Comparison of Mobile Application-based tele-rehabilitation and In-person Rehabilitation in Elderly Patients with Sarcopenia: A Randomized Controlled Trial (Preprint)
Authors: Zhang Lu , Ge Ying , Zhao Wowa , Shu Xuan , Kang Lin , Wang Qiumei , Liu Ying 
Published: December 2024

BACKGROUND

Sarcopenia is closely associated with poor quality of life and mortality and the prevention and treatment of sarcopenia represent a critical area of research, with significant implications for the health of the elderly population. Resistance training is an effective treatment for elderly patients with sarcopenia. However, due to reasons such as inadequate rehabilitation facilities, transportation barriers, financial constraints, and diminished physical ability, elderly patients with sarcopenia often face challenges when receiving traditional rehabilitation treatments at hospitals.

OBJECTIVE

This study aims to compare the effects of a digital rehabilitation program with traditional therapist-supervised rehabilitation training in elderly patients with sarcopenia.

METHODS

Fifty-eight sarcopenia patients, diagnosed according to the criteria of the Asian Working Group for Sarcopenia (AWGS), were recruited offline and randomly assigned to the tele-rehabilitation group (TRG, n=29) or the in-person rehabilitation group (IRG, n=29) supervised by a therapist. Both groups underwent the same 4-week resistance training program targeting six major muscle groups. After receiving one session of in-person exercise guidance from a therapist, the TRG Group received exercise guidance via a mobile application and exercised completely independently at home. Meanwhile, the IRG Group received in-person training from a therapist each time. Offline assessments of body composition, strength, balance, cardiorespiratory endurance, and self-care ability were conducted in the hospital before and after the intervention. Specific assessments included grip strength, 30-Second Arm Curl Test (30SACT), 30-Second Sitting-to-Rising Test (30SSRT), quadriceps femoris extension peak torque (EPT) and total power (ETP), Berg Balance Scale (BBS), timed up-and-go test (TUGT), 6-minute walk test (6MWT), and instrumental activities of daily living (IADL).

RESULTS

In the TRG and IRG groups, 24 and 27 patients respectively completed the training and 4-week follow-up, with exercise intervention adherence rates of 97% and 92%. Both groups demonstrated significant improvements in strength (grip strength, 30SACT, 30SSRT, quadriceps femoris EPT and ETP), balance (BBS), and IADL (P<0.05). After 4 weeks of treatment, there were no significant differences between the two groups in terms of changes in body composition, strength, balance, cardiorespiratory endurance, and IADL.

CONCLUSIONS

A 4-week remote resistance training program is effective in improving strength, balance, and IADL in elderly patients with sarcopenia, with effects comparable to rehabilitation supervised by a physical therapist. Tele-rehabilitation may be a convenient and effective alternative for elderly sarcopenia patients who have limited access to rehabilitation resources.

CLINICALTRIAL

http://www.chictr.org.cn/, ChiCTR 2300071648, May 22, 2023.