Introduction
Methods
Results
Author, year | Sample | Intervention | Main findings |
---|---|---|---|
Cameron et al. 2013 [22] | 216 frail adults ≥70 years | 12 months Intervention (I) : multifactorial, individually tailored treatment 1) If weight loss criterion was met, a dietician came. 2) If exhaustion criterion was met and the Geriatric Depression Scale score was high, a psychiatrist or psychologist came. 3) If weakness, slowness or low energy expenditure criteria was present, 10 home-based physiotherapy sessions were performed Control (C): usual care, including health and aged care services | Change of frail people in % acc. to the CHS criteria (Fried et al.) [5]. I: Baseline: 64%; 3 months: 64% 12 months: 62% C: Baseline: 65%; 3 months: 75%; 12 months: 76% → sig. group difference was 14.7% at 12 months Change in frailty status (Number of frailty criteria present) I: Baseline: 3.4 (SD: 0.7); 3 months: 0.6 (SD: 1.1); 12 months: 0.8 (SD: 1.2) C: Baseline: 3.5 (SD: 0.7); 3 months: 0.4 (SD: 0.9); 12 months: 0.4 (SD: 1.0) → sig. group difference |
Chan et al. 2012 [23] | 117 prefrail or frail adults; 65–79 years | 3 months Exercise and nutrition (EN): 3 × a week (1 h), structured exercise course warm up (15 min), brisk walks (10 min), stretching, strength training (10–15 rep., rubber band and bottled water), balance training, cool down (5 min) Control (Non-EN): no intervention | Improvement of the frailty status by one category acc. to the CHS criteria (Fried et al.) [5]. EN: 3 months: 45%; 3 months: 42%; 12 months: 40% Non-EN: 3 months: 27%; 6 months: 26%; 12 months: 31% → sig. difference at 3‑month between EN and non EN |
Luger et al. 2016 [21] | 80 prefrail or frail persons; ≥65 years | 3 months Physical training and nutritional (PTN): 2 × a week; home visits by trained lay volunteers strength exercises (6 exercises, 2 sets, 15 rep until muscular exhaustion) and nutritional support Social support (SoSu): 2 × a week; home visits with social support | Decrease in frailty prevalence—SHARE-FI (score) (Romero et al.) [37]. PTN: −17% SoSu: −16% → sig. decrease in both groups |
Li et al. 2010 [24] | 310 prefrail or frail elderly; ≥65 years | 6 months Intervention (I): medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and specialty referrals Control (C): received screening evaluation only | Change in frailty status acc. to the CHS criteria (Fried et al.) [5]. I: Same: 83.7%; Improvement: 7.8%; Decline: 8.5% C: Same: 82.9%; Improvement: 6.4%; Decline: 10.7% → no sig. group differences |
Tarazona-Santabalbina et al. 2016 [25] | 100 sedentary frail elderly people from rural care centers | 6 months Intervention (I): 5 × a week (66 min), group training balance (10–15 min), aerobic (initially at 40% of maximum heart rate increasing to 65%), strength training (initially at 25% of 1 repetition maximum to 75%), and stretching Control (C): received no training and attended the regular primary care program | Number of frailty criteria acc. to the CHS criteria (Fried et al.) [5]. I: 3.6 (SD: 0.8)–1.6 (SD: 0.9) C: 3.8 (SD: 0.6)–3.8 (SD: 0.3) Edmonton criteria [20] I: 8.7 (SD: 2.5)–7.7 (SD: 2.0) C: 8.5 (SD: 2.1)–9.3 (SD: 2.3) → 31.4% (95% CI: 20.3–45.0) of the I reversed frailty; no participant in the C |
Author, year | Sample | Intervention | Main findings |
---|---|---|---|
Kwon et al. 2015 [26] | 89 prefrail women; ≥70 years | 3 months Training (T): 1 × a week; group training warm-up, strength training (1 set, 5–10 rep), balance training (20–45 min), and cool-down (5–10 min) Training and nutrition (TN): training & cooking classes (2–3 h) once a week Control (C): 3 sessions of health education | Change in mean handgrip strength (kg) T: +2.3 (SD: 3.1) TN: +1.2 (SD: 4.0) C: +0.4 (SD: 2.6) → sig. increase in the T group |
Gine-Garriga et al. 2010 [27] | 41 frail individuals; 80–90 years | 3 months Functional circuit training (FCT): 2 × a week (45 min), group training warm-up, walking at usual pace (10 min), cool-down, stretching (5 min) Control (C): continue their routine daily activities and usual care from their primary-care practice | Mean maximal isometric quadriceps and hamstring strength (Nm/kg) FCT: Baseline: 0.8 (SD: 0.1); 12 weeks: 0.9 (SD: 0.1); 36 weeks: 0.8 (SD: 0.1) C: Baseline: 0.8 (SD: 0.1); 12 weeks: 0.7 (SD: 0.1); 36 weeks: 0.6 (SD: 0.1) → sig. group and time effect |
Tieland et al. 2012 [28] | 62 frail individuals; ≥65 years | 3 months Strength training and nutrition supplementation (TS): 2 × a week; individual warm-up (5 min, cycle ergometer), strength training (4 sets on the leg-press and the leg-extension, 3 sets on the chest press, lat pulldown, pec deck and vertical row machine; 50% of the RM increased to 75%) and 2 × daily protein supplementation Control (C): no training and placebo supplementation | Mean handgrip strength (kg) TS: 25.9 (95% CI: 22.3; 29.5)–27.2 (95% CI: 23.6; 30.9) C: 26.7 (95% CI: 23.1; 30.3)–26.7 (95% CI: 23.1; 30.3) → no sig. group and time difference Mean leg extensor strength (kg) TS: 56.0 (95% CI: 49.5; 62.7)–70.0 (95% CI: 62.7; 77.3) C: 58.3 (95% CI: 51.7; 64.9)–74.1 (95% CI: 66.8; 81.4) → no sig. group difference |
Vestergaard et al. 2008 [29] | 61 frail women; ≥75 years | 5 months Training (T): 3 × a week with a video tape warm-up (15 min, focusing on flexibility and dynamic balance exercises), strength training (6 min, using elastic bands), aerobic exercises (5 min) Control (C): no intervention at all | Mean handgrip strength (kg) T: 17.5 (SD: 5.5)–20.5 (SD: 5.6) C: 19.1 (SD: 4.3)–19.8 (SD: 4.5) → no sig. group difference Mean biceps brachii strength (kg) T: 6.7 (SD: 2.0)–7.4 (SD: 2.4) C: 6.8 (SD: 1.7)–6.9 (SD: 1.7) → no sig. group difference |
Haider et al. 2017 [30] | 80 prefrail or frail persons; ≥65 years | 3 months Physical training and nutritional (PTN): 2 × a week; home visits by trained lay volunteers strength exercises (6 exercises, 2 sets, 15 rep until muscular exhaustion) and nutritional support Social support (SoSu): 2 × a week; home visits with social support | Change in mean handgrip strength (kg) PTN: +2.4 (95% CI: 1.0–3.8) SoSu: +0.8 (95% CI: −0.4–2.0) → sig. increase in the PTN group; no sig. group difference |
Chin et al. 2001 [31] | 157 frail elderly persons; ≥70 years | 17 weeks Exercise (E): 2 × a week (45 min); group training Strength training (increasing intensity 6–8 on a 10-point perceived exertion scale) Nutrition (N): several fruit and dairy products were enriched with vitamins and minerals; the E and C group received the same products, but the foods were not enriched Both (B): Exercise and nutritional intervention Control (C): No intervention | Change in mean handgrip strength (kgf) Exercise (E or B): 0 (10th–90th percentile: −3 to 5) No Exercise (N or C): +1 (10th–90th percentile: −3 to 4) N + B: +1 (10th–90th percentile: −3 to 5) E + C: 0 (10th–90th percentile: −3 to 4) → no sig. differences between exercises vs. no exercise Change in quadriceps strength (kgf) Exercise (E or B): +1.5 (10th–90th percentile: −4.9 to 8.7) No Exercise (N or C): +0.3 (10th–90th percentile: −4.6 to 6.0) N + B: +1.3 (10th–90th percentile: −3.8 to 7.8) E + C: +0.9 (10th–90th percentile: −5.4 to 6.8) → no sig. differences between exercises vs. no exercise |
Ng et al. 2015 [32] | 246 prefrail and frail individuals; ≥65 years | 6 months Nutrition supplementation (S): 1 × a day hypercaloric supplement Training (T): 2 × a week (90 min) strength (8–10 muscle groups, 8–15 rep, starting with <50% of the RM increasing to 80%) and balance training; after 12 weeks a home-based program was conducted Training & supplementation (TS): combination of both Control (C): standard care from health & aged care services + sweetened, vanilla-flavored liquid, 2 capsules & 1 tablet identical in appearance to the active supplements | Change in mean knee extension strength (kg) S: +0.97 (95% CI: 0.15; 2.09) T: +2.75 (95% CI: 1.66; 3.83) TS: +2.67 (95% CI: 1.58; 3.76) C: +0.02 (95% CI: −1.08; 1.12) → sig. group difference between T and C; and TS and C |
Chandler et al. 1998 [33] | 100 frail people; ≥65 years | 10 weeks Intervention (I): 3 × a week, in-home program strength training (progressive, lower extremity using dynaband and body weight) Control (C): no intervention | Change in mean right knee extension strength (Nm) I: +4.9 (SD: 14); C: −0.7 (SD: 8.2) Change in mean right knee flexion strength (Nm) I: +4.6 (SD: 7.1); C: +0.3 (SD: 4.8) Change in mean right dorsiflexion strength (Nm) I: +0.8 (SD: 3.1); C: −0.3 (SD: 2.1) Change in mean right plantar flexion strength (Nm) I: +3.1 (SD: 6.4); C: −0.3 (SD: 5.7) → I: 9% to 16% strength gain; C: 1% gain to 3% decline |
Author, year | Sample | Intervention | Main findings |
---|---|---|---|
Kwon et al. 2015 [26] | 89 prefrail women; ≥70 years | 3 months Training (T): 1 × a week; group training warm-up, strength training (1 set, 5 progressing to 10 rep.), balance training (20–45 min), cool down (5–10 min) Training & nutrition (TN): 1 × a week (2–3 h), training & cooking classes Control (C): 3 sessions of health education | Change in stork stand (s) T: −2.0 (SD: 16.9); TN: +2.9 (SD: 18.6); C: −0.4 (SD: 11.9) → no sig. changes in any group
Change in usual walking speed (m/s)
T: +0.1 (SD: 0.6); TN: +0.2 (SD: 0.3); C: +0.1 (0.4) → no sig. change in any group |
Tieland et al. 2012 [28] | 62 frail individuals; ≥65 years | 3 months Strength training & nutrition supplementation (TS): 2 × a week, individual warm-up (5 min, cycle ergometer), strength training (4 sets on the leg-press and the leg-extension, 3 sets on the chest press, lat pulldown, pecdeck and vertical row machine; 50% of the RM increased to 75%) & 2 × daily protein supplementation Control (C): no training & placebo supplementation | Mean chair rise (sec) TS: 15.6 (95% CI: 13.0; 18.1)–13.6 (95% CI: 10.9; 16.3) C: 17.3 (95% CI: 14.8; 19.9)–16.4 (95% CI: 13.9; 19.0) → no sig. group difference Mean points Short Physical Performance Battery TS: 8.0 (95% CI: 7.2; 8.9)–9.2 (95% CI: 8.3; 10.1) C: 7.9 (95% CI: 7.0; 8.8)–8.3 (95% CI: 7.3; 9.1) → no sig. group difference |
Ng et al. 2015 [32] | 246 prefrail and frail individuals; ≥65 years | 6 months Nutrition supplementation (S): 1 × a day hypercaloric supplement Training (T): 2 × a week (90 min) strength (8–10 muscle groups, 8–15 rep starting with <50% of the RM increasing to 80%) and balance training; after 12 weeks a home-based program was conducted Training & nutrition supplementation (TS): combination of both Control (C): standard care from health & aged care services + sweetened, vanilla-flavoured liquid, 2 capsules & 1 tablet identical in appearance to the active supplements |
Mean change in gait speed (s)
S: −0.8 (95% CI: −1.2; −0.4) T: −1.1 (95% CI: −1.5, −0.7) TS: −0.5 (95% CI: −1.0, −0.1) C: −0.7 (95% CI: −1.1; −0.3) → sig. group difference between the T and the C group |
Vestergaard et al. 2008 [29] | 61 frail women; ≥75 years | 5 months Training (T): 3 × a week; with a video tape warm-up (15 min, focusing on flexibility and dynamic balance exercises), strength training (6 min, using elastic bands), aerobic exercises (5 min) Control (C): no intervention at all |
Mean semi balance (s)
T: 11.9 (SD: 8.0) to 15.5 (SD: 7.3) C: 13.2 (SD: 7.5) to 13.3 (SD: 8.1) → no sig. group difference
Mean chair rise (s)
T: 19.3 (SD: 11.6) to 14.1 (SD: 8.5) C: 16.4 (SD: 5.3) to 16.3 (SD: 6.2) → no sig. group difference
Mean physical performance test (score)
T: 16.3 (SD: 5.6) to 18.1 (SD: 5.8) C: 17.0 (SD: 4.9) to 17.4 (SD: 5.5) → no sig. group difference |
Haider et al. 2017 [30] | 80 prefrail or frail persons; ≥65 years | 3 months Physical training and nutritional (PTN): 2 × a week; home visits by trained lay volunteers strength exercises (6 exercises, 2 sets, 15 rep until muscular exhaustion) and nutritional support Social support (SoSu): 2 × a week; home visits with social support | Change in mean points of the Short Physical Performance Battery PTN: +1.2 (95% CI: 0.3–2.1) SoSu: +0.5 (95% CI: 0.1–0.9) → sig. improvements in both groups; sig. group differences |
Cameron et al. 2013 [22] | 216 frail adults; ≥70 years | 12 months Intervention (I): multifactorial, individually tailored treatment 1) If weight loss criterion was met, a dietician came. 2) If exhaustion criterion was met and the Geriatric Depression Scale score was high, a psychiatrist or psychologist came. 3) If weakness, slowness or low energy expenditure criteria was present, 10 home-based physiotherapy sessions were performed Control (C): usual care, including health and aged care services | Mean points of the Short Physical Performance Battery I: Baseline: 5.2 (SD: 1.9); 3 months: 5.4 (SD: 2.3); 12 months: 5.8 (SD: 2.8) C: Baseline: 5.7 (SD: 2.1); 3 months: 5.7 (SD: 2.3); 12 months: 4.7 (SD: 2.9) → sig differences between I and C group after 12 months |
Zech et al. 2012 [34] | 69 prefrail adults; 65–94 years | 3 months Strength training (T): 2 × a week; individual 9 strength exercises (2 sets, 2 min rest, intensity was increased continuously) Muscle power training (PT): same exercises as described above; the concentric phase was conducted rapidly, the eccentric phase as slowly Control (C): no intervention | Mean points of the Short Physical Performance Battery T: 8.8 (SD: 2.4) to 9.7 (SD: 2.2) PT: 9.0 (SD: 2.1) to 10.1 (SD: 2.3) C: 10.2 (SD: 2.1) to 9.7 (SD: 2.1) → sig. difference in the T and the PT group |
Chin et al. 2001 [31] | 157 frail elderly people; ≥70 years | 17 weeks Exercise (E): 2 × a week (45 min), group exercise Strength training (increasing intensity 6–8 on a 10-point perceived exertion scale) Nutrition (N): several fruit and dairy products were enriched with vitamins and minerals; the E and C group received the same products, but the foods were not enriched Both (B): Exercise and nutritional intervention Control (C): No intervention | Change in mean chair stands (rep) E + B: −2.3 (10th–90th: −7.7 to 1.4) N + D: −1.0 (10th–90th: −6.4 to 3.8) N + B: −1.8 (10th–90th: −7.8 to 2.2) E + C: −1.9 (10th–90th: −6.0 to 2.5) → sig. differences between E + B and N + D group Change in mean walking speed (m/s) E + B: +0.6 (10th–90th: 0.1) N + D: 0.0 (10th–90th: 0.4) N + B: 0.0 (10th–90th: 0.1) E + C: +0.1 (10th–90th: 0.1) → sig. differences between E + B and N + D group
Change in mean tandem stand (s)
E + B: +0.9 (10th–90th: 2.8) N + D: −0.8 (10th–90th: 3.4) N + B: +0.3 (10th–90th: 3.3) E + C: −0.1 (10th–90th: 3.1) → sig. differences between E + B and N + D group |
Gine-Garriga et al. 2010 [27] | 41 frail individuals; 80–90 years | 3 months Functional circuit training (FCT): 2 × a week (45 min), group training warm-up, walking at usual pace (10 min), cool-down, stretching (5 min) Control (C): continue their routine daily activities and usual care from their primary-care practice |
Mean stand-up Test (s)
FCT: Baseline: 19.6 (SD: 0.7); 12 weeks: 15.6 (SD: 0.7); 36 weeks: 17.8 (SD: 0.7) C: Baseline: 17.1 (SD: 0.9); 12 weeks: 17.9 (SD: 0.9); 36 weeks: 17.5 (SD: 1.1) → sig. group and time effect
Mean modified timed up-and-go (s)
FCT: Baseline: 38.0 (SD: 1.3); 12 weeks: 35.0 (SD: 1.3); 36 weeks: 37.5 (SD: 1.3) C: Baseline: 39.3 (SD: 1.4); 12 weeks: 41.3 (SD: 1.4); 36 weeks: 42.0 (SD: 1.4) → sig. group and time effect |
Tarazona-Santabalbina et al. 2016 [25] | 100 sedentary frail elderly from rural care centers | 24 weeks Intervention (I): 5 × a week (66 min); group exercise balance (10–15 min), aerobic (initially at 40% of maximum heart rate increasing to 65%), strength training (initially at 25% of 1 repetition maximum to 75%), and stretching Control (C): received no training and they attended the regular primary care program |
Mean Tinetti (s)
I: 23.5 (SD: 4.4) to 24.5 (SD: 4.4) C: 24.7 (SD: 3.4) to 21.7 (SD: 4.5)
Mean point Short Physical Performance Battery
I: 8.6 (SD: 2.0) to 9.5 (SD: 1.8) C: 8.6 (SD: 1.7) to 7.1 (SD: 2.8) → sig. improvements in the I, deteriorations in the C |
Chan et al. 2012 [23] | 117 prefrail or frail adults; 65–79 years | 3 months Exercise and nutrition (EN): 3 × a week (1 h); structured exercise course warm up (15 min), brisk walks (10 min), stretching, strength training (10–15 rep., rubber band and bottled water), balance training, cool down (5 min) Problem solving therapy (PST): 6 session of evidence-based physiotherapy |
Change in mean leg stand (s)
EN: 3 months: +2.9 (SD: 9.2); 6 months: +2.6 (SD: 8.4); 12 months: +3.7 (SD: 9.2) PST: 3 months: +2.4 (SD: 8.9); 6 months: +3.1 (SD: 8.9); 12 months: +4.3 (SD: 10.2) → sig. increase in both groups |
Author, year | Sample | Intervention | Main findings |
---|---|---|---|
Tieland et al. 2012 [28] | 62 frail individuals; ≥65 years | 3 months Strength training & nutrition supplementation (TS): 2 × a week, individual warm-up (5 min, cycle ergometer), strength training (4 sets on the leg-press and the leg-extension, 3 sets on the chest press, lat pulldown, pec-deck and vertical row maschin; 50% of the RM increased to 75%) and 2 × daily protein supplementation Control (C): no training and placebo supplementation | Mean lean mass (kg) TS: 47.2 (95% CI: 43.5; 50.9)–48.5 (95% CI: 44.8; 52.1) C: 45.7 (95% CI: 42.1; 49.2)–45.6 (95% CI: 42.1; 49.2) → sig. group and time interaction Mean appendicular lean mass (kg) TS: 20.1 (95% CI: 18.3; 21.8)–20.4 (95% CI: 18.6; 22.1) C: 19.3 (95% CI: 17.6; 20.9)–19.3 (95% CI: 19.7; 21.0) → sig. group and time interaction |
Zech et al. 2012 [34] | 69 prefrail older adults; 65–94 years | 3 months Strength training (T): 2 times a week; individual 9 strength exercises (2 sets, 2 min rest, intensity was increased continuously) Muscle power training (PT): same exercises as described above; the concentric phase was conducted rapidly, the eccentric phase as slowly Control (C): no intervention | Mean appendicular lean mass (kg) T: 17.9 (SD: 3.3)–18.0 (SD: 3.3) PT: 19.2 (SD: 4.4)–19.1 (SD: 4.2) C: 17.1 (SD: 2.6)–17.5 (SD: 2.6) → no sig. change in any group |
Chan et al. 2012 [23] | 117 prefrail or frail adults; 65–79 years | 3 months Exercise and nutrition (EN): 3 × a week (1 h); group training warm up (15 min), brisk walks (10 min), stretching, strength training (10–15 rep., rubber band and bottled water), balance training, cool down (5 min) Problem solving therapy (PST): 6 session of evidence-based physiotherapy | Change in mean fat free mass (kg) EN: 12 months: −0.5 (SD: 1.4) PST: 12 months: −0.6 (SD: 1.3) → sig. decrease in all groups |
Haider et al. 2017 [30] | 80 prefrail or frail persons; ≥65 years | 3 months Physical training and nutritional (PTN): 2 × a week; home visits by trained lay volunteers strength exercises (6 exercises, 2 sets, 15 rep until muscular exhaustion) and nutritional support Social support (SoSu): 2 × a week; home visits with social support | Change appendicular skeletal muscle mass (kg) PTN: +0.3 (95% CI: −0.2; 0.7) SoSu: +0.2 (95% CI: −0.1; 0.5) → no sig. change in any group |