Effectiveness of Exercise-Training on Frailty and the Specificity of Exercise Effectiveness on Frailty-Related Indices among Community Dwelling Robust, Pre-Frailty and Frailty Older Peoples

Abstract

Background: Although several systematic reviews have shown the effects of exercise interventions on frailty, no exercise intervention studies based on cardiopulmonary exercise testing (CPET) have been conducted, and no studies investigated whether robust, pre-frailty and frailty has specificity of effectiveness on frailty related indices with same exercise training (ET). Objectives: The aim of this study is examine the effect of ET based on CPET on physical, cognitive and psychological frailty including with health-related quality of life (HRQOL), and verified whether there are specificity of exercise effectiveness on frailty related indices with same ET among community-dwelling robust, pre-frailty and frailty older adult. Methods: Seventy-three older adult completed ET twice per week over a 6-month period in this cohort study. Frailty-related physical indices included body mass index (BMI), skeletal muscle mass index (SMI), handgrip strength (HGS), Timed Up and Go test (TUG), usual walking speed (UWS), and exercise tolerance (Peak and Anaerobic threshold (AT)). Cognitive and psychological status and HRQOL were also measured. Participants were divided into robust, pre-frailty, and frailty groups according to the Japanese version of the Cardiovascular Health Study criteria. Results: Twenty-four (32.9%) participants were classified as robust, 39 (53.4%) as pre-frailty, and 10 (13.7%) as frailty. Analysis of variance for split-plot factorial design showed improvement in HGS, TUG, UWS, exercise tolerance, cognitive and psychological as main effects of this ET. The interaction (intervention × group) analyses showed significant differences in UWS and AT watts. Post hoc analyses showed improvement of frailty in UWS and pre-frailty and frailty in AT watts, as specificity of ET effectiveness. We found that 89% of robust, pre-frailty, and frailty participants improved or maintained their status with this ET. Conclusion: This study showed exercise training based on CPET is effective for frailty and showed the specificity of exercise effectiveness in pre-frailty and frailty.