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UBC Theses and Dissertations

Exercise to reverse frailty in older females Bray, Nicholas Walter


The risk of becoming frail increases with age. One million Canadians are frail, placing them at greater risk for disease and disability. Frailty is easily observed yet difficult to define. No gold-standard definition exists, but most clinicians support frailty as a medical syndrome characterized as a state of mild to severe vulnerability. Sex-differences complicate frailty; females experience this syndrome sooner yet paradoxically live longer than males. Exercise might be an effective therapy for frailty; however, which components are most effective is yet unknown. This study hypothesized: 1) More individuals in an exercise (EX) intervention would reverse frailty, versus a control (CON) group; and 2) Changes in frailty would be related to improvement in functional task performance and measures of strength. Female participants 65-81 years of age, classified as pre-frail as determined by a score of; 1-2 on the Cardiovascular Health Study-Frailty Phenotype (FP) tool or 4-6 on the Clinical Frailty Scale (CFS) or a normal gait speed (GS) between 1.0-1.5 m/sec. The EX group (n = 9) completed a 12-week exercise intervention (3 days/week, 60 min/session). Exercise included multi-component training (MCT), inclusive of aerobic, flexibility, resistance and balance training, with a focus on the latter two modalities. The CON group (n = 11) maintained their normal daily routine. According to the FP, CFS and GS, 25, 37.5 and 62.5% more EX group participants reversed frailty status than the CON group, respectively. There was a statistically significant improvement in GS (0.24 m/sec), grip strength (3.9 kg) and sit-to-stand (STS) time (5.0 sec) within the EX group from baseline to follow-up. STS was faster in the CON group at baseline but no significant between-group difference existed at follow-up. There was also a statistically significant improvement in knee extension isometric torque (7.4 Nm) and isotonic velocity (37.5 º/sec) within the EX group from baseline to follow-up. Elbow flexion isotonic velocity was faster (40.8 º/sec) in the EX group at follow-up but no significant between-group difference existed at baseline. A MCT intervention that utilizes progressive resistance and balance exercise may be safe and effective at reversing frailty in pre-frail females.

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