Abstract
BACKGROUND: Exercise has been one of the key strategies for preventing frailty. While training programs for preventing frailty have been mainly developed in person, which have now become difficult to perform due to the coronavirus disease pandemic. It would be worthwhile to explore a feasibility of methods for a remote-based training with information and communications technology (ICT) in the pre-frail/robust older adults living at home. METHODS: We assessed the feasibility of a remote-based training with ICT device in terms of 1) a measurement accuracy and 2) whether it could be used for remote-based training of different intensities. To evaluate a measurement accuracy of the ICT device, we evaluated an inter-rater reliability between a true score and scores obtaining from the ICT device in 20 participants aged 65 years and older. Intraclass correlation was calculated. To evaluate a feasibility of remote-based training interventions of different intensities, we did a parallel, randomized, active controlled trial. Participants aged 65 years or older were randomly allocated to the two 3-month intervention programs with different intensity of exercise with the ICT (i.e., an Exercise-Intensive program and a Light-load exercise program). The primary outcome was 3-month scores of the 30-s chair-stand test (CS-30), which was compared between two groups using mixed models for repeated measures to account for within-person correlations. RESULTS: The ICT device showed a high intraclass correlation of over 0.99 for all outcomes including CS-30. Between Aug and Oct 2020, 70 participants (36 and 34 in the Exercise-Intensive and Light-load exercise programs, respectively) were randomized. After 3 months of intervention, CS-30 scores and other physical function improved in both groups. Difference in the 3-month CS-30 scores between two programs was found to be 0.08 (95% confidence interval: - 2.64, 2.79; p = 0.955), which was not statistically significant. No harmful incidents, such as falls, occurred in either group. CONCLUSION: We showed a remote-based training with ICT device in the older adults living at home was feasible. Further studies are warranted to determine what kind of remote exercise intervention programs is more effective for maintaining a physical performance and, beyond that, preventing frailty. TRIAL REGISTRATION NUMBER: UMIN000041616 (05/09/2020) https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000047504&type=summary&language=E.