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

Abstract

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.