One-year concurrent training improves physical performance and handgrip strength in nursing home residents

This parallel two-arm pragmatic controlled trial aimed to examine the effectiveness of a 12-month exercise intervention on physical performance, handgrip strength, independence in basic activities of daily living (BADL), and falls in real-world settings. Ninety-five older residents of nursing homes (mean age 81.9 ± 8.0 years) were allocated to either an exercise (n = 43) or usual care only (n = 52) group. The 12-month exercise training consisted of resistance and aerobic exercises (2 days/week), while the usual care consisted of everyday routine and standard care. The primary endpoint was the change in physical performance measured by the short physical performance battery (SPPB, score range 0-12). The secondary endpoints were changes in handgrip strength, independence in BADL measured by the Barthel index (BI), and the rate of falls. The exercise intervention significantly provided benefits over usual care on SPPB score by 2.59 points (95% CI: 1.75, 3.43) and handgrip strength by 1.85 kgf (95% CI: 0.56, 3.14). No significant between-group differences were observed for the BI or the rate of falls. However, within-group analysis revealed a significant decline in the BI score (- 11.8) and an increase in the rate of falls (+ 31.5 falls per 100 person-years) in the usual care group. Long-term concurrent exercise programme significantly improved physical performance and handgrip strength, but not independence in BADL and rate of falls in mostly frail nursing home residents. These findings support the integration of exercise physiologists and exercise programmes into standard care practices in nursing homes to help preserve physical function among residents.