Changes in physical performance and frailty-associated risk associated with participation in a community exercise...

Exercise can improve physical function and reduce disability in older adults living with frailty. ExWell Medical is a national, community-based, medically supported group exercise program for people living with chronic conditions in Ireland.

We aimed to evaluate the longitudinal association between baseline frailty status and outcomes including gait speed in ExWell programme participants.

This is a secondary data analysis of a prospective cohort study. All participants attending an ExWell Medical induction in the Dublin/Kildare regions January-September 2023 were invited to participate. At baseline, 12, and 24 weeks we collected data on socio-demographics; health behaviours; measures of physical function; patient-reported outcomes. The cohort were stratified by Clinical Frailty Scale category at baseline.

We recruited 1290 participants (mean age 69 (SD:10.9) years; 60% female. At baseline 15% of participants were classified as frail, 23% prefrail, 62% robust. Baseline frailty was associated with a higher chronic condition count, higher health service use, poorer scores on measures of physical function, EQVAS, EQ5D5L index scores. There was an inverse association between frailty and class attendance (p < 0.001). Attrition increased with increasing baseline frailty status (p = 0.006). Participants who were frail at baseline had improvements between baseline and 24-week reassessment in gait speed, timed up and go, six-minute time trial, EQVAS; prefrail participants in the sit to stand test, six-minute time trial, EQVAS, but no improvement in timed up and go. Robust participants recorded improvements in all measures.

Participation in the ExWell programme was associated with improvements across frailty groups in community-dwelling adults living with chronic conditions.