Targeted Physical Function Exercises for Frailty and Falls Management in Pre-Frail Community-Dwelling Older Adults: A Randomized Controlled Trial.

Background/Objectives: Exercise is essential for older adults to maintain or improve their physical condition. This study aimed to investigate whether improvements in physical performance, functional mobility, and balance through targeted physical function exercises could positively influence Concerns about Falling (CaF) and frailty in pre-frail community-dwelling older adults. Methods: We conducted an 18-month randomized controlled trial involving 112 pre-frail community-dwelling older adults aged 65 years or older. 55 individuals in the control group (CG) and 57 in the intervention group (IG) were assessed. The IG participated in a home-based physical function exercise program. Primary outcomes included Physical Performance (Short Physical Performance Battery, SPPB), Functional Mobility (Timed Up and Go, TUG), Balance (Berg Balance Scale, BBS), CaF (Falls Efficacy Scale-International, FES-I), and Frailty status (SHARE-FI). Assessments were conducted at baseline, 6, 12, and 18 months. Results: The IG showed significant improvements in BBS (p < 0.01, partial eta2 0.17), SPPB (p < 0.01, partial eta2 0.13), TUG (p < 0.01, partial eta2 0.14) and FES-I (p < 0.01, partial eta2 0.07) compared to the CG and their baseline after 6, 12 and 18 months of intervention. By 18 months, frailty status improved in the IG, with 12.3% classified as non-frail compared to 2.0% in the CG, while 14.5% of the CG transitioned to frailty versus none in the IG. Discussion: The intervention appears to support improvements in physical function and may contribute to reductions in CaF and beneficial changes in frailty status among pre-frail community-dwelling older adults.