Resistance Training for Frail and Pre-Frail Older Adults: Feasibility, and Impact on Multidimensional Health

Abstract

This thesis investigated the feasibility and impact of a resistance training (RT) intervention on multidimensional health and physical function in frail and pre-frail older adults living in residential care. It also examined the reliability of maximal strength measures in this population. Chapter One introduces the literature on ageing and multidimensional health relating to the prevalence, causes and consequences of frailty. RT is offered as a potent strategy for lifelong health. Chapter Two describes a comprehensive feasibility trial evaluating a RT intervention with frail older adults in a residential care home. Chapter Three presents the feasibility and impact of a RT intervention with pre-frail care home and supported living residents. Chapter Four is an evaluation of the reliability of maximal handgrip and lower limb strength assessments across both frail and pre-frail older adults. Chapter Five is an overall Discussion summarising and critically appraising the findings, including strengths and limitations, practical implications, and recommendations for future research. This thesis makes several original contributions to knowledge. First, that RT interventions assessing measures of multidimensional health and physical function with frail and pre-frail older adults in residential care are feasible. Second, that RT can positively impact strength and functional ability, and perceived changes in mood, vitality, and movement confidence. Third, that maximal strength testing with frail and pre-frail older adults with no prior experience is both reliable and appropriate and identifies clear recommendations for strength testing with this population group. However, limitations and suggested revisions identified in the feasibility trials would need further consideration before progression to definitive Randomised Controlled Trials (RCTs). The thesis supports a multidimensional health approach to RT research with frail and pre-frail older adults and confirms that frailty is not a barrier to RT, and that structured progressive RT can improve physical function and quality of life in ageing.