Abstract
Rational and Background: Frailty is a physical decline that can be observed in older adults
aged 65 years or older. It results in an increased risk of illness, reduced ability to perform daily
activities independently, a higher risk of falling, and potential cognitive issues such as memory
and cognitive problems. Exercise is one effective method to reduce the risk of frailty. However,
due to physical limitations, older adults often face difficulties in exercising or movement,
leading to a sedentary lifestyle. This restricts their opportunities to participate in social
activities, impacts their mobility, and reduces their ability to perform daily self-care tasks.
Access to appropriate exercise equipment or programs suitable for the older adults’ physical
condition can help them live independently, decrease dependence on others, and lower the
risk of disability, including health issues related to non-communicable diseases, thereby
improving their quality of life.
Objectives: To investigate the effectiveness of exercise using the I-walk training machine and
home-based exercises on mobility, physical fitness, memory and cognition, depression, and
nutritional status after 12 weeks of exercise in older adults with pre-frailty.
Method: Thai participants with aged 65 and above, with pre-frailty status, and low grip strength
(n = 53), were randomly assigned into 3 groups: the control group (n=18), the I-walk group
(n=17), and the home-based exercise group (n=18). The exercise groups participated in 60
minutes of exercise per day, 3 days per week, for 12 weeks. Data on mobility, physical fitness,
memory and cognition, body composition, respiratory muscle strength, depression, and
nutritional status were assessed before and after the exercise intervention. The data collected
were analyzed using a two-way mixed model (3x2) and post-hoc analysis with the Bonferroni
test to examine differences before and after exercise, as well as between groups. Statistical
significance was set at 0.05.
Result: After 12 weeks of exercise, the I-walk group had better cardiovascular endurance and
balance compared to the control group (p < 0.05, p < 0.05, respectively). The walking balance
with dual-tasks (calculation) improved after training only in the I-walk group (p < 0.05). The
walking balance with dual-tasks (word recall) improved after training in both the I-walk group
and the home-based exercise group (p < 0.05, p < 0.01, respectively). After the exercise, the
control group showed increased walking speed (p < 0.01) and higher grip strength (p < 0.01).
Furthermore, the control group had a faster walking speed than the home-based exercise
group (p < 0.05). Additionally, the I-walk group showed an increase in inspiratory muscle
strength (p < 0.01), whereas hip flexor muscle strength decreased (p < 0.05). The home-based
exercise group showed an increase in both knee extensor and hip extensor muscles strength
(p < 0.01) and hip flexor muscles (p < 0.05). Moreover, memory and cognition improved after
exercise in all three groups (p < 0.001, p < 0.001, p < 0.001, respectively).
Conclusion: Exercise using the I-walk training machine and home-based exercises can improve
balance during dual-tasks (processing thoughts, enhance memory and cognition). Additionally,
exercise with the I-walk training machine can increase inspiratory muscle strength, while homebased exercise can improve the strength of the knee flexor and extensor muscles in older
adults with pre-frailty.
