{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T02:50:41Z","timestamp":1775443841570,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place\u2013rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants\u2019 homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg\u2019s perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p &lt; 0.05) in the experimental group. Among the older adults\u2019 lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults.<\/jats:p>","DOI":"10.3390\/healthcare11020276","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T04:06:47Z","timestamp":1673842007000},"page":"276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of the Active Aging-in-Place\u2013Rehabilitation Nursing Program: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5838-0080","authenticated-orcid":false,"given":"Ana da Concei\u00e7\u00e3o Alves","family":"Faria","sequence":"first","affiliation":[{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal"},{"name":"Aces Ave\/Famalic\u00e3o, North Region Health Administration, 4000-447 Porto, Portugal"}]},{"given":"Maria Manuela F. P. S.","family":"Martins","sequence":"additional","affiliation":[{"name":"Nursing School of Porto (ESEP), 4200-072 Porto, Portugal"},{"name":"CINTESIS@RISE, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-9537","authenticated-orcid":false,"given":"Olga Maria Pimenta Lopes","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Nursing School of Porto (ESEP), 4200-072 Porto, Portugal"},{"name":"CINTESIS@RISE, 4200-450 Porto, Portugal"}]},{"given":"Jo\u00e3o Miguel Almeida","family":"Ventura-Silva","sequence":"additional","affiliation":[{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal"},{"name":"Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Esmeralda Faria","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7601-284X","authenticated-orcid":false,"given":"Luciano Jos\u00e9 Moreira","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3661-3584","authenticated-orcid":false,"given":"Jos\u00e9 Alberto","family":"Laredo-Aguilera","sequence":"additional","affiliation":[{"name":"Facultad de Fisioterapia y Enfermer\u00eda, Campus de F\u00e1brica de Armas, Universidad de Castilla-La Mancha, 45071 Toledo, Spain"},{"name":"Multidisciplinary Research Group in Care (IMCU), University of Castilla-La Mancha, 45005 Toledo, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/ggi.13689","article-title":"Prevalence of frailty status among the European elderly population: Findings from the Survey of Health, Aging and Retirement in Europe","volume":"19","author":"Manfredi","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e018195","DOI":"10.1136\/bmjopen-2017-018195","article-title":"Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: A systematic review and meta-analysis","volume":"8","author":"Siriwardhana","year":"2018","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"CMAJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.outlook.2009.09.005","article-title":"Toward a conceptual definition of frail community dwelling older people","volume":"58","author":"Gobbens","year":"2010","journal-title":"Nurs. Outlook"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1007\/s12603-018-1054-0","article-title":"Social Frailty Is Associated with Physical Functioning, Cognition, and Depression, and Predicts Mortality","volume":"22","author":"Ma","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1003.e7","DOI":"10.1016\/j.jamda.2015.08.023","article-title":"Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability","volume":"16","author":"Makizako","year":"2015","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104119","DOI":"10.1016\/j.archger.2020.104119","article-title":"Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: A scoping review","volume":"90","author":"Mehrabi","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.maturitas.2018.06.009","article-title":"Tackling frailty and functional decline: Background of the action group A3 of the European innovation partnership for active and healthy ageing","volume":"115","author":"Cano","year":"2018","journal-title":"Maturitas"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2147\/CIA.S328423","article-title":"Association Between Fear of Falling and Frailty in Community-Dwelling Older Adults: A Systematic Review","volume":"17","author":"Canever","year":"2022","journal-title":"Clin. Interv. Aging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.11124\/JBISRIR-2016-003018","article-title":"Predicting risk and outcomes for frail older adults: An umbrella review of frailty screening tools","volume":"15","author":"Cooke","year":"2017","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"752","DOI":"10.11124\/JBISRIR-2017-003551","article-title":"Effectiveness of exercise interventions on physical function in community-dwelling frail older people: An umbrella review of systematic reviews","volume":"16","author":"Jadczak","year":"2018","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104757","DOI":"10.1016\/j.archger.2022.104757","article-title":"Effects of strength exercises combined with other training on physical performance in frail older adults: A systematic review and meta-analysis","volume":"102","author":"Weng","year":"2022","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.smhs.2019.08.007","article-title":"Reversal of age-associated frailty by controlled physical exercise: The pre-clinical and clinical evidences","volume":"1","author":"Millan","year":"2019","journal-title":"Sports Med. Heal. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Li, P.-S., Hsieh, C.-J., Tallutondok, E.B., and Peng, H.-J. (2022). The Dose-Response Efficacy of Physical Training on Frailty Status and Physical Performance in Community-Dwelling Elderly: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Healthcare, 10.","DOI":"10.3390\/healthcare10030586"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.gerinurse.2019.10.006","article-title":"Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: A systematic review and meta-analysis of randomized controlled trials","volume":"41","author":"Zhang","year":"2020","journal-title":"Geriatr. Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"E728","DOI":"10.9778\/cmajo.20200222","article-title":"Effectiveness of physical activity interventions in older adults with frailty or prefrailty: A systematic review and meta-analysis","volume":"9","author":"Racey","year":"2021","journal-title":"CMAJ Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1136\/bjsports-2014-094015","article-title":"Older people\u2019s perspectives on participation in physical activity: A systematic review and thematic synthesis of qualitative literature","volume":"49","author":"Franco","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1479-5868-11-79","article-title":"Understanding the relationships between the physical environment and physical activity in older adults: A systematic review of qualitative studies","volume":"11","author":"Moran","year":"2014","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/1479-5868-8-121","article-title":"Barriers to physical activity in older adults in Germany: A cross-sectional study","volume":"8","author":"Moschny","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_21","first-page":"311","article-title":"Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review","volume":"25","author":"Burton","year":"2017","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1159\/000500778","article-title":"Attitudes Towards Adapted Lifestyle-Integrated Functional Exercise Developed for 60\u201370-Year-Olds: Perceptions of Participants and Trainers","volume":"65","author":"Boulton","year":"2019","journal-title":"Gerontology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1159\/000499962","article-title":"The Adapted Lifestyle-Integrated Functional Exercise Program for Preventing Functional Decline in Young Seniors: Development and Initial Evaluation","volume":"65","author":"Schwenk","year":"2019","journal-title":"Gerontology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1159\/000479965","article-title":"Feasibility and effectiveness of intervention programmes integrating functional exercise into daily life of older adults: A systematic review","volume":"64","author":"Weber","year":"2018","journal-title":"Gerontology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1016\/j.apmr.2021.06.017","article-title":"Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial","volume":"102","author":"Suikkanen","year":"2021","journal-title":"Arch. Phys. Med. Rehabilit."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Schwarzer, R., and Hamilton, K. (2020). Changing behavior using the health action process approach. The Handbook of Behavior Change, Cambridge University Press.","DOI":"10.1017\/9781108677318.007"},{"key":"ref_27","unstructured":"Pender, N., Murdaugh, C., and Parsons, M. (2019). Health Promotion in Nursing Practice, Pearson\/Prentice-Hall. [8th ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1080\/17437199.2014.981777","article-title":"Efficacy of theory-based interventions to promote physical activity. A meta-analysis of randomised controlled trials","volume":"10","author":"Gourlan","year":"2016","journal-title":"Health Psychol. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s12160-014-9593-z","article-title":"Which Behaviour Change Techniques Are Most Effective at Increasing Older Adults\u2019 Self-Efficacy and Physical Activity Behaviour? A Systematic Review","volume":"48","author":"French","year":"2014","journal-title":"Ann. Behav. Med."},{"key":"ref_30","first-page":"129","article-title":"Aging with health: Aging in place strategies of a Portuguese population aged 65 years or older","volume":"54","author":"Marques","year":"2020","journal-title":"Rev. de Saude Publ."},{"key":"ref_31","first-page":"726","article-title":"WITHDRAWN: CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials","volume":"152","author":"Schulz","year":"2010","journal-title":"Int. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Faria, A.d.C.A., Martins, M.M.F.P.S., Ribeiro, O.M.P.L., Ventura-Silva, J.M.A., Fonseca, E.F., Ferreira, L.J.M., Teles, P.J.F.C., and Laredo-Aguilera, J.A. (2022). Multidimensional Frailty and Lifestyles of Community-Dwelling Older Portuguese Adults. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192214723"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/ggi.12373","article-title":"Portuguese version of the Tilburg Frailty Indicator: Transcultural adaptation and psychometric validation","volume":"15","author":"Coelho","year":"2015","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_34","unstructured":"Sequeira, C.A.C. (2007). Cuidar de Idosos Dependentes, Quarteto. [1st ed.]."},{"key":"ref_35","unstructured":"Duarte, M. (2015). Fragilidade em Idosos: Modelos, Medidas e Implica\u00e7\u00f5es Pr\u00e1ticas, Coisas de Ler."},{"key":"ref_36","first-page":"199","article-title":"Grau de depend\u00eancia em doentes que sofreram AVC","volume":"8","author":"Azeredo","year":"2003","journal-title":"Rev. Facul. Med. Lisboa"},{"key":"ref_37","unstructured":"Baptista, F., and Sardinha, L. (2005). Avalia\u00e7\u00e3o de Aptid\u00e3o F\u00edsica e do Equil\u00edbrio de Pessoas Idosas: Baterias de Fullerton, Faculdade de Motricidade Humana."},{"key":"ref_38","unstructured":"Petiz, E.M. (2002). A Actividade F\u00edsica, Equil\u00edbrio e Quedas. um Estudo em Idosos Institucionalizados. [Unpublished Master\u2019s Thesis, Faculdade de Ci\u00eancias do Desporto e de Educa\u00e7\u00e3o F\u00edsica da Universidade do Porto]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_40","first-page":"5","article-title":"Valida\u00e7\u00e3o da escala perfil do estilo de vida individual","volume":"13","author":"Both","year":"2008","journal-title":"Rev. Bras. Ativ. F\u00edsica Sa\u00fade"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.pmedr.2018.06.015","article-title":"Does modified Otago Exercise Program improves balance in older people? A systematic review","volume":"11","author":"Martins","year":"2018","journal-title":"Prev. Med. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Clemson, L., Munro, J., and Singh, M.F. (2014). Lifestyle-Integrated Functional Exercise (LiFE) Program to Prevent Falls: Trainer\u2019s Manual, Sydney University Press.","DOI":"10.30722\/sup.9781743324004"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Chiu, T.-Y., and Yu, H.-W. (2022). Associations of multicomponent exercise and aspects of physical performance with frailty trajectory in older adults. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-03246-6"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Mulasso, A., Roppolo, M., Rainoldi, A., and Rabaglietti, E. (2022). Effects of a Multicomponent Exercise Program on Prevalence and Severity of the Frailty Syndrome in a Sample of Italian Community-Dwelling Older Adults. Healthcare, 10.","DOI":"10.3390\/healthcare10050911"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.amjmed.2015.06.017","article-title":"Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial","volume":"128","author":"Ng","year":"2015","journal-title":"Am. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/gerona\/glu099","article-title":"A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study","volume":"70","author":"Cesari","year":"2015","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1123\/jpah.2020-0323","article-title":"Evidence on physical activity and the prevention of frailty and sarcopenia among older people: A systematic review to inform the world health organization physical activity guidelines","volume":"17","author":"Oliveira","year":"2020","journal-title":"J. Phys. Act. Health"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rogers, N.T., Marshall, A., Roberts, C.H., Demakakos, P., Steptoe, A., and Scholes, S. (2017). Physical activity and trajectories of frailty among older adults: Evidence from the English Longitudinal Study of Ageing. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170878"},{"key":"ref_49","first-page":"420","article-title":"An\u00e1lise da rela\u00e7\u00e3o do suporte social e da s\u00edndrome de fragilidade em idosos","volume":"18","author":"Souza","year":"2017","journal-title":"Psicol Sa\u00fade Doen\u00e7as"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Faller, J.W., Pereira, D.D.N., De Souza, S., Nampo, F.K., Orlandi, F.D.S., and Matumoto, S. (2019). Instruments for the detection of frailty syndrome in older adults: A systematic review. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0216166"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1080\/13814788.2019.1635113","article-title":"Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it","volume":"25","author":"Vrotsou","year":"2019","journal-title":"Eur. J. Gen. Pract."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Jung, H., Kim, M., Lee, Y., and Won, C.W. (2020). Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.20944\/preprints202009.0423.v1"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Blanco-Reina, E., Aguilar-Cano, L., Garc\u00eda-Merino, M.R., Oca\u00f1a-Riola, R., Valdell\u00f3s, J., Bellido-Est\u00e9vez, I., and Ariza-Zafra, G. (2021). Assessing Prevalence and Factors Related to Frailty in Community-Dwelling Older Adults: A Multinomial Logistic Analysis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10163576"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1111\/jgs.16391","article-title":"Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults","volume":"68","author":"Zhang","year":"2020","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jamda.2016.01.019","article-title":"A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: A randomized clinical trial","volume":"17","author":"Cabo","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.exger.2019.04.007","article-title":"Multicomponent exercise and the hallmarks of frailty: Considerations on cognitive impairment and acute hospitalization","volume":"122","author":"Cadore","year":"2019","journal-title":"Exp. Gerontol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1002\/jcsm.12925","article-title":"Effects of Vivifrail multicomponent intervention on functional capacity: A multicentre, randomized controlled trial","volume":"13","year":"2022","journal-title":"J. Cachex. Sarcopenia Muscle"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.2147\/CIA.S194543","article-title":"Grip Strength: An Indispensable Biomarker For Older Adults","volume":"14","author":"Bohannon","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2174\/1874609810666171116164000","article-title":"Patterns and correlates of grip strength in older Americans","volume":"11","author":"Forrest","year":"2018","journal-title":"Curr. Aging Sci."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Iconaru, E.I., Ciucurel, M.M., Georgescu, L., and Ciucurel, C. (2018). Hand grip strength as a physical biomarker of aging from the perspective of a Fibonacci mathematical modeling. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0991-0"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S0140-6736(14)62349-7","article-title":"Grip strength and mortality: A biomarker of ageing?","volume":"386","author":"Sayer","year":"2015","journal-title":"Lancet"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Haider, S., Dorner, T.E., Luger, E., Kapan, A., Titze, S., Lackinger, C., and Schindler, K.E. (2017). Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0169613"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.arr.2017.04.003","article-title":"Circuit resistance training is an effective means to enhance muscle strength in older and middle aged adults: A systematic review and meta-analysis","volume":"37","author":"Buch","year":"2017","journal-title":"Ageing Res. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Lai, X., Bo, L., Zhu, H., Chen, B., Wu, Z., Du, H., and Huo, X. (2021). Effects of lower limb resistance exercise on muscle strength, physical fitness, and metabolism in pre-frail elderly patients: A randomized controlled trial. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02386-5"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Sobrinho, A.C.d.S., Almeida, M.L.d., Rodrigues, G.d.S., Bertani, R.F., Lima, J.G.R., and Junior, C.R.B. (2022). Stretching and Multicomponent Training to Functional Capacities of Older Women: A Randomized Study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010027"},{"key":"ref_66","first-page":"531","article-title":"Effects of different resistance training frequencies on flexibility in older women","volume":"10","author":"Carneiro","year":"2015","journal-title":"Clin. Interv. Aging"},{"key":"ref_67","unstructured":"Li, Y., Gao, Y., Hu, S., Chen, H., Zhang, M., Yang, Y., and Liu, Y. (2022). Effects of multicomponent exercise on the muscle strength, muscle endurance and balance of frail older adults: A meta-analysis of randomised controlled trials. J. Clin. Nurs., 1\u201311."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/ggi.14346","article-title":"Longitudinal effects of physical exercise on health-related outcomes based on frailty status in community-dwelling older adults","volume":"22","author":"Wakida","year":"2022","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1002\/jcsm.12444","article-title":"Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living","volume":"10","author":"Izquierdo","year":"2019","journal-title":"J. Cachex. Sarcopenia Muscle"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.puhe.2021.10.017","article-title":"Effects of social participation and physical activity on all-cause mortality among older adults in Norfolk, England: An investigation of the EPIC-Norfolk study","volume":"202","author":"Fain","year":"2022","journal-title":"Public Health"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Bacanoiu, M.V., and Danoiu, M. (2022). New Strategies to Improve the Quality of Life for Normal Aging versus Pathological Aging. J. Clin. 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