Resistance exercises or vitamin D did not improve physical health or reduce falls in frail older people
QUESTION: In frail older people, does a home based programme of quadriceps resistance exercise or vitamin D supplementation improve physical health and reduce falls?
Design
Randomised (allocation concealed), blinded (clinicians, patients, and outcome assessors), controlled, factorial design trial with 6 months of follow up.
Setting
5 teaching hospitals in Auckland, New Zealand and Sydney, Australia.
Patients
243 people admitted to geriatric rehabilitation units (inpatient or day wards) who were ≥65 years of age (mean age 79 y, 53% women), considered frail (≥1 health problem or functional limitation [eg, dependency in an activity of daily living, prolonged bed rest, impaired mobility, or a recent fall]), and had no indication or contraindication for the study treatments. Exclusion criteria included poor prognosis, severe cognitive impairment, physical limitations restricting adherence to the exercise programme, unstable cardiac status, and large ulcers around the ankles. Follow up was 91%.
Intervention
Patients were allocated to resistance exercise (n=120) or attention control (n=123) and to vitamin D (six 1.25 mg tablets of calciferol) (n=121) or placebo (n=122). The quadriceps resistance exercise involved warm up stretches and 3 sets of 8 repetitions of knee extensions using ankle cuff weights in a seated position 3 times per week for 10 weeks. Patients were monitored weekly by a physiotherapist, with …
