Activity Counselling for Frailty

(Moving_More Trial)

Overseen By Stephenie Therrien, BA

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Psychiatric conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 8-13 weeks

20 Participants Needed

Trial Summary

Is 24-hour Activity Counselling safe for humans?

The studies reviewed focus on physical activity and nutrition interventions for frailty, which are generally considered safe and beneficial for older adults. Participants in these studies showed high adherence and satisfaction, with improvements in physical function and dietary habits, suggesting that such interventions are safe and well-tolerated. ^{1 2 3 4}

How does 24-hour Activity Counselling differ from other treatments for frailty?

24-hour Activity Counselling is unique because it focuses on continuous, personalized guidance to increase physical activity levels, which can improve frailty by enhancing physical function and reducing functional limitations. Unlike other treatments that may involve group exercises or dietary changes, this approach provides individualized support, potentially making it more adaptable to each person's needs. ^{3 4 5 6 7}

What is the purpose of this trial?

Physically frail older adults often have chronic conditions that contribute to a higher chance of them being limited in daily activities and becoming dependent. Physical activity can help to better manage chronic conditions and prevent frailty. In this project, the counselling approach using the new Canadian 24-hour Movement Guidelines will be adapted for older adults at an early state of frailty. This new approach will be tested against the one in current use by physiotherapists. This ethics application will address the pilot implementation evaluation, including interviews and focus groups, conducted to refine the new approach.

Research Team

Linda Li, PhD

Principal Investigator

University of British Columbia

Eligibility Criteria

This trial is for older adults who are physically frail and at an early stage of frailty, with chronic conditions that limit daily activities. Participants should be able to follow the counselling program and provide feedback.

Inclusion Criteria

I am a physiotherapist in Greater Vancouver, mostly work with older adults, and am open to online training and random group assignment.

Exclusion Criteria

Those who do not meet the Inclusion Criteria

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the 24-hour Activity Counselling or the Current Physical Activity Counselling

8-13 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

Treatment Details

Interventions

• 24-hour Activity Counselling

Trial Overview The study tests a new counselling approach based on Canadian 24-hour Movement Guidelines against the current physiotherapy practices. It aims to see if this new method helps manage chronic conditions and prevent further frailty.

Participant Groups

Group I: 24-hour Activity Counselling Experimental Treatment 1 Intervention

Participating physiotherapists will be trained to deliver counselling that focuses on increasing moderate-to-vigorous physical activity, with a balance of activity, rest and sleep in a 24-hour day. Patients (n=4) of these physiotherapists will receive the 24-hour Activitiy Counselling

Group II: Current Physical Activity Counselling Active Control 1 Intervention

Participating physiotherapists will continue delivering counselling that focuses on achieving 150 minutes/week of moderate-to-vigorous physical activity, which is the current practice. Patients (n=4) of these physiotherapists will receive the Current Physical Activitiy Counselling

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Arthritis Research Centre of Canada

Collaborator

Trials

16

Recruited

12,200+

Findings from Research

Researchers at the University of Manchester are developing a behavior change intervention aimed at pre-frail older adults to encourage participation in group-based physical activity classes, which have been shown to effectively slow the progression of frailty.

There is strong support from stakeholders for proactively addressing pre-frailty, as a significant number of older adults are affected, suggesting that such interventions could enhance healthy aging and improve overall health outcomes in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability of physical activity signposting for pre-frail older adults: a qualitative study to inform intervention development. Money, A., Harris, D., Hawley-Hague, H., et al.[2023]

The MoveStrong program, an 8-week exercise and nutrition intervention delivered via telephone and virtual sessions, was feasible and well-accepted by older adults, with a high retention rate of 93% and adherence to sessions exceeding 80%.

Participants showed significant improvements in physical function, as evidenced by increased chair stand test scores and enhanced dietary protein intake, indicating the program's effectiveness in addressing frailty in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults. Wang, E., Keller, H., Mourtzakis, M., et al.[2022]

In a study involving 300 older adults (average age 82.5 years) with signs of frailty, it was found that greater severity of frailty is linked to lower functional independence and health-related quality of life (HRQoL).

The participants were randomized into a 12-month home-based exercise program or usual care, highlighting the potential for supervised physical activity to improve outcomes for frail individuals, although the results of the intervention are not detailed in this abstract.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Older persons with signs of frailty in a home-based physical exercise intervention: baseline characteristics of an RCT. Suikkanen, S., Soukkio, P., Pitkälä, K., et al.[2022]

Training interventions are the most effective way to improve health outcomes in frail older adults, according to several systematic reviews and meta-analyses.

Group exercise programs are more beneficial than home-based exercise for frail individuals, highlighting the need for expanded access to group training opportunities for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Diagnosis of frailty as starting point for training interventions]. Benzinger, P., Rapp, K., Bauer, J.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Acceptability of physical activity signposting for pre-frail older adults: a qualitative study to inform intervention development. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Objectively Measured Patterns of Daily Physical Activity and Phenotypic Frailty. [2022]

3. Canada pubmed.ncbi.nlm.nih.gov

MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults. [2022]

4. Ireland pubmed.ncbi.nlm.nih.gov

Protocol for a randomised controlled trial of a primary care intervention to Reverse Frailty and Enhance Resilience through Exercise and dietary protein Education (REFEREE) in community-dwelling adults aged 65 and over. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Effect of telephone exercise counseling on frailty in older veterans: project LIFE. [2021]

6. Germany pubmed.ncbi.nlm.nih.gov

Older persons with signs of frailty in a home-based physical exercise intervention: baseline characteristics of an RCT. [2022]

7. Germany pubmed.ncbi.nlm.nih.gov

[Diagnosis of frailty as starting point for training interventions]. [2022]