Abstract

The purpose of this study was to test the effects of Strong for Life (SFL) on the physical performance and self-rated health of older adults receiving Home and Community-Based Services (HCBS). We used a randomized, two-group trial with pre-post measures to deliver the in-home exercise program. Clients aged 65–95 (n=42) and their Home Care Aide (HCA) (n=32) were randomly assigned to a usual care and SFL intervention or usual care control group. Clients were instructed in SFL by their HCA and completed SFL three times per week for twelve-weeks. Outcomes included grip and quadriceps strength, Timed Up and Go, gait speed, Self-Efficacy for Exercise, pain, and PROMIS-global health measured at baseline and immediately following the intervention. Clients completed opened-ended survey items on SFL program evaluation. Effect sizes were moderate for grip strength (d= .38), pain (d= .34), and PROMIS-global health (d= .27). Small effect sizes were found for all other measures. Median quadriceps and TUG scores differentially improved among intervention participants versus controls. No adverse health events and high program satisfaction were reported. Frailty prevalence in the control group increased between baseline and posttest while frailty prevalence in the intervention group decreased during the same time period. Strong for Life has the potential to improve the strength, mobility, health, and frailty of older adults receiving HCBS. This study provides initial evidence of the impact of SFL for older adults receiving HCBS, as well as the safety of the intervention evidenced by the lack of reported adverse events.