Effects of Mobility-Fit, a tailored multicomponent physical activity program with upper-limb emphasis, on strength, mobility and fall risk among older adults in long-term care: a cluster randomised controlled trial.

BACKGROUND

Older adults in long-term care (LTC) face accelerated functional decline due to frailty, affecting mobility and quality of life (QoL). Upper-body strength is crucial for daily activities and injury prevention, yet conventional physical activity (PA) programs often overlook it. This cluster randomised controlled trial evaluated Mobility-Fit, a 12-week multicomponent PA program emphasising upper-limb and core strength among LTC residents.

METHODS

Twenty LTC facilities were randomised into the Mobility-Fit (10 facilities, n = 73) or control (10 facilities, n = 73) group. Mobility-Fit included agility, balance and resistance exercises (3 times/week, 45 minutes), tailored to participants' functional capacity. The control group received standard care with lower-limb exercises, delivered with the same frequency. Outcomes included upper- and lower-limb strength, postural sway, reaction time, mobility (Short Physical Performance Battery), frailty (FRAIL-Nursing Home), fall risk (Longitudinal Aging Study Amsterdam fall risk profile questionnaire, LASA) and QoL [EuroQol (EQ)-5D]. An intention-to-treat analysis with generalised estimating equations was conducted.

RESULTS

Participants (median age = 86, 60% female) exhibited high adherence (83.3%). Mobility-Fit demonstrated superior improvements in elbow extension strength [β = 0.50, 95% confidence interval 0.26-3.89] and QoL (EuroQol five-dimension questionnaire utility: β = 0.17, P < .001; EQ-Visual Analogue Scale: β = 7.13, P = .006). Both groups improved lower-limb strength (knee extension: β = 2.72, P < .001) and mobility (Sit-To-Stand time: β = -3.69, P < .001), with a reduced LASA score (β = -1.20, P < .001).

CONCLUSIONS

Mobility-Fit effectively enhanced upper-limb strength and QoL in LTC residents. Both groups showed improvements in lower-limb strength and mobility, highlighting the universal benefits of structured PA. The program addresses a critical gap by demonstrating the value of integrating upper-body training into standard care to promote holistic well-being.