Effects of a blended home-based exercise program and protein counselling in community dwelling older adults: results of the VITAMIN RCT

Purpose: With the ageing population, there is an increasing demand for strategies to optimise muscle mass, strength and physical performance in community dwelling older adults. We designed a new innovative e-health intervention "VITAMIN" to improve physical performance in older adults. The blended home-based exercise intervention contains digital support to improve personalised coaching as well as dietary protein counselling. This study evaluates the 6 months effectiveness of the intervention. Methods: The cluster RCT included 245 community dwelling older adults (age = 55y) randomised to control, exercise, and exercise+dietary protein counselling group. Data was collected at baseline and after 6 months of intervention. The primary outcome was the modified Physical Performance test (mPPT) with an emphasis on daily functioning. Secondary measures were gait speed (GS; m/s), physical activity level (PAL), protein intake (g/kg/d), appendicular skeletal muscle mass by DXA (ASMM; kg), hand grip strength (HGS; kg). For statistical analysis SPSSv24.0 was used. A mixed models analysis was performed, with group, time and group*time interaction as fixed factors, subject and cluster as random factors, and additional posthoc Bonferroni test. Results: Mean age of the 224 evaluated participants was 72.0±smn;6.5y, 71% were females and 44% low educated. No significant intervention effect was found for mPPT (p=.889). Secondary outcomes showed a significant intervention effect: GS (p=.002), PAL (p=.014), protein intake (p<.001), ASSM (p=.029),HGS (p<.001). Posthoc Bonferroni showed that exercise+protein group had statistical improved outcome compared to control for these secondary outcomes (p<.001; p=.003; p<.001; p=.009; p<.001). Control group showed declined values at 6 months compared to baseline for GS (D-.23 m/s), PAL (D -.03), ASSM (D -.32 kg) and HGS (D -.96 kg).Conclusions: Older adults had already very high scores for physical performance (mPPT), however the blended home-based exercise intervention with protein counselling was still effective for gait speed, physical activity level, dietary protein intake, muscle mass and strength. This personalised innovative e-health intervention showed to be a promising strategy for community dwelling older adults for maintenance instead of declining physical function.