| Objective:To construct a multicomponent exercise intervention program for older adults with possible sarcopenia based on the International Classification of Functioning,Disability and Health(ICF)theoretical framework and to explore the feasibility and effectiveness of the multicomponent exercise intervention program in improving health-related physical fitness and quality of life in older adults with possible sarcopenia.Methods:1.Guided by evidence-based medicine,randomized controlled trials on exercise interventions for sarcopenia in the last 10 years were reviewed,and Cochrane quality criteria were used to select the higher quality literature for the study combined with the ICF theoretical framework to construct the protocol.Two rounds of Delphi method and pre-experiments were used to further modify and refine the intervention protocol.2.A convenience sampling method was used to select 54 older adults with possible sarcopenia who met the inclusion and exclusion criteria in the community of Bengbu,and they were divided into the intervention and control groups using the residence grouping method.The intervention group implemented the multicomponent exercise intervention program,and the control group maintained their daily activity status.Before and after 12 weeks of the intervention,the health-related physical fitness and quality of life were used to evaluate the effectiveness of the application of the exercise intervention program.Descriptive statistics,χ~2test,Fisher’s precision probability test,Mann-Whitney U test,t test,and Paired Samples Wilcoxon signed rank test were mainly used for statistical analysis,and P<0.05 was considered a significant difference.Results:1.Construction of a multicomponent exercise intervention program(1)Through an evidence-based approach,nineteen studies were eventually included,one at level A and 18 at level B.The first draft of the refined intervention program,including 4 first-level items,15 second-level items,and 36 third-level items.(2)For the both rounds consultations,the response rates was 100%,the expert authority coefficients were 0.875 and 0.900,and the Kendall’s concordance coefficients were 0.124 and 0.165,respectively.15 items were revised and 4 items were added after the first round of expert consultation,2 items were revised after the second round,and 4items were revised after the pre-experiment.The final multicomponent exercise intervention program for older adults with possible sarcopenia was formed with 4first-level items,14 second-level items,and 37 third-level items.The program specifically includes multicomponent exercise group training once a week,home training twice a week,group communication and telephone follow-up once a month,and four knowledge skills training sessions.2.Quasi-experimental study(1)During the intervention,one case was lost in the intervention group and two cases were lost in the control group.Finally,there were 51 participants in this study,including 26 cases in the intervention group and 25 cases in the control group.(2)Baseline data were comparable between the two groups of older adults before the intervention,and the differences were not statistically significant(P>0.05).(3)Health-related physical fitness:(1)Body composition:After the intervention,the differences in BMI and waist-to-hip ratio in the intervention group,compared with those before the intervention,were not statistically significant(P>0.05);compared with those in the control group,the differences were not statistically significant(P>0.05).(2)Muscle fitness:Left hand grip strength,right hand grip strength and 5-time chair stand test were significantly better in the intervention group after the intervention than before the intervention,with statistically significant differences(P<0.05).The post-intervention left hand grip strength,right hand grip strength and 5-time chair stand test of the intervention group were significantly better than those of the control group,with statistically significant differences(P<0.05).(3)Flexibility:Left hand back scratch test,right hand back scratch test,left foot chair sit-and-reach test and right foot chair sit-and-reach test were significantly better in the intervention group than before the intervention,and the difference was statistically significant(P<0.05),but compared with the control group,the difference was not statistically significant(P>0.05).(4)Cardiorespiratory fitness:Vital capacity and 2-min step test were significantly better in the intervention group after the intervention than before the intervention,with statistically significant differences(P<0.05).The difference in vital capacity between the intervention group and the control group after the intervention was statistically significant(P<0.05),while the difference in 2-min step test was not statistically significant(P>0.05).(5)Balanced capacity:The 2.44-m up-and-go test was significantly better in the intervention group after the intervention than before the intervention,with statistically significant difference(P<0.05).Compared with the two groups,the intervention group was significantly better than the control group,and the difference was statistically significant(P<0.05).(4)Quality of life:General health and mental health were significantly better in the intervention group after the intervention than before the intervention,with statistically significant differences(P<0.05).Compared to the two groups,role-physical,mental health,vitality,social function and mental component summary were significantly better in the intervention group than in the control group,with statistically significant differences(P<0.05).Conclusion:1.The ICF-based multicomponent exercise intervention program for older adults with possible sarcopenia is simple,easy to implement,scientific,feasible and safe,which is suitable for further application in the community.2.The multicomponent exercise intervention program can effectively improve muscle fitness and balanced capacity in older adults with possible sarcopenia.It also has a positive effect on improving flexibility,cardiorespiratory fitness and quality of life. |
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