The Efficacy of 12-Week Progressive Home-Based Strength and Tai-Chi Exercise Snacking in Older Adults: A Mixed-Method Exploratory Randomised Control Trial

Background Maintaining physical function is important for independence and frailty prevention in later life, but very few older adults meet exercise recommendations. Previous studies found that 4-week ‘exercise and Tai-chi snacking’ as a viable alternative to traditional exercise is acceptable to healthy older adults. Objectives This study aimed to investigate the effectiveness of a 12-week progressive exercise and Tai-chi snacking programme on physical function and psychological outcomes in pre-frail older adults. Design Randomised controlled trial. Setting Community-dwelling older adults. Participants 90 older adults with impaired strength and balance were recruited. Participants were randomly allocated to an intervention or waitlist control group. Intervention A 12-week progressive exercise and Tai-chi snacking programme. Measurements Physical function (the short physical performance battery (SPPB), single-leg balance test and sit-to-stand test) was remotely measured at participants’ homes via video calls at baseline, 4-, 8-, and 12-weeks. The self-reported psychological outcomes were also assessed every 4 weeks using online questionnaires. A subset of 40 participants also completed in-person functional assessments, and 26 intervention participants underwent semi-structured interviews to feedback on their experiences. Results The 12-week progressive home-based exercise and Tai-chi snacking improved SPPB strength (estimated mean difference in week 4: 1.05; week 8: 0.79; and week 12: 0.79) and balance (estimated mean difference in week 4: 0.71; week 8: 0.57; and week 12: 0.65) at each timepoint compared to control group. Timed-up-and-go (estimated mean difference in week 4: 1.94; week 8: 1.58; and week 12: 1.1) and total SPPB scores (estimated mean difference in week 4: 2.24; week 8: 1.79; and week 12: 1.76) were also better in the intervention group compared to the control group in lab subset participants. Based on the qualitative findings, Participants found the programme accessible and beneficial, making it suitable for older adults and increasing self-efficacy in physical activities. Conclusion The home-based exercise and Tai-chi snacking programme significantly improved lower extremity strength, balance, and mobility in pre-frail older adults. This programme is considered to be a beneficial, acceptable and easy implemented physical function intervention.