PROMOTING ADL INDEPENDENCE IN VULNERABLE ELDERLY: SIX-MONTH FOLLOW-UP OF A PILOT COMPARATIVE TRIAL

Abstract

Muscle strength is essential but insufficient to reduce ADL disability in older adults. A parallel-group randomized controlled trial was conducted to compare whether adding functional and task-oriented training to resistance exercise would generate a greater improvement on ADL performance relative to resistance exercise alone. Fifty-two older adults who showed muscle weakness, lived a sedentary life style, and had ADL difficulty were recruited from local subsidized housing properties. They received 10 weeks of resistance exercise or the 3-Step Workout for Life, which included practicing functional movements and ADL tasks at home in addition to resistance exercise. The Box and Blocks test, Timed Up and Go, and Assessment of Motor and Process Skills were used to measure physical function and ADL performance. At six-month follow-up, all three outcomes in the 3-Step Workout for Life group were not different from the baseline while the resistance exercise only group showed a significant decline (mean change in the Box and Blocks = -4.05, p = 0.02; mean change in the Timed Up and Go = 1.84, p = 0.01; mean change in the Assessment of Motor and Process Skills = -0.25, p = 0.01). More importantly, the 3-Step Workout for Life group showed a greater improvement in ADL performance when compared to the resistance exercise only group (group mean difference = 0.37, p < 0.01). Adding functional, task-oriented training to resistance exercise may help retain physical function and delay the decline of ADL performance after six months of detraining in vulnerable older adults.