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The percentage of people aged over 80 will double in 25 years, reaching 10% of the population. This means that care practices for older adults will have to be adapted. Furthermore, disability-free life expectancy at 65 years old is 10.4 years, well below the overall life expectancy of 24.4 years for women and 19.1 years for men. Beneficiaries of the personalized autonomy allowance would increase by 60%, representing a major cost. Among the various factors predictive of loss of autonomy, loss of mobility and muscle weakness are major components (OR = 3.28 at 3 years) according to data from the latest meta-analyses. These two disability-causing factors are also responsible for multiple adverse events (falls, fractures, etc.), impaired quality of life and increased mortality. The only components accessible to preventive action and with a proven track record are exercise and nutrition. Despite a high level of evidence on the improvement of physical abilities and muscle strength, these programs are still not sufficiently implemented in practice. Indeed, neither the identification of seniors at risk of mobility disability, nor preventive actions are usually carried out in primary care. Setting up a care path, with personalized intervention combining, after identification, learning of good physical activity practices by a specialized kinesiologist and nutritional advice, followed by supervised exercise, for subjects at risk, is a public health imperative. The "Well on my legs" prevention program, supported by Hospices Civils de Lyon and present since 2014 in the Rhône region, is a concrete solution to this major public health challenge.
Analyses will be based on data collected through participant assessments during the "Well on my legs" prevention program. The analyses will make it possible to assess the risk factors of mobility disability in older adults at the start (T0) and at the end of the program (T3+12months), with the aim of improving the program's efficiency and evaluating its effectiveness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Community-dwelling older adults assessed without mobility disability risk factors following initial | Community-dwelling older adults aged of >70y, screened at risk of mobility disability risk factors and assessed without any mobility disability risk factors. This group is not included for intervention and received lifestyle counselling to maintain habits. No follow-up is conducted in this group. Or community-dwelling older adults aged of >70y, screened with medical contraindication. This group is not included for intervention and oriented to other medical practitioners. No follow-up is conducted in this group. |
| |
| Community-dwelling older adults assessed with mobility disability risk factors following initial ass | Community-dwelling older adults aged of >70y, screened at risk of mobility disability risk factors and assessed with at least 1 mobility disability risk factor. This group is included for 3 months exercise intervention. Follow-up is conducted at 3 months (T3) and from T3 at 6 months (phone call) and 12 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Assessment | Diagnostic Test | Evaluation carried out during a day hospital at T0 (initial assessment) and T3 (after the exercise program at around 3 months) including:
|
| Measure | Description | Time Frame |
|---|---|---|
| SPPB (Short Physical Performance Battery) | Functional status is assessed by the overall Short Physical Performance Battery (SPPB) score, based on three components: gait speed, chair raising and balance tests. | Change in the SPPB Score at 3 months of intervention and 1 year after |
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Inclusion Criteria:
At least 1 of the following signs:
Exclusion Criteria:
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Community-dwelling older adults aged 70 and over, living at home, presenting risk factors for loss of mobility and having been assessed in the "Well on my legs" program for, at least, initial assessment (T0).
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| Name | Affiliation | Role |
|---|---|---|
| DELAIRE Leo, Kinesiologist | Hospices Civils de Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service de médecine du vieillissement - Hôpital Edouard Herriot | Lyon | France | 69003 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40877763 | Derived | Courtay-Breuil A, Delaire L, Humblot J, Gilbert T, Aubertin-Leheudre M, Bonnefoy M. Influence of a multicomponent exercise intervention on fear of falling and gait parameters in community-dwelling older adults: a prospective study. BMC Geriatr. 2025 Aug 28;25(1):668. doi: 10.1186/s12877-025-06257-1. |
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| ID | Term |
|---|---|
| D055948 | Sarcopenia |
| D000073496 | Frailty |
| D057185 | Sedentary Behavior |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D010808 | Physical Examination |
| D014284 | Triiodothyronine |
| ID | Term |
|---|---|
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D013970 | Thyronines |
| D013963 | Thyroid Hormones |
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Evaluation of the concentration of various markers of undernutrition (albuminemia and pre-albuminemia), inflammation (CRP) and metabolism (calcium and vitamin D) at T0 (initial assessment) and T3 (after the exercise program at around 3 months)
|
| Multicomponent exercise program | Other | After inclusion in the protocol, participants with mobility disability risk factors are assigned to specialized and experienced kinesiologists at the end of the medical consultation. Patients will be invited to take part in group-based exercise sessions, in small groups of no more than 10 patients, under the supervision of a kinesiologist. There will be 20 sessions over 10 weeks, at a rate of 2 sessions per week, each lasting one hour. The Multicomponent exercise program included progressive resistance and balance training. |
|
| Follow-up at T3 + 6 months and T3 + 12 months | Other | Follow-up at T3 + 6 months : - After the T3 visit, patients will either be redirected to independent practice (booklet) or to relay structures. At T3 + 6 months (6 months after the 3-month visit), the kinesiologists will call each patient to assess their compliance with the program, any difficulties encountered, any falls (and their severity and consequences), fear of falling, their level of ADL/IADL autonomy, level of PA practice (RAPA), presence of frailty appreciation (FRIED), whether or not they have entered an institution. Follow-up at T3 + 12 months : At T3+12 months (12 months after the 3-month visit), patients will be seen again by the kinesiologists to make a final assessment of their physical and functional conditions, with measurements (Handgrip, SPPB, TUG, gait parameters, leg strength) and questionnaires (SarQol and FES-I). Patients will only be seen again by the kinesilogists, as this is mainly a check-up and final advice visit, to continue the exercises performed since. |
|
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |
| D010335 | Pathologic Processes |
| D001519 | Behavior |
| D006728 |
| Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D013974 | Thyroxine |
| D024322 | Amino Acids, Aromatic |
| D000598 | Amino Acids, Cyclic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |