Enhancing Physical Reserve to Promote Resilience in Physically Frail Older Adults

NCT07513701 | Recruiting

• 2 other identifiers: HSEARS2025070900325603525
• Study Type: interventional
• Target: 224
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to assess the efficacy of combined aerobic and resistance training in enhancing physical reserve in older adults with physical frailty. Investigator contend that enhanced physical reserve will enable preservation of cognitive and physical function. The main questions aims to answer are: (1) Compared with usual care (i.e., CON), will 3-month aerobic and resistance training (ATRT) improve physical reserve in older adults with physical frailty? (2) Compared with CON, will ATRT lead to changes in the neural network organization? (3) Will improved physical reserve lead to better maintenance of cognitive and physical functioning in spite of presence of white matter hyperintensities (WMH)?

Conditions

Frailty at Older Adults

Keywords

physical frailty; aerobic exercise; resistance training; magnetic resonance imaging; physical reserve

Outcome Measures

Primary Outcomes (4)

• 30 seconds sit-to-stand test

  Mobility

  Baseline and 3 months

• Quantification of physical reserve

  Physical reserve will be operationally defined as the unexplained residual variance in 30-second Sit-to-Stand Test after accounting for the effects of age, cognitive capacity, and brain structural integrity.

  Baseline and 3 months

• Alzheimer's Disease Assessment Scale-Cognitive-13

  Cognitive capacity will be assessed by the Alzheimer's Disease Assessment Scale-Cognitive-13. It measures memory, language, praxis, attention, and executive function, with scores ranging from 0 to 85; higher scores indicate greater cognitive impairment.

  Baseline and 3 months

• Total hippocampal volume

  Total hippocampal volume will be selected to reflect brain structural integrity

  Baseline and 3 months

Secondary Outcomes (10)

• Trail Making Test

  Baseline and 3 months

• Resting state functional connectivity

  Baseline and 3 months

• Education

  Baseline and 3 months

• Physical Activity Scale for the EAlderly

  Baseline and 3 months

• Body mass index

  Baseline and 3 months

Study Arms (2)

Aerobic and resistance training

EXPERIMENTAL

Participants will complete two aerobic training sessions and two resistance training sessions per week for a total of four exercise training sessions each week lasting for 3-month (i.e., 13-weeks). Aerobic exercise intensity will be tracked through heart-rate monitors with an age-specific targeted heart-rate-reserve initially set at 50% and progressively increased by 5% weekly until 70% heart-rate-reserve is reached in Week-5, then it will be sustained for the remainder of the trial. The first four weeks of the resistance training program will emphasize on assisting the study participants in gaining familiarity with proper technique. The intensity of the resistance training stimulus will be set to a weight where the participants can complete two sets of 10-15 repetitions, then progressed from 45% to 85% of predicted 1-repetition-maximum determined at Week-4 using the 8-rep maximum test. The 8-rep maximum test is rrepeated every 4 weeks to ensure the exercise intensity is maintained

Behavioral: Aerobic and resistance training

Usual care

PLACEBO COMPARATOR

Participant Retention and Care: Investigator will implement strategies to promote participant retention by: (1) conducting monthly phone calls by the project assistant to encourage and motivate participants to stay within the study; (2) discussing participant barriers/distress and developing coping/action plans; (3) providing monthly updates in the form of in-person/online/phone sessions; and (4) offering a comprehensive report on cognitive function, mobility, brain MRI, and monetary compensation for their time upon completion of the study. Investigator will facilitate participant care by recording incidental findings from the MRI and providing clinical assessment data that may be shared with healthcare providers upon request. All personnel on the research team will be trained to detect/assess distress or any possibility of harm and respond appropriately.

Behavioral: Usual Care

Interventions

Aerobic and resistance training BEHAVIORAL

The aerobic training sessions will involve standardized sets of stationary training, including on-spot jogging, burpees, aerobic steppers, agility ladders, and non-contact boxing. Each participant will rotate through the stations within the 40-minute training period, with one-minute of rest breaks in-between each station. A 20-point rate-of-perceived exertion will be used to monitor participant status during training with a target rate-of-perceived exertion of 16-17. The resistance training sessions will involve utilizing free weights and resistance bands to stimulate muscle strength. The set of movements include triceps extension, dumbbell bicep curls, seated overhead dumbbell press, bent-over dumbbell row, wall squats, standing calf raises, wall push-ups.

Aerobic and resistance training

Usual Care BEHAVIORAL

Participant Retention and Care: Investigator will implement strategies to promote participant retention by: (1) conducting monthly phone calls by the project assistant to encourage and motivate participants to stay within the study; (2) discussing participant barriers/distress and developing coping/action plans; (3) providing monthly updates in the form of in-person/online/phone sessions; and (4) offering a comprehensive report on cognitive function, mobility, brain MRI, and monetary compensation for their time upon completion of the study. Investigator will facilitate participant care by recording incidental findings from the MRI and providing clinical assessment data that may be shared with healthcare providers upon request. All personnel on the research team will be trained to detect/assess distress or any possibility of harm and respond appropriately.

Usual care

Eligibility Criteria

• Age: 60 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• are community-dwelling (i.e., not residing in a nursing home or extended care unit) ;
• scored \< 9/12 on the SPPB;
• scored \>18/30 on the MoCA;
• are able to walk independently; use of walking aid is acceptable;
• are able to safely engage in exercise as indicated by the Physical Activity Readiness Questionnaire Plus33 and confirmed by their physician;
• have internet at home; and
• are able to provide written informed consent.

You may not qualify if:

• diagnosed with dementia or stroke;
• self-report engaging in strength and balance training exercises \> two-times-per-week in the 3 months prior to screening;
• unable to understand, speak, and read Cantonese/Chinese/English proficiently; and
• contraindications for MRI such as MRI-incompatible implants.

Sponsors & Collaborators

• The Hong Kong Polytechnic University: lead
• University of British Columbia: collaborator

Study Sites (1)

The Hong Kong Polytechnic University, Department of Rehabilitation Sciences

Hong Kong, Hong Kong, 0000000, Hong Kong

RECRUITING

MeSH Terms

Interventions

Resistance Training

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Central Study Contacts

Chun Liang HSU, PhD

CONTACT

852-27666755; chun-liang.hsu@polyu.edu.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant professor

Study Record Dates

• First Submitted: March 23, 2026
• First Posted: April 7, 2026
• Study Start: January 19, 2026
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): March 31, 2029
• Last Updated: September 25, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Dec 2028
• Access Criteria: a commitment to using the data only for research purposes and not to identify an individual participant; a commitment to securing the data using appropriate computer technology; a commitment to destroying or returning the data after analyses are completed; all data sharing requests must be reviewed and approved by the PI.

Locations

HK (1)