model, we identified physical frailty and pre-frailty in 33.7% and 55.2%, respectively, of participants at baseline. There was a significant improvement in quadriceps isometric strength per body weight (Δ2.48%), gait speed (comfortable: Δ0.057 m/s, maximum: Δ0.063 m/s), and SPPB (Δ0.55 point) in the three months following the start of using facility (P 0.001), providing reassurance about the effectiveness of the exercise. These significant and reassuring improvements were then maintained for one year. The observed five times sit to stand time was tended to gradually decrease over the course of a year. There was no consistent trend among all cases of skeletal muscle index, one leg stand, muscle quality, or grip strength.
The usefulness of goal-setting based exercise at facilities for preventing nursing care through the long-term care insurance system was demonstrated, particularly in lower limb power and function.
Addressing reversible factors through goal-based exercise could significantly reduce the need for nursing care. This enlightening implication of our research should guide and encourage healthcare professionals, researchers, policymakers, and long-term care providers to consider the value of exercise and the need to assess physical function as part of care strategies.
physical function
preventive care
