Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Criteria for Selection of Studies
2.3. Data Synthesis and Analyses
2.4. Biased Risk Assessment
2.5. Statistical Analyses
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Risk of Bias
3.4. The Impact of Consistency with ACSM Recommendations on the Fried Frailty Phenotype
3.5. The Impact of Consistency with ACSM Recommendations on the Barthel Index
3.6. The Impact of Consistency with ACSM Recommendations on the Short Physical Performance Battery
3.7. The Impact of Consistency with ACSM Recommendations on the Grip Strength
3.8. The Impact of Consistency with ACSM Recommendations on the Body Mass Index
4. Discussion
5. Strengths and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Exercise Dose | Cardiorespiratory Exercise | Resistance Exercise | Flexibility Exercise |
---|---|---|---|
Frequency | 4–5 days/week | On non-consecutive days, 1–2 days each week, progressively rising to 2–3 days per week. | 5–7 days/week |
Intensity/workload | Moderate intensity, 40–59%VO2R/HRR, CR-10 scale rating of 3–4 | The last two sets should be difficult; adjust the resistance accordingly. If it’s manageable, high-intensity exercise may be done. | Stretch until you feel your muscles being pulled tight or a slight discomfort. |
Duration | Gradually increase from 20 min to at least 30 min (up to 45–60 min) | After approximately two weeks, work your way up to two sets of eight to twelve repetitions. Don’t exceed 8–10 exercises in a single session. | Repeated 2–4 times, static stretching is sustained for 10–30 s. |
Author | Country | Year | Population | Age (Mean + SD) | Total/Male/Female | Intervention | Control | Outcome |
---|---|---|---|---|---|---|---|---|
Juan Luis Sánchez-Sánchez [39] | France | 2022 | Frailty Pre-frailty | T:84.15(4.76) C:83.99(4.8) | T:88/28/60 C:100/40/60 | Vivifrail training Length of Intervention: 12 weeks Freq: 3–5 times a week Duration: 30–60 min | CON | SPPB Grip strength |
Ulku K. Sahin [34] | Turkey | 2018 | Frailty | T:84.18(6.85) C:85.37(4.7) | T:16/NA/NA C:16/NA/NA | Resistance training Length of Intervention: 8 weeks Freq: 3 times a week Duration: 40 min | CON | Grip strength BI |
Haritz Arrieta [42] | Spain | 2019 | Frailty | T:85.1(7.6) C:84.7(6.1) | T:57/15/42 C:55/18/37 | MEP Length of Intervention: 24 weeks Freq: 2 times a week Duration: 60 min | CON | SPPB BI |
Maria Giné-Garriga [33] | Spain | 2010 | Frailty | T:83.9(2.8) C:84.1(3) | T:22/9/13 C:19/7/12 | FCT Length of Intervention: 12 weeks Freq: 2 times a week Duration: 45 min | CON | BI |
Sonja Vestergaard [45] | Denmark | 2008 | Frailty | T:81(3.3) C:82.7(3.8) | T:25/0/25 C:28/0/28 | Vivifrail training Length of Intervention: 12 weeks Freq: 3–5 times a week Duration: 30–60 min | CON | Grip strength |
Yoshiji Kato [38] | Japan | 2018 | Frailty | T:77.6(7.2) C:79.6(7.7) | T:18/11/7 C:13/7/6 | NHK&MP&CR Length of Intervention: 12 weeks Freq: 7 times a week Duration: 25 min | CON | BMI BI |
Francisco José Tarazona-Santabalbina [48] | Spain | 2016 | Frailty | T:79.7(3.6) C:80.3(3.7) | T:51/22/29 C:49/24/25 | MEP Length of Intervention: 24 weeks Freq: 5 times a week Duration: 65 min | CON | SPPB BI Fried |
Tsung-Jen Hsieh [47] | Taiwan | 2019 | Frailty Pre-frailty | T:72.0(6.0) C:72.5(5.5) | T:79/28/60 C:80/40/60 | Exercise training Length of Intervention: 24 weeks Freq: 3–7 times a week Duration: 5–60 min | CON | Fried Grip strength |
Tze Pin Ng [50] | Singapore | 2015 | Frailty Pre-frailty | T:70.3(5.25) C:70.1(5.02) | T:48/21/27 C:50/22/28 | Physical training Length of Intervention: 12 weeks Freq: 2 times a week Duration: 90 min | CON | BMI Fried |
Álvaro Casas-Herrero [43] | Spain | 2022 | Frailty | T:84.2(4.8) C:84.0(4.8) | T:88/25/63 C:100/31/69 | Vivifrail training Length of Intervention: 12 weeks Freq: 5 times a week Duration: 30 min | CON | SPPB BI Grip strength |
John Travers [32] | Ireland | 2023 | Frailty | T:77.6(5.2) C:76.5(5.2) | T:79/25/54 C:77/26/51 | Home-based exercise Length of Intervention: 12 weeks Freq: 4 times a week Duration: 45–60 min | CON | Grip strength |
Mario Ulises Pérez-Zepeda [46] | Canada | 2022 | Frailty | T:87.1(4.8) C:87.9(4.5) | T:163/72/91 C:160/69/91 | Vivifrail training Length of Intervention: 12 weeks Freq: 3–5 times a week Duration: 30–60 min | CON | BI SPPB Grip strength |
Rujie Chen [41] | China | 2020 | Pre-frailty | T:76.97(5.19) C:75.27(5.98) | T:33/12/21 C:33/11/22 | Elastic band training Length of Intervention: 8 weeks Freq: 3 times a week Duration: 45–60 min | CON | Grip strength |
T. Liu [40] | China | 2022 | Frailty | T:80.75(2.99) C:80.74(2.82) | T:67/16/51 C:68/24/44 | Integrated exercise Length of Intervention: 12 weeks Freq: 5 times a week Duration: 40 min | CON | Fried |
Zhang Xiaohong [44] | China | 2023 | Frailty | T:64.75(4.35) C:64.94(4.29) | T:36/13/23 C:36/20/16 | Dance training Length of Intervention: 16 weeks Freq: 5 times a week Duration: 60 min | CON | SPPB Grip strength |
Joaquín Barrachina-Igual [37] | Spain | 2021 | T:74.83(5.78) C:75.25(8.20) | T:23/7/16 C:20/5/15 | MEP Length of Intervention: 12 weeks Freq: 2 times a week Duration: 65 min | CON | BI SPPB Grip strength | |
Nien Xiang Tou [36] | Singapore | 2021 | Frailty | T:79.5(4.2) C:74.6(6.5) | T:23/NA/NA C:27/NA/NA | FPT Length of Intervention: 12 weeks Freq: 2 times a week Duration: 60 min | CON | Fried SPPB Grip strength |
Pedro Otones [51] | Spain | 2020 | Frailty | T:79.5(4.2) C:74.6(6.5) | T:17/5/12 C:15/2/13 | Physical training Length of Intervention: 32 weeks Freq: 1 time a week Duration: 60 min | CON | SPPB Grip strength |
Uratcha Sadjapong [49] | Thailand | 2020 | Frailty | T:76.68(1.14) C:78.87(1.32) | T:32/16/16 C:32/23/9 | MEP Length of Intervention: 12 weeks Freq: 3 times a week Duration: 60 min | CON | Fried Grip strength |
Fermín García-Gollarte [35] | Spain | 2023 | Frailty | T:86(5.9) C:84.9(6) | T:39/9/30 C:34/13/21 | OEP training Length of Intervention: 24 weeks Freq: 3 times a week Duration: 40–60 min | CON | SPPB Grip strength |
Author, Year | Cardiorespiratory Exercise | Resistance Exercise | Flexibility Exercise | ACSM Consistency | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Frequency | Intensity/Workload | Duration | Frequency | Intensity/Workload | Repetitions | Sets | Frequency | Intensity/Workload | Duration | Points (Percent) | |||||||||||
4–5 d/wk | 40–59% VO2R/HRR, Moderate Exertion, with a CR-10 Scale Grade of 3–4. | Increase by 20 Minutes Gradually to at Least 30 Min (or Up to 45–60 Min). | 1–2 Days per Week, Rising to 2–3 Days per Week over Time | Change the Resistance from Medium to High. | 8–12 | 1–2 | 5–7 d/wk | Stretch until You Start to Feel a Mild Soreness or a Tugging Sensation in Your Muscles. | Repeated 2–4 Times, Static Stretching Is Sustained for 10–30 s. | ||||||||||||
Juan Luis Sánchez-Sánchez, 2022 [39] | 5 | ☺ | Walk at the usual pace. | ☺ | 50–105 (s) | ☹ | 3 | ☺ | 30 RM | ☹ | 12–15 | ☹ | 2 | ☺ | 3 | ☹ | NR | ☹ | 20–30 (s) | ☺ | 11/20 (55%) |
Ulku K. Sahin, 2018 [34] | 3 | ☺ | 40–70% 1 RM | ☺ | 6–10 | ☺ | NR | ☹ | 7/8 (88%) | ||||||||||||
Haritz Arrieta, 2019 [42] | 7 | ☹ | NR | ☹ | 20 min | ☺ | 2 | ☺ | 40–70% 1 RM | ☺ | NR | ☹ | NR | ☹ | 2 | ☹ | NR | ☹ | 5 (min) | ☹ | 10/20 (50%) |
Maria Giné-Garriga, 2010 [33] | 2 | ☹ | Walk at the usual pace. | ☺ | 10 min | ☹ | 2 | ☺ | 12–14 RM | ☺ | 6–15 | ☺ | 1–2 | ☺ | 2 | ☹ | NR | ☹ | 5 (min) | ☹ | 11/20 (55%) |
Sonja Vestergaard, 2008 [45] | 3 | ☹ | Walking on the spot | ☹ | 5 min | ☹ | 3 | ☺ | NR | ☹ | NR | ☹ | NR | ☹ | 3 | ☹ | NR | ☹ | 15 (min) | ☹ | 6/20 (30%) |
Yoshiji Kato, 2018 [38] | 7 | ☹ | Walking on the spot | ☹ | 15 min | ☹ | 7 | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | 7 | ☺ | NR | ☹ | 5 (min) | ☹ | 6/20 (30%) |
Francisco José Tarazona-Santabalbina, 2016 [48] | 3 | ☹ | Moderate intensity | ☺ | 40 min | ☺ | 2 | ☺ | 75%1 RM | ☺ | 8 | ☺ | 3 | ☹ | 5 | ☺ | NR | ☹ | 20 (s) | ☺ | 15/20 (75%) |
Tsung-Jen Hsieh, 2019 [47] | 3–7 | ☹ | ACSM intensity | ☺ | 8–12 | ☺ | 1–2 | ☺ | 3–7 | ☹ | ACSM intensity | ☺ | 10–30 s | ☺ | 12/14 (86%) | ||||||
Tze Pin Ng, 2015 [50] | 2 | ☺ | ACSM intensity | ☺ | 8–15 | ☺ | NR | ☹ | 7/8 (88%) | ||||||||||||
Álvaro Casas-Herrero, 2022 [43] | 5 | ☺ | Walk at the usual pace. | ☺ | 24 min | ☺ | 3 | ☺ | NR | ☹ | 12 | ☺ | 3 | ☹ | 3 | ☹ | NR | ☹ | 10 s | ☺ | 14/20 (70%) |
John Travers, 2023 [32] | 3–4 | ☹ | Walking | ☺ | 35–45 min | ☺ | 4–7 | ☹ | NR | ☹ | 10–15 | ☺ | ≥4 | ☹ | 8/14 (57%) | ||||||
Mario Ulises Pérez-Zepeda, 2022 [46] | NR | ☹ | Walk at the usual pace. | ☺ | 24 min | ☺ | NR | ☹ | 30–60% 1 RM | ☹ | 8–10 | ☺ | 2–3 | ☺ | 10/14 (71%) | ||||||
Rujie Chen, 2020 [41] | 3 | ☺ | NR | ☹ | 10–15 | ☺ | 2 | ☺ | 7/8 (88%) | ||||||||||||
T. Liu, 2022 [40] | 5 | ☺ | Tai Chi | ☺ | 40 min | ☺ | 5 | ☺ | NR | ☹ | NR | ☹ | 10/12 (83%) | ||||||||
Sonja Vestergaard, 2008 [45] | 5 | ☺ | Dance | ☺ | 40 min | ☺ | 5 | ☺ | NR | ☹ | NR | ☹ | 10/12 (83%) | ||||||||
Yoshiji Kato, 2018 [38] | 2 | ☹ | Walking | ☺ | 10 min | ☹ | 2 | ☺ | ≥70%1 RM | ☺ | 10–15 | ☺ | 3 | ☹ | 2 | ☹ | NR | ☹ | NR | ☹ | 10/20 (50%) |
Francisco José Tarazona-Santabalbina, 2016 [48] | 2 | ☺ | NR | ☹ | 10–20 | ☺ | 3 | ☹ | 5/8 (63%) | ||||||||||||
Tsung-Jen Hsieh, 2019 [47] | NR | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | 4/8 (50%) | ||||||||||||
Tze Pin Ng, 2015 [50] | ≥3 | ☺ | 40–65% HRR | ☹ | 10–20 min | ☹ | ≥3 | ☹ | 65–100%1 RM | ☺ | 8–12 | ☺ | 2–3 | ☺ | 10/14 (71%) | ||||||
Álvaro Casas-Herrero, 2022 [43] | NR | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | NR | ☹ | 7/14 (50%) |
Frequency | Intensity/Workload | Repetitions | Sets | |
---|---|---|---|---|
ACSM exercise prescriptions | 1–2 d/wk, 2–3 d/wk | Change the resistance from medium to high | 8–12 | 1–2 |
Other exercise prescriptions (1) | 2–3 d/wk | 1 RM 50–80% | 5–8 | 1–2 |
Other exercise prescriptions (2) | 2 d/wk | 1 RM 51–69% | 7–9 | 2–3 |
Other exercise prescriptions (3) | 2 d/wk | relatively high degree of effort | 6–12 | 1–3 |
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Pan, N.; Ossowski, Z.; Tong, J.; Li, D.; Gao, S. Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Clin. Med. 2024, 13, 3037. https://doi.org/10.3390/jcm13113037
Pan N, Ossowski Z, Tong J, Li D, Gao S. Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine. 2024; 13(11):3037. https://doi.org/10.3390/jcm13113037
Chicago/Turabian StylePan, Neng, Zbigniew Ossowski, Jun Tong, Dan Li, and Shan Gao. 2024. "Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" Journal of Clinical Medicine 13, no. 11: 3037. https://doi.org/10.3390/jcm13113037
APA StylePan, N., Ossowski, Z., Tong, J., Li, D., & Gao, S. (2024). Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine, 13(11), 3037. https://doi.org/10.3390/jcm13113037