Home-Based Exercise Supported by General Practitioner Practices: Ineffective in a Sample of Chronically Ill, Mobility-Limited Older Adults (the HOMEfit Randomized Controlled Trial).
To evaluate the effects a home-based exercise program delivered to ill and mobility-limited elderly individuals on physical function, physical activity, quality of life, fall-related self-efficacy, and exercise self-efficacy.



Randomized controlled trial (ISRCTN Registry, Reg.-No. ISRCTN17727272).



Fifteen general practitioner (GP) practices and participants' homes.



Chronically ill and mobility-limited individuals aged 70 and older (N = 209).



An exercise therapist delivered the experimental intervention-a 12-week multidimensional home-based exercise program integrating behavioral strategies-in individual counseling sessions at the GPs' practices and over the telephone. The control intervention focused on promoting light-intensity activities of daily living. Interventions took place between February 2012 and March 2013.



The primary outcome was functional lower body strength (chair-rise test). Secondary outcomes were physical function (battery of motor tests), physical activity (step count), health-related quality of life (Medical Outcomes Study 8-item Short-Form Survey), fall-related (Falls Efficacy Scale-International Version), and exercise self-efficacy (Selbstwirksamkeit zur sportlichen Aktivitaet (SSA) scale). Postintervention differences between the groups were tested using analysis of covariance (intention to treat; adjusted for baseline value and GP practice; significance level P ≤ .05).



Participants had a mean age ± standard deviation of 80 ± 5, 74% were female, 87% had three or more chronic diseases, and 54% used a walking aid. The difference (intention to treat; experimental minus control) between adjusted postintervention chair-rise times was -0.1 (95% confidence interval = -1.8-1.7). Differences for all secondary outcomes were also nonsignificant.



The program was ineffective in the target population. Possibilities for improving the concept will have to be evaluated.
Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.|Department of Sports Medicine and Sports Nutrition, University of Bochum, Bochum, Germany.
Timo
T
Hinrichs
Institute of General Practice and Family Medicine, University of Witten/Herdecke, Witten, Germany.|Institute of General Practice, University of Düsseldorf, Düsseldorf, Germany.
Bettina
B
Bücker
Department of Medical Informatics, Biometry and Epidemiology, University of Bochum, Bochum, Germany.
Renate
R
Klaaßen-Mielke
Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany.
Michael
M
Brach
Institute of General Practice, University of Düsseldorf, Düsseldorf, Germany.
Stefan
S
Wilm
Department of Sports Medicine and Sports Nutrition, University of Bochum, Bochum, Germany.
Petra
P
Platen
Department of Sports Medicine and Sports Nutrition, University of Bochum, Bochum, Germany.|Department of Medical Informatics, Biometry and Epidemiology, University of Bochum, Bochum, Germany.
Anna
A
Mai
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000534:rehabilitation*; D002985:Clinical Protocols; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D058005:General Practitioners; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D020377:Self Efficacy
aged; chronic disease; general practice; mobility limitation; physical activity