高齢者施設入居者における上半身重点の個別化多成分運動プログラム「モビリティ・フィット」が筋力、移動能力、転倒リスクに及ぼす影響：クラスターランダム化比較試験
Ziwei Zeng1, Jing Wen Pan1, Kimberley S van Schooten2,3
1Department of Sports Science and Physical Education, The Chinese University of Hong Kong, N.T., Hong Kong, China.
Background:
Older adults in long-term care (LTC) face accelerated functional decline due to frailty, affecting mobility and quality of life (QoL). Upper-body strength is crucial for daily activities and injury prevention, yet conventional physical activity (PA) programs often overlook it. This cluster randomised controlled trial evaluated Mobility-Fit, a 12-week multicomponent PA program emphasising upper-limb and core strength among LTC residents.
Methods:
Twenty LTC facilities were randomised into the Mobility-Fit (10 facilities, n = 73) or control (10 facilities, n = 73) group. Mobility-Fit included agility, balance and resistance exercises (3 times/week, 45 minutes), tailored to participants' functional capacity. The control group received standard care with lower-limb exercises, delivered with the same frequency. Outcomes included upper- and lower-limb strength, postural sway, reaction time, mobility (Short Physical Performance Battery), frailty (FRAIL-Nursing Home), fall risk (Longitudinal Aging Study Amsterdam fall risk profile questionnaire, LASA) and QoL [EuroQol (EQ)-5D]. An intention-to-treat analysis with generalised estimating equations was conducted.
Results:
Participants (median age = 86, 60% female) exhibited high adherence (83.3%). Mobility-Fit demonstrated superior improvements in elbow extension strength [β = 0.50, 95% confidence interval 0.26-3.89] and QoL (EuroQol five-dimension questionnaire utility: β = 0.17, P < .001; EQ-Visual Analogue Scale: β = 7.13, P = .006). Both groups improved lower-limb strength (knee extension: β = 2.72, P < .001) and mobility (Sit-To-Stand time: β = -3.69, P < .001), with a reduced LASA score (β = -1.20, P < .001).
Conclusions:
Mobility-Fit effectively enhanced upper-limb strength and QoL in LTC residents. Both groups showed improvements in lower-limb strength and mobility, highlighting the universal benefits of structured PA. The program addresses a critical gap by demonstrating the value of integrating upper-body training into standard care to promote holistic well-being.
