An interventional study of ALIFE exercise program and OTAGO exercise program in Older Adults Living in Residential Care Facilities, sponsored by The Hong Kong Polytechnic University. Completed at 1 site in Hong Kong. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2026-09-23.
Sponsored by The Hong Kong Polytechnic University · Not applicable, Interventional, and Treatment
More than half of older adults living in care homes experience a fall each year, which can cause serious injuries, hospital visits, and a loss of independence. While balance and muscle-strengthening exercises help prevent falls, traditional exercise programs are often difficult for care home residents to maintain because they require set schedules and unfamiliar movements, especially for those experiencing cognitive problems.
To address this challenge, our 12-week study evaluated the Assisted Lifestyle-integrated Functional Exercise (ALIFE) program across six residential care homes. Rather than holding separate workout sessions, ALIFE weaves personalized balance and strengthening activities directly into daily routines-such as rising from a chair or practicing steady standing while grooming. Visiting physiotherapists tailored the movements to each resident's needs, while trained care home staff offered gentle reminders and encouragement throughout the program. The investigators compared ALIFE to a traditional structured Otago exercise program (OTAGO) to determine if this approach is feasible, safe, and enjoyable for residents.
The investigators expect this lifestyle-based exercise program to be safe, enjoyable, and more effective than the traditional exercise program at helping residents preserve their balance and muscle strength. If successful, it will provide care homes with a practical, low-cost way to turn everyday habits into health-promoting activities without needing expensive equipment. Ultimately, these findings could guide future clinical practice and larger studies aimed at helping older adults stay mobile, confident, and independent.
Exclusion Criteria:
Behavioral: ALIFE exercise program
Behavioral: OTAGO exercise program
Residents who will be assigned to the ALIFE exercise program will perform balance and muscle strengthening exercises together with associated daily activities for 12 weeks. Outreach physiotherapists will assess the daily routine of participants in the participating facilities. The physiotherapists will help participants to set realistic exercise goals, selecte appropriate balance and muscle strengthening exercises, and pair them with the preferred daily activities. Participants will be recommended to perform the exercises at least once per day whenever the opportunity arises during each day. Personal care workers in the facilities will serve as the facilitators who will provide positive encouragement and remind participants to perform the exercises.
The OTAGO exercise program is a structured balance and muscle strengthening exercises tailored to the needs and ability of each participant. Based on the balance, muscle strengthen, and mobility levels of participants at baseline, the outreaching physiotherapists will select the appropriate balance and muscle strengthening exercises for participants. They recommend participants to perform the assigned exercises at least once per day. Participants will also be encouraged to walk every day at their usual speed with their walking aids (if any) as often as possible.
Retention rate
Proportion (%) of enrolled participants who completed the post-intervention assessment at 12 weeks.
Time frame: 12 weeks
Adverse event counts
Number of adverse events reported by participants and interventionists throughout the 12 weeks
Time frame: 12 weeks
Physical Activity Enjoyment Scale (PACES)
Physical activity enjoyment scale (PACES) scores at 6 weeks and 12 weeks. The PACES is an 8-item instrument scored on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree), yielding a total score between 8 and 56. A higher score denotes greater exercise enjoyment.
Time frame: 6 weeks and 12 weeks
Balance
Berg Balance Scale (BBS) - a 14-tem assessment tool evaluating static and dynamic balance. The score ranges from 0 to 56. A higher score indicates better balance.
Time frame: Baseline, 6 weeks, and 12 weeks
Mobility
Timed Up and Go test
Time frame: Baseline, 6 weeks, and 12 weeks
Lower limb muscle strength
30-second sit to stand test
Time frame: Baseline, 6 weeks, and 12 weeks
Global cognition
Montreal Cognitive Assessment uses a maximum total score of 30 points distributed across 7 main cognitive categories. The range of score is 0 to 30. A higher score indicates better cognitive function.
Time frame: Baseline, 6 weeks, and 12 weeks
Attention
Digit Span Test Forward
Time frame: Baseline, 6 weeks, and 12 weeks
Working memory
Digit Span Test Backward
Time frame: Baseline, 6 weeks, and 12 weeks
Fear of falling
Iconographical Falls Efficacy Scale - a 10-item assessment tool evaluating fear of falling in daily activities. The score ranges from 10 to 40. A higher score indicates great concern of falling.
Time frame: Baseline, 6 weeks, and 12 weeks
Depressive symptoms
Geriatric Depression Scale - a 15-tem assessment tool evaluating depressive symptoms in older adults. The score ranges from 0 to 15. A higher score indicates higher level of depressive symptoms.
Time frame: Baseline, 6 weeks, and 12 weeks
Plan to share: No
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The Hong Kong Polytechnic University