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Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial

Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial
Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial

Background: To the best of our knowledge, although ageing-induced fatigue could cause adverse outcomes such as frailty, there is currently no intervention for it. This study evaluated the effects of an individualised exercise programme with/without BCE strategies on reducing fatigue in older adults. Methods: A three-armed cluster-randomised controlled trial (RCT) was conducted with 184 participants (mean age: 79.1 ± 6.4; mean frailty score: 2.8 + 0.8) from 21 community centres (ClinicalTrials.gov: NCT03394495). They were randomised into either: the COMB group (n = 64), receiving 16 weeks of exercise training plus the BCE programme; the EXER group (n = 65), receiving exercise training and health talks; or the control group (n = 55), receiving only health talks. Fatigue was assessed using the Multi-dimensional Fatigue Inventory (range: 20 to 100, with higher scores indicating higher fatigue levels) at baseline, and immediately, 6 months, and 12 months post-intervention. Results: The GEE analyses showed significant interaction (time x group) between the COMB and control groups immediately (p < 0.001), 6 months (p < 0.001), and 12 months (p < 0.001) post-intervention. Comparing the COMB and EXER groups, there was a significant interaction immediately (p = 0.013) and at 12 months post-intervention (p = 0.007). However, no significant difference was seen between the EXER group and control group at any time point. Conclusions: The COMB intervention showed better immediate and sustainable effects (i.e., 12 months after the intervention) on reducing fatigue in frail older adults than exercise training or health education alone. Trial registration: ClinicalTrials.gov (NCT03394495), registered on 09/01/2018.

Behaviour change enhancement, Exercise, Fatigue, Frailty, Humans, Aged, 80 and over, Quality of Life, Aged, Frail Elderly, Exercise Therapy/methods, Fatigue/therapy
1471-2318
370
Liu, Justina Y.W.
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Yin, Yue Heng
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Kor, Patrick P.K.
a53553a2-eb35-4ba5-9e9a-0fee2a7c1e3f
Kwan, Rick Y.C.
4ad03790-4557-41c1-8584-3313a4235e51
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Chien, Wai Tong
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Siu, Parco M.
3a92bd40-810f-44e8-80d3-585b634d0bf6
Hill, Keith D.
5b1b0163-6d58-4457-b308-2691991cf7eb
Liu, Justina Y.W.
6274f844-c636-44ad-aa6e-4d83a3225c7a
Yin, Yue Heng
16b6a1ad-c32b-4d82-a782-99acea4afa78
Kor, Patrick P.K.
a53553a2-eb35-4ba5-9e9a-0fee2a7c1e3f
Kwan, Rick Y.C.
4ad03790-4557-41c1-8584-3313a4235e51
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Chien, Wai Tong
b060431b-1453-4064-a8b0-6c3d44bae8d1
Siu, Parco M.
3a92bd40-810f-44e8-80d3-585b634d0bf6
Hill, Keith D.
5b1b0163-6d58-4457-b308-2691991cf7eb

Liu, Justina Y.W., Yin, Yue Heng, Kor, Patrick P.K., Kwan, Rick Y.C., Lee, Paul H., Chien, Wai Tong, Siu, Parco M. and Hill, Keith D. (2023) Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial. BMC Geriatrics, 23 (1), 370, [370]. (doi:10.1186/s12877-023-04080-0).

Record type: Article

Abstract

Background: To the best of our knowledge, although ageing-induced fatigue could cause adverse outcomes such as frailty, there is currently no intervention for it. This study evaluated the effects of an individualised exercise programme with/without BCE strategies on reducing fatigue in older adults. Methods: A three-armed cluster-randomised controlled trial (RCT) was conducted with 184 participants (mean age: 79.1 ± 6.4; mean frailty score: 2.8 + 0.8) from 21 community centres (ClinicalTrials.gov: NCT03394495). They were randomised into either: the COMB group (n = 64), receiving 16 weeks of exercise training plus the BCE programme; the EXER group (n = 65), receiving exercise training and health talks; or the control group (n = 55), receiving only health talks. Fatigue was assessed using the Multi-dimensional Fatigue Inventory (range: 20 to 100, with higher scores indicating higher fatigue levels) at baseline, and immediately, 6 months, and 12 months post-intervention. Results: The GEE analyses showed significant interaction (time x group) between the COMB and control groups immediately (p < 0.001), 6 months (p < 0.001), and 12 months (p < 0.001) post-intervention. Comparing the COMB and EXER groups, there was a significant interaction immediately (p = 0.013) and at 12 months post-intervention (p = 0.007). However, no significant difference was seen between the EXER group and control group at any time point. Conclusions: The COMB intervention showed better immediate and sustainable effects (i.e., 12 months after the intervention) on reducing fatigue in frail older adults than exercise training or health education alone. Trial registration: ClinicalTrials.gov (NCT03394495), registered on 09/01/2018.

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Accepted/In Press date: 31 May 2023
e-pub ahead of print date: 16 June 2023
Published date: 16 June 2023
Additional Information: Funding Information: This study was funded by the Hong Kong University Grants Committee and the Hong Kong Polytechnic University (ref. no. 1560717). Publisher Copyright: © 2023, The Author(s).
Keywords: Behaviour change enhancement, Exercise, Fatigue, Frailty, Humans, Aged, 80 and over, Quality of Life, Aged, Frail Elderly, Exercise Therapy/methods, Fatigue/therapy

Identifiers

Local EPrints ID: 480726
URI: http://eprints.soton.ac.uk/id/eprint/480726
ISSN: 1471-2318
PURE UUID: 26d19e62-9ecb-46a6-834b-8734e1af6b76
ORCID for Paul H. Lee: ORCID iD orcid.org/0000-0002-5729-6450

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Date deposited: 08 Aug 2023 16:57
Last modified: 18 Mar 2024 04:09

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Contributors

Author: Justina Y.W. Liu
Author: Yue Heng Yin
Author: Patrick P.K. Kor
Author: Rick Y.C. Kwan
Author: Paul H. Lee ORCID iD
Author: Wai Tong Chien
Author: Parco M. Siu
Author: Keith D. Hill

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