Abstract
BackgroundFrailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility.Methods/DesignThe Home-Based Older People's Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to assess the effectiveness of a 12 week exercise intervention (the HOPE programme) designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care. The primary outcome is the timed-up-and-go test (TUGT), measured at baseline and 14 weeks post-randomisation. Secondary outcomes include the Barthel Index of activities of daily living (ADL), EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) quality of life measure and the geriatric depression scale (GDS), measured at baseline and 14 weeks post-randomisation. We will record baseline frailty using the Edmonton Frail Scale (EFS), record falls and document muscle/joint pain. We will test the feasibility of collection of data to identify therapy resources required for delivery of the intervention.DiscussionThe HOPE trial will explore and evaluate a home-based exercise intervention for frail older people. Although previous RCTs have used operationalised, non-validated methods of measuring frailty, the HOPE trial is, to our knowledge, the first RCT of an exercise intervention for frail older people that includes a validated method of frailty assessment at baseline.Trial registrationISRCTN: ISRCTN57066881
Highlights
Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care
To conduct a pilot randomised controlled trial (RCT) to: 1) explore the feasibility of identification of frail older people in community settings; 2) assess the acceptability of the Home-Based Older People’s Exercise (HOPE) programme to frail older people; 3) test for a preliminary estimate of effectiveness; 4) test the feasibility of recording data to identify the therapy resources required to deliver the HOPE programme; 5) gather data to inform the design of a definitive clinical trial
The HOPE trial is a two arm, assessor blind pilot RCT to assess the effectiveness of an exercise intervention designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care
Summary
Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Frailty is self-perpetuating; its development results in a spiral of decline that leads to worsening frailty and increased risk of adverse health consequences including disability, admission to hospital or long-term care, and death [2,4]. Because of these adverse health consequences, frailty impacts directly on health and wellbeing and has important health resource implications [5]. Any attenuation of the prevalence or severity of frailty is likely to have large benefits for the individual, their families and for society
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