Feasibility, Safety, Acceptability, and Effects of an Assisted Lifestyle-integrated Functional Exercise Program on Balance and Muscle Strength in Older Adults Living in Residential Care Facilities: a Feasibility Cluster Randomized Controlled Trial

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.