The Assisted Lifestyle-Intergrated Functional Exercise Program in Older Adults Living in Residential Care Facilities

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.

Inclusion Criteria: 1. Are at least 60 years old, 2. Are permanently residing in care facilities, 3. Are able to walk 10 meters with or without a walking aid independently, 4. And their main caregiver (e.g., health and social care professionals working in the residential care facilities) can provide written consent. Exclusion Criteria: 1. Have a diagnosis of a terminal illness, 2. Have participated in a structured balance or muscle strengthening program in the past 6 months, 3. Are unsafe to participate in an exercise program due to any severe or unstable medical illness (e.g., advanced Parkinson's disease, acute exacerbation of knee osteoarthritis, and unstable angina), and 4. Are unable to communicate due to severe visual or hearing impairment, 5. Have a score below 10 in the Hong Kong version of the Montreal Cognitive Assessment, indicating that they have moderate to severe cognitive impairment.