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Genoline Jeyasehar

A feasibility trial evaluating mobility and strength training with and without protein supplements in pre-frail/frail older adults with low protein intake.

As people age, loss of muscle size and strength, slower walking, low activity levels, weight loss and feeling tired are common. Older people reporting some or all of these problems may be called frail. Frail people find it harder to get over illness and are more likely to fall or need hospital care. We need to find ways to stop people becoming frail and allow them to live independently without care and support.

Exercise is a treatment for frailty that can improve muscle strength and walking. Including extra protein in an older person’s diet may also help. Protein provides the building blocks for muscles but many older people do not eat enough protein. Taking extra protein while exercising may increase the benefits of exercise. However, we do not know if this approach reduces frailty or improves walking and quality of life.

The aim of this multicentre, parallel, 2-group, randomised controlled feasibility study is to find out if it is possible to carry out a larger trial comparing exercise plus extra protein to exercise alone, in older people with low protein intake. We will find out if we can find enough people with a low protein diet willing to take part; whether participants are happy to take the protein supplements; and whether NHS physiotherapy departments can provide the exercise sessions.

We will work with NHS physiotherapy departments to recruit 50 older people living in the community who are frail or at risk of becoming frail and have low protein intake. Participants will be randomly allocated to exercise plus protein or exercise only.

All participants will undertake exercise twice a week with support from a physiotherapist for 6 months. The exercise programme involves muscle strengthening, balance and walking. Participants will be invited to attend 16 weekly group exercise classes run by the physiotherapist and to carry out the exercises at home once a week. They will then be asked to exercise at home twice weekly for a further 8 weeks. Half the participants will also take protein supplements for 6 months.
At enrolment and 8 months later, we will measure walking ability, balance, muscle strength and size. We will ask participants about QoL and use of health and social care services.