Home training with and without additional group training in physically frail old people living at home: effect on health-related quality of life and ambulation.

OBJECTIVE To test the effect of two exercise regimes on health-related quality of life (HRQoL) and ambulatory capacity. DESIGN Randomized controlled trial. SUBJECTS Seventy-seven community-dwelling physically frail people over 75 years of age (mean = 81, SD = 4.5). INTERVENTIONS Home training (HT, N= 38) comprised twice daily functional balance and strength exercises and three group meetings. Combined training (CT, N= 39) included group training twice weekly and the same home exercises. Interventions lasted 12 weeks. Physiotherapists ran both programmes. Home exercises were recorded daily. MAIN MEASURES HRQoL was assessed by SF-36, and ambulatory capacity by walking speed and frequency and duration of outdoor walks. RESULTS Following intervention, CT improved the SF-36 mental health index significantly more than HT (p = 0.01). The SF-36 physical health index (p = 0.002) and walking speed (p = 0.02) demonstrated improvements, but no group differences. Six months after cessation of intervention there was still overall improvements on the mental health index (p = 0.032), borderline overall improvements on the physical health index (p = 0.057), higher weekly number of outdoor walks for the CT group than for the HT group (p = 0.027) and an improved habitual walking speed in the CT group only (p = 0.022). CONCLUSIONS HT improved HRQoL and walking speed, but additional group training gave larger benefits on mental health. Group training away from home may be beneficial for mental health and ambulatory capacity.