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Home training with and without additional group training in physically frail old people living at home: effect on health-related quality of life and ambulation

Section of Physiotherapy Science, Department of Public Health and Primary Health Care, University of Bergen, Norway

Olav Sletvold

Section of Geriatric Medicine, St. Olavs Hospital and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Rolf Moe-Nilssen

Section of Physiotherapy Science, Department of Public Health and Primary Health Care, University of Bergen, Norway

Objective: To test the effect of two exercise regimes on health-related quality of life (HRQoL) and ambulatory capacity.

Design: Randomized controlled trial.

Subjects: Seventy-seven community-dwelling physically frail people over 75 years of age (mean=81, SD=4.5).

Interventions: Home training (HT, N =38) comprised twice daily functional balance and strength exercises and three group meetings. Combined training (CT, N =39) included group training twice weekly and the same home exercises. Interventions lasted 12 weeks. Physiotherapists ran both programmes. Home exercises were recorded daily.

Main measures: HRQoL was assessed by SF-36, and ambulatory capacity by walking speed and frequency and duration of outdoor walks.

Results: Following intervention, CT improved the SF-36 mental health index significantly more than HT (p =0.01). The SF-36 physical health index (p =0.002) and walking speed (p =0.02) demonstrated improvements, but no group differences. Six months after cessation of intervention there was still overall improvements on the mental health index (p =0.032), borderline overall improvements on the physical health index (p =0.057), higher weekly number of outdoor walks for the CT group than for the HT group (p =0.027) and an improved habitual walking speed in the CT group only (p =0.022).

Conclusions: HT improved HRQoL and walking speed, but additional group training gave larger benefits on mental health. Group training away from home may be beneficial for mental health and ambulatory capacity.

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