Sarcopenia is the progressive loss of muscle mass and strength that occurs with aging, leading to slower movements, decreased strength, and increased risk of falls. On average, adults experience a 30% muscle mass loss between ages 50–70. The good news is that sarcopenia can be managed through resistance training, preserving muscle strength and function.
For older adults with prediabetes, however, there is an added concern. Through metabolic and physiological changes, aging and insulin resistance can lead to impaired physical function and a progression to type 2 diabetes (T2DM); individuals with T2DM have increased risk for functional disability and mobility limitation.
In 2022, Vivo was awarded a National Institue of Health (NIH) Small Business Innovation Research (SBIR) grant and partnered with Duke University to assess the feasibility and acceptability of Vivo for older adults with prediabetes (NCT05497960). Last fall, our team shared the following Phase I results at the annual Gerontological Society meeting in Seattle, Washington.
Criteria for feasibility and acceptability were defined as ≥80% of participants would stay in the study, ≥80% would attend all 24 classes and ≥90% of the exercise program would be delivered as designed. In this 12-week single arm feasibility study, 28 older adults (69±6 years; 58% female; and 73% non-Hispanic white) with prediabetes were recruited.
Out of the 28 individuals enrolled 22 (79%) successfully completed the 12-week intervention and 85% of these individuals attended all classes. The results revealed the following:
- 27% increase in upper body strength (30-sec arm curl)
- 13.5% increase in lower body strength (30-sec chair stand)
- 33% improvement in endurance (2-minute knee raise)
At the end of the study, participants completed a program satisfaction survey and participated in a focus group (four groups of 5-8 participants each). The satisfaction survey showed:
- 95% were satisfied with the program;
- 86% indicated they would continue to do strength training exercises after the study; and
- 77% indicated participation in Vivo made them more aware of the importance of strength training.
To further examine acceptability and satisfaction with Vivo, our team conducted focus groups to identify key barriers and facilitators to participation in Vivo. Our team identified four themes:
- self-reported positive outcomes (i.e., regained function after injury, variety of exercise kept interest);
- positive exercise experience (i.e., manageable exercise with little equipment, felt inclusive, focus on safe exercise);
- social connection with others (i.e., developed peer group, facilitate group discussion that helped bond group);
- importance of an individualized exercise program (i.e., modifiable depending on ability that day, individual feedback from trainers).
Beyond physical benefits, participants underscored the significance of socialization within the Vivo community. Participating in live sessions facilitated meaningful connections with peers, fostering a supportive network that transcended geographical boundaries. These interactions not only enhanced motivation but also nurtured a sense of belonging and camaraderie, vital components of holistic well-being among older adults.
Areas identified by participants that Vivo could improve upon and is already improving included: making rescheduling easier, optimizing trainer communication, and clear technology requirements for participating in Vivo.
Vivo shows potential for reaching individuals with chronic illnesses who would benefit from adding strength training to their routines in a safe and accessible environment. The study findings support the acceptability of and high satisfaction with virtual exercise programs such as Vivo for older adults with prediabetes.
We are currently in Phase II of this grant, where we are conducting a randomized controlled trial (RCT) to test the effects of Vivo on lower body strength and blood glucose. Results from this portion of the study will come out this fall, and once they do, our intention is to publish them in a medical journal. Given that more than 27 million adults in the US over the age of 65 have prediabetes, we want research of virtual exercise programs to be widely disseminated to healthcare providers and health plans.
For more information, contact Vivo’s Director of Research Liz Kemp at liz@teamvivo.com