{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:18:35Z","timestamp":1786123115355,"version":"build-2736575974"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia prevalence is high in long-term care settings (LTCS), yet existing guidelines often overlook this population. The Reablement Strategies targeting Sarcopenia (ReStart-S) program was developed to address this gap. This study evaluated its effects on muscle outcomes, physical performance, quality of life (QoL), and a blood biomarker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cluster-randomized trial was conducted in LTCS across Udupi and neighboring districts. Sarcopenic older adults (\u2265 60\u2009years, Barthel Index \u2265 60, Mini-Cog \u2265 3, AWGS-2019 criteria) were recruited. LTCS were randomized into intervention (IG) and control (CG) groups. IG received a 6-week ReStart-S program, while CG continued usual activities. Outcomes at baseline, 6, 12, and 18\u2009weeks included handgrip strength (HGS, primary outcome), skeletal muscle index (SMI), Short Physical Performance Battery (SPPB), SarQoL, and C-terminal Agrin Fragment (CAF; not assessed at 12\u2009weeks). Linear mixed models evaluated group*time interactions with Bonferroni correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 12 LTCS screened, 7 were eligible; 78 participants enrolled (IG\u2009=\u200939; CG\u2009=\u200939). CG was older than IG (74.3\u2009\u00b1\u20099.4 vs 67.9\u2009\u00b1\u20096.0; p\u2009&amp;lt;\u2009.001). Significant group*time interaction was observed for HGS (F\u2009=\u20095.524; p\u2009=\u2009.001), improving at 12 (2.49; 95% CI, 1.16-3.82; p\u2009&amp;lt;\u2009.001) and 18\u2009weeks (2.14; 0.79-3.48; p\u2009=\u2009.002). SPPB improved at 6, 12, and 18\u2009weeks (all p\u2009&amp;lt;\u2009.001). SarQoL improved at all follow-ups (all p\u2009&amp;lt;\u2009.001). SMI improved at 18\u2009weeks (0.20; p\u2009=\u2009.011). CAF decreased at 18\u2009weeks (\u221261.77; p\u2009&amp;lt;\u2009.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ReStart-S improved muscle strength, physical performance, and QoL, reduced CAF, and showed delayed muscle mass gains, supporting its role in sarcopenia care in LTCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>The study was prospectively registered on October 20, 2022 on the Clinical Trial Registry-India (CTRI) platform. Trial registration number CTRI\/2022\/10\/046680. The trial can be accessed at: https:\/\/ctri.nic.in\/Clinicaltrials\/showallp.php? mid1=71007&amp;EncHid=&amp;userName=CTRI\/2022\/10\/046680<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag141","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:43:24Z","timestamp":1779968604000},"source":"Crossref","is-referenced-by-count":0,"title":["Cluster randomized trial of reablement strategies targeting sarcopenia (ReStart-S) in long-term care settings"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-5456","authenticated-orcid":false,"given":"Prabal","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education , Manipal, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-7457","authenticated-orcid":false,"given":"Shashikiran","family":"Umakanth","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dr TMA Pai Hospital, Udupi, Manipal Academy of Higher Education , Manipal, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-532X","authenticated-orcid":false,"given":"Kusumakshi","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Manipal College of Health Professions, Manipal Academy of Higher Education , Manipal, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-9393","authenticated-orcid":false,"given":"Olivier","family":"Bruy\u00e8re","sequence":"additional","affiliation":[{"name":"Research Unit in Public Health, Epidemiology and Health Economics, University of Liege , Liege,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6472-6631","authenticated-orcid":false,"given":"Vennila","family":"Jaganathan","sequence":"additional","affiliation":[{"name":"Manipal College of Health Professions, Manipal Academy of Higher Education , Manipal, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-5332","authenticated-orcid":false,"given":"Girish","family":"Nandakumar","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education , Manipal, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2026080710063740800_glag141-B1","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"2026080710063740800_glag141-B2","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"2026080710063740800_glag141-B3","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s12603-019-1267-x","article-title":"Differences in the prevalence of sarcopenia in community-dwelling, nursing home and hospitalized individuals. 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