Low-intensity exercise as a modifier of physical frailty in older adults

Objective: To examine the effects of a 3-month low-intensity exercise program on physical frailty. Design: Randomized clinical trial. Setting: Regional tertiary-care hospital and academic medical center with an outpatient rehabilitation fitness center. Participants: Eighty-four physically frail older adults (mean age, 83 +/- 4 yrs). Intervention: Three-month low-intensity supervised exercise (n = 48) versus unsupervised home-based flexibility activities (n = 36). Main Outcome Measures: Physical performance test, measures of balance, strength, flexibility, coordination, speed of reaction, peripheral sensation. Results: Significant improvement was made by the exercise group on our primary indicator of frailty, a physical performance test (PPT) (29 +/- 4 vs 31 +/- 4 out of a possible 36 points), as well as many of the risk factors previously identified as contributors to frailty; eg, reductions in flexibility, strength, gait speed, and poor balance. Although the home exercise control group showed increases in range of motion, the improvements in flexibility did not translate into improvements in physical performance capacity as assessed by the PPT. Conclusions: Our results suggest that physical frailty is modifiable with a program of modest activities that can be performed by virtually all older adults. They also indicate that exercise programs consisting primarily of flexibility activities are not likely to reverse or attenuate physical frailty. Although results suggest that frailty is modifiable, it is not likely to be eliminated with exercise, and efforts should be directed toward preventing the condition.