In 2015, a randomized controlled trial (RCT) sheds light on the safety and risks associated with exercise interventions for elderly individuals who are both mobility-limited and chronically ill. The study, led by Timo Hinrichs and colleagues, aimed to evaluate the adverse events (AEs) experienced by participants engaging in a 12-week home-based exercise program.

The trial, known as HOMEfit, involved 209 community-dwelling seniors aged 70 and older, with an average age of 80 years. These individuals, who were at high risk due to their chronic conditions and limited mobility, were divided into two groups: one receiving the exercise intervention and the other receiving standard physical activity counseling.

The exercise program was delivered by an exercise therapist following medical clearance from a general practitioner (GP). Both the intervention and control groups received counseling sessions at the GP’s practice and over the phone. The researchers meticulously documented adverse events during these sessions, with oversight from both a GP and an AE manager.

The findings reveal that nearly half (47%) of the participants reported a total of 151 adverse events. Of these, 14% were classified as serious, requiring immediate attention. In some cases, participation in the study had to be discontinued, particularly for six participants (4%)—four from the experimental group and two from the control group. Additionally, 17% of the events led to a temporary suspension of the intervention.

Interestingly, while the intervention was determined to be the cause of only two adverse events—both nonserious and occurring in the experimental group—the study highlights the challenges of implementing exercise programs in this vulnerable population. The high morbidity unrelated to the exercise itself posed significant challenges for sustained participation.

The researchers concluded that while the home-based exercise program appears generally safe, the health complexities of elderly participants with chronic illnesses must be carefully considered to ensure ongoing engagement and safety in such interventions.

Reference: Hinrichs, T., Bücker, B., Wilm, S., Klaaßen‐Mielke, R., Brach, M., Platen, P., & Moschny, A. (2015). Adverse events in mobility‐limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. Journal of the American Geriatrics Society, 63(2), 258-269.