Impact of Tailored Multicomponent Exercise for Preventing Weakness and Falls on Nursing Home Residents’ Functional Capacity
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OBJECTIVES: We aimed to determine whether the benefits of long (24 weeks) and short (4 weeks) training programs persisted after short (6 weeks) and long (14 weeks) periods of inactivity in older adult nursing home residents with sarcopenia. DESIGN: Multicenter randomized trial. INTERVENTION: The Vivifrail tailored, multicomponent exercise program (http://vivifrail.com) was conducted to individually prescribe exercise for frail older adults, depending on their functional capacity. The training included 4 levels combining strength and power, balance, flexibility, and cardiovascular endurance exercises. SETTING AND PARTICIPANTS: Twenty-four institutionalized older adults (87.1 ± 7.1 years, 58.3% women) diagnosed with sarcopenia were allocated into 2 groups: the Long Training-Short Detraining (LT-SD) group completed 24 weeks of supervised Vivifrail training followed by 6 weeks of detraining; the Short Training-Long Detraining (ST-LD) group completed 4 weeks of training and 14 weeks of detraining. MEASURES: Changes in functional capacity and strength were evaluated at baseline, and after short and long training and detraining periods. RESULTS: Benefits after short and long exercise interventions persisted when compared with baseline. Vivifrail training was highly effective in the short term (4 weeks) in increasing functional and strength performance (effect size = 0.32-1.44, P < .044) with the exception of handgrip strength. Continued training during 24 weeks produced 10% to 20% additional improvements (P < .036). Frailty status was reversed in 36% of participants, with 59% achieving high self-autonomy. Detraining resulted in a 10% to 25% loss of strength and functional capacity even after 24 weeks of training (effects size = 0.24-0.92, P < .039). CONCLUSIONS AND IMPLICATIONS: Intermittent strategies such as 4 weeks of supervised exercise 3 times yearly with no more than 14 weeks of inactivity between exercise periods appears as an efficient solution to the global challenge of maintaining functional capacity and can even reverse frailty in vulnerable institutionalized older adults.
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Recent evidence suggests that exercise confers a protective effect even after short and long-term cessations, which is particularly relevant for frail and institutionalized populations.
“Despite these interruptions, recent evidence suggests that exercise confers a protective effect even after short and long-term cessations, which is particularly relevant for frail and institutionalized populations.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
In older adults with sarcopenia living in nursing homes, a tailored multicomponent exercise program (VIVIFRAIL) produced significant improvements in both functional capacity and strength.
“The results demonstrated significant improvements in both functional capacity and strength, with 36% of participants changing scores to “robust” or “non-frail” and 59% achieving a high level of self-autonomy at 4 weeks.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Although detraining led to a 10%-25% decline in functional capacity, the improvements remained well above baseline levels.
“Although detraining led to a 10%–25% decline in functional capacity, the improvements remained well above baseline levels.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Participants in the long-term training group saw additional benefits, with a further 10%-20% enhancement in performance compared to the short-term group.
“Participants in the long-term training group saw additional benefits, with a further 10%–20% enhancement in performance compared to the short-term group.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Intermittent exercise strategies-such as 4-week training blocks repeated three times per year-have the potential to sustain and enhance functional capacity in frail older adults, even in the face of inevitable periods of inactivity.
“These findings suggest the potential of intermittent exercise strategies—such as 4-week training blocks repeated three times per year—to sustain and enhance functional capacity in frail older adults, even in the face of inevitable periods of inactivity [243,251].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
In that study, 36% of participants changed scores to robust or non-frail and 59% achieved a high level of self-autonomy at 4 weeks.
“The results demonstrated significant improvements in both functional capacity and strength, with 36% of participants changing scores to “robust” or “non-frail” and 59% achieving a high level of self-autonomy at 4 weeks.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Cognitive performance, executive function, and mobility can continue to improve or retain improvements even after training stops.
“Conversely, cognitive performance, executive function, and mobility can continue to improve or retain improvements even after training stops, as noted above in the study by Courel-Ibáñez et al. [243,251] and others [[273], [274], [275]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Based on research findings, the most widely used mobile application for physical exercise prescription in frail older adults is VIVIFRAIL.
“Based on research findings, the most widely used mobile application for physical exercise prescription in frail older adults is VIVIFRAIL [251].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
The VIVIFRAIL app fulfills the needs of frail older adults by providing adaptable, accessible, and progressive exercise programs that provide both written and audiovisual information.
“This evidence-based app fulfills the needs of frail older adults by providing adaptable, accessible, and progressive exercise programs that provide both written and audiovisual information.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
The VIVIFRAIL multicomponent program has shown potential as an effective intervention for maintaining and ameliorating physical frailty in vulnerable institutionalized older adults.
“The VIVIFRAIL multicomponent program has shown potential as an effective intervention for maintaining and ameliorate physical frailty in vulnerable institutionalized older adults [243,251].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Although detraining led to a 10%-25% decline in functional capacity, improvements remained well above baseline levels.
“Although detraining led to a 10%–25% decline in functional capacity, the improvements remained well above baseline levels.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
In a study by Courel-Ibáñez et al., significant improvements in functional capacity and strength were demonstrated, with 36% of participants changing scores to robust or non-frail and 59% achieving a high level of self-autonomy at 4 weeks.
“The results demonstrated significant improvements in both functional capacity and strength, with 36% of participants changing scores to “robust” or “non-frail” and 59% achieving a high level of self-autonomy at 4 weeks.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
Findings suggest potential of intermittent exercise strategies-such as 4-week training blocks repeated three times per year-to sustain and enhance functional capacity in frail older adults even in the face of periods of inactivity.
“These findings suggest the potential of intermittent exercise strategies—such as 4-week training blocks repeated three times per year—to sustain and enhance functional capacity in frail older adults, even in the face of inevitable periods of inactivity [243,251].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
The most widely used mobile application for physical exercise prescription in frail older adults is VIVIFRAIL.
“Based on research findings, the most widely used mobile application for physical exercise prescription in frail older adults is VIVIFRAIL [251].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
The VIVIFRAIL app fulfills needs of frail older adults by providing adaptable, accessible, and progressive exercise programs that provide both written and audiovisual information.
“This evidence-based app fulfills the needs of frail older adults by providing adaptable, accessible, and progressive exercise programs that provide both written and audiovisual information.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [251]
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- Authors
- Courel-Ibáñez, J., Buendía-Romero, Á., Pallarés, J. G., García-Conesa, S., Martínez-Cava, A., & Izquierdo, M.
- Affiliations
- Universidad de Murcia (ES)
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2022-01
- Volume
- 23
- Issue
- 1
- Pages
- 98-104.e3
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W3175069585
- Cited by
- 62
- References
- 53
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 15 · 2023: 14 · 2022: 6 · 2021: 3
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Medical Directors Association (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by-nc-nd)
- RUIdeRA - Institutional University Repository (University of Castilla-La Mancha) (submittedVersion)
- Funders
- Fundacion Seneca (20872/PI/18)
- Instituto de Salud Carlos III
- European Regional Development Fund
- Ministerio de Economía, Industria y Competitividad, Gobierno de España (PI17/ 01814)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- sarcopenia, frailty, nursing home residents, older adults, multicomponent exercise, tailored exercise, detraining, functional capacity, muscle strength, fall prevention, grip strength, intermittent exercise, institutionalized elderly
- MeSH terms
- Accidental Falls, Frailty, Aged, Exercise Therapy, Female, Humans, Male, Nursing Homes, Exercise, Hand Strength
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