Frail ElderlyNCT07564076
Comparison of the Effects of Different Exercise Protocols in Frail Elderly Individuals
A study testing Vivifrail Exercise Program and Otago Exercise Program in people with Frail Elderly, run by Marmara University at 1 site in Turkey (Türkiye).
Trial summary
The aim of this research is to investigate and compare the effects of two different exercise programs developed for frail geriatric individuals on fall risk, fear of falling, and physical performance. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- Frail Elderly
- What is being tested?
- Vivifrail Exercise Program and Otago Exercise Program
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 10 Mar 2026to 20 Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Who may be able to join
- Volunteering to participate in the study
- Having been diagnosed as frail according to Fried Frail Phenotype (3 or more criteria)
- Being able to walk with or without a walking aid
Who cannot join
- Being in the terminal stage of illness
- Presence of cognitive impairment (Mini Mental State Assessment score below 24)
- Severe vision and hearing loss
- Acute myocardial infarction (within the last 3-6 months) or unstable angina;
- Uncontrolled atrial or ventricular arrhythmias;
- Aortic dissection aneurysm;
Show all 15Show fewer
- Severe aortic stenosis;
- Acute endocarditis/pericarditis;
- Uncontrolled high blood pressure (> 180/100 mmHg);
- Acute thromboembolism;
- Acute or severe heart failure;
- Acute or severe respiratory failure;
- Uncontrolled postural hypotension;
- Uncontrolled acute decompensated diabetes or low blood sugar;
- History of fracture within the last 3 months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Comparison of the Effects of Different Exercise Programs on Fall Risk, Fall Fear, and Physical Performance in Frail Geriatric Individuals
The aim of this research is to investigate and compare the effects of two different exercise programs developed for frail geriatric individuals on fall risk, fear of falling, and physical performance.
Read the detailed description
Frailty is a syndrome characterized by a decline across multiple physiological systems associated with aging. It results in diminished physiological reserve and increased vulnerability to stressors, leading to limitations in activities of daily living. This condition is closely linked to adverse outcomes, including falls, illness, hospitalization, and mortality. The frailty phenotype is generally defined by five criteria: weight loss, exhaustion, low grip strength, slowness, and reduced physical activity. The presence of three or more of these criteria indicates frailty, while one or two criteria signify a pre-frail state. Research indicates that frail geriatric individuals face a significantly higher risk of falling compared to their non-frail peers. Furthermore, a heightened fear of falling is associated with an increased risk of frailty. Consequently, prioritizing frailty management in geriatric care is essential for mitigating fall risks.
Exercise interventions have been shown to produce positive effects on physical function and quality of life in frail older adults. By improving muscle mass and strength, exercise plays a pivotal role in the treatment of frailty. Various exercise programs specifically designed as fall prevention strategies are recommended for this population. Notably, the frailty status of elderly individuals residing in nursing homes requires greater clinical attention compared to those living in the community. Nursing home residents often exhibit lower physical activity levels and a higher need for structured exercise interventions. Investigating and comparing the effectiveness of different exercise programs for this vulnerable group is crucial for selecting the most efficient protocols to reduce fall risks and enhance physical performance.
The Otago Exercise Program (OEP) is a well-established, evidence-based fall prevention protocol frequently utilized in geriatric care. It comprises warming up, progressive strengthening and balance exercises, walking sessions, and aerobic components. OEP has the potential to delay or even reverse frailty while improving the overall health status of participants. Current evidence suggests that OEP can reduce frailty, increase grip strength, and improve balance and mobility in frail and pre-frail individuals, although its impact on quality of life remains less certain. Despite its widespread use, there is a need for more robust study designs to confirm its efficacy, particularly regarding its effects on the fear of falling, where existing research is limited.
In addition, multicomponent exercise programs-which integrate strengthening, balance, aerobic, and flexibility training within a single session-are considered a viable and effective alternative for geriatric populations. Such programs are recommended as part of routine clinical practice for frail or sedentary individuals. A prominent example is the Vivifrail project, developed by international experts to provide personalized exercise prescriptions for preventing frailty and falls. In the Vivifrail program, the exercise regimen is tailored to the individual's functional status and fall risk, encompassing strength, balance, flexibility, and cardiovascular endurance. Studies have demonstrated that Vivifrail can reverse functional decline associated with hospitalization and improve functional capacity in older women with dynapenia as well as in frail individuals with mild cognitive impairment. The program is noted for its ease of implementation, offering a quick assessment to guide exercise prescription.
Currently, there is a paucity of research regarding the impact of the Vivifrail program on fall risk and the fear of falling in frail geriatric individuals. Similarly, further high-quality studies are required to fully establish the benefits of OEP in this population. Furthermore, there is a notable gap in the literature regarding direct comparisons between the Vivifrail and Otago programs. Therefore, this study is designed to investigate and compare the effects of these two distinct exercise protocols on fall risk, fear of falling, and physical performance among frail geriatric individuals residing in nursing homes.
- Conditions
- Frail Elderly
- Being tested
- Vivifrail Exercise Program, Otago Exercise Program
- Keywords
- Exercise Therapy, Frail Elderly, Accidental Falls, Physical Functional Performance, Postural Balance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Vivifrail Exercise ProgramOther
Following an initial assessment and random assignment to exercise groups, participants will undergo a multicomponent exercise program (Vivifrail) consisting of 60 sessions, 5 days a week, for 12 weeks. Each session will last approximately 60 minutes and will be conducted on two non-consecutive days with a physiotherapist present, and on the other three days following instructions given by the physiotherapist and patient education. The program will be supervised by the institution's physician, who is also a researcher in the study, and will include an organization that can provide emergency assistance if needed.
Participants will be provided with the necessary equipment for the exercises (resistance bands, towels, and water bottles). Attendance at exercise sessions will be recorded.
Otago Exercise ProgramOther
The Otago Exercise Program (OEP) consists of balance and strengthening exercises and walking exercises. Each exercise session in the OEP begins with 5-7 minutes of light warm-up exercises and continues with approximately 30-35 minutes of strengthening and balance exercises. Additionally, participants are included in moderate-paced walking sessions for 30 minutes at least twice a week on days when the exercise program is not in progress. The number of repetitions, frequency, intensity, and duration of the exercises are planned individually for each participant.
In our study, balance and strengthening exercises will be performed twice a week in a group setting with a physiotherapist. Each group will consist of 4-5 participants with similar physical capacity and function.
| Study group | Role | What they receive |
|---|---|---|
| Vivifrail Exercise Group | Experimental | In this group, participants will take part in the Vivifrail Exercise Program, a 12-week multi-component exercise program. The Vivifrail Exercise Program is a personalized exercise program designed for frail older adults, incorporating various exercise types. Receives: Other: Vivifrail Exercise Program |
| Otago Exercise Group | Experimental | Participants in this group will be enrolled in a 12-week Otago Exercise Program. Developed as a fall prevention exercise program, the Otago Exercise Program is one of the most frequently used exercise programs in geriatric individuals. It is an evidence-based exercise program whose effectiveness has been demonstrated in different geriatric populations. The Otago Exercise Program includes warm-up exercises, progressive strength and balance exercises, walking sessions, and aerobic exercise. Receives: Other: Otago Exercise Program |
| Control Group | No intervention | Participants in the control group will be evaluated at the beginning of the study and at the end of 12 weeks. They will not be included in any exercise program. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mini-BESTest: Balance Evaluation Systems Test
Developed by Franchignoni et al. in 2010, the Mini-BESTest consists of four groups: pre-postural preparation, reactive postural responses, sensory orientation, and gait balance. The test contains 14 items, each scored between 0 and 2. '0' represents the lowest functional level, and '2' represents the highest. The lowest possible score on the Mini-BESTest is '0', and the highest is '28'.
Measured: two weeks
Falls Efficacy Scale
This scale, developed by Yardley et al. in 2005, assesses fear of falling. The FFS consists of 16 items, each scored from 1 to 4. The total score ranges from 16 to 24, with a higher score indicating greater fear of falling.
Measured: two weeks
Short Physical Performance Battery (SPPB)
Guralnik et al. developed this test by combining balance, timed up and go, and walking speed tests. The first test assesses static balance in three standing positions, the second test assesses lower extremity strength and power after standing and sitting in a chair, and the third test assesses walking speed at a normal pace. Each test is scored from 0 (failure to perform the task) to 4 points (best test performance). The total score is between 0 and 12. A high score is considered good performance.
Measured: two weeks
Secondary outcomes (3)
Fear of Falling Questionnaire Revised (FFQ-R)
Developed by Bower et al. in 2015, it consists of six items. Each item is scored between 1 and 4 points. The total score ranges from 6 to 24 points. Higher scores indicate a greater fear of falling.
Measured: two weeks
The Four Square Step Test (FSST)
This test, developed by Dite and Temple, is used to assess balance in older adults. The test involves placing a bar on a flat surface to create four squares, each numbered. Participants are instructed to start at the first square (with their faces towards the second square), step clockwise and then counterclockwise as quickly as possible without touching the bars, ensuring both feet touch the ground at each square. The time taken to complete the test is recorded as a score. Higher times indicate poorer performance, while higher scores indicate a greater fear of falling.
Measured: two weeks
Nottingham Health Profile
439 The scale assesses six health-related dimensions and has 38 items. It evaluates quality of life by questioning the problems a person may have encountered in the past week. The sub-dimensions are energy, pain, emotional reactions, sleep, social isolation, and physical activity. Each dimension is scored between 0 and 100 points. The total score ranges from 0 to 600 points. Higher scores indicate worse health status.
Measured: two weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 May 2026
- Study start10 Mar 2026
- Primary completion10 Oct 2026 (estimated)
- Study completion20 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Frail ElderlyStudies of the same condition, open and under way.
- More trials run by Marmara UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A total of 3 groups, including one group that did not participate in the exercise program.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Marmara University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Onur Körtelli, Marmara University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07564076
- Sponsor's protocol ID
- MU-FTR-OSK-01
- Status last verified
- Apr 2026
- First submitted
- 26 Apr 2026
- Last updated
- 4 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 4 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Effects of Different Exercise Programs on Fall Risk, Fall Fear, and Physical Performance in Frail Geriatric Individuals
- ClinicalTrials.gov ID
- NCT07564076
- Acronym / sponsor ID
- MU-FTR-OSK-01
- Conditions
- Frail Elderly
- Keywords
- Exercise Therapy, Frail Elderly, Accidental Falls, Physical Functional Performance, Postural Balance
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Marmara UniversityUniversity, hospital or other
- Study start
- 10 Mar 2026 (actual)
- Primary completion
- 10 Oct 2026 (estimated)
- Study completion
- 20 Oct 2026 (estimated)
- First posted
- 4 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this research is to investigate and compare the effects of two different exercise programs developed for frail geriatric individuals on fall risk, fear of falling, and physical performance.
Detailed description
Frailty is a syndrome characterized by a decline across multiple physiological systems associated with aging. It results in diminished physiological reserve and increased vulnerability to stressors, leading to limitations in activities of daily living. This condition is closely linked to adverse outcomes, including falls, illness, hospitalization, and mortality. The frailty phenotype is generally defined by five criteria: weight loss, exhaustion, low grip strength, slowness, and reduced physical activity. The presence of three or more of these criteria indicates frailty, while one or two criteria signify a pre-frail state. Research indicates that frail geriatric individuals face a significantly higher risk of falling compared to their non-frail peers. Furthermore, a heightened fear of falling is associated with an increased risk of frailty. Consequently, prioritizing frailty management in geriatric care is essential for mitigating fall risks.
Exercise interventions have been shown to produce positive effects on physical function and quality of life in frail older adults. By improving muscle mass and strength, exercise plays a pivotal role in the treatment of frailty. Various exercise programs specifically designed as fall prevention strategies are recommended for this population. Notably, the frailty status of elderly individuals residing in nursing homes requires greater clinical attention compared to those living in the community. Nursing home residents often exhibit lower physical activity levels and a higher need for structured exercise interventions. Investigating and comparing the effectiveness of different exercise programs for this vulnerable group is crucial for selecting the most efficient protocols to reduce fall risks and enhance physical performance.
The Otago Exercise Program (OEP) is a well-established, evidence-based fall prevention protocol frequently utilized in geriatric care. It comprises warming up, progressive strengthening and balance exercises, walking sessions, and aerobic components. OEP has the potential to delay or even reverse frailty while improving the overall health status of participants. Current evidence suggests that OEP can reduce frailty, increase grip strength, and improve balance and mobility in frail and pre-frail individuals, although its impact on quality of life remains less certain. Despite its widespread use, there is a need for more robust study designs to confirm its efficacy, particularly regarding its effects on the fear of falling, where existing research is limited.
In addition, multicomponent exercise programs-which integrate strengthening, balance, aerobic, and flexibility training within a single session-are considered a viable and effective alternative for geriatric populations. Such programs are recommended as part of routine clinical practice for frail or sedentary individuals. A prominent example is the Vivifrail project, developed by international experts to provide personalized exercise prescriptions for preventing frailty and falls. In the Vivifrail program, the exercise regimen is tailored to the individual's functional status and fall risk, encompassing strength, balance, flexibility, and cardiovascular endurance. Studies have demonstrated that Vivifrail can reverse functional decline associated with hospitalization and improve functional capacity in older women with dynapenia as well as in frail individuals with mild cognitive impairment. The program is noted for its ease of implementation, offering a quick assessment to guide exercise prescription.
Currently, there is a paucity of research regarding the impact of the Vivifrail program on fall risk and the fear of falling in frail geriatric individuals. Similarly, further high-quality studies are required to fully establish the benefits of OEP in this population. Furthermore, there is a notable gap in the literature regarding direct comparisons between the Vivifrail and Otago programs. Therefore, this study is designed to investigate and compare the effects of these two distinct exercise protocols on fall risk, fear of falling, and physical performance among frail geriatric individuals residing in nursing homes.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
- Model description
- A total of 3 groups, including one group that did not participate in the exercise program.
| Arm | Type | Receives |
|---|---|---|
| Vivifrail Exercise Group | Experimental | Other: Vivifrail Exercise ProgramIn this group, participants will take part in the Vivifrail Exercise Program, a 12-week multi-component exercise program. The Vivifrail Exercise Program is a personalized exercise program designed for frail older adults, incorporating various exercise types. |
| Otago Exercise Group | Experimental | Other: Otago Exercise ProgramParticipants in this group will be enrolled in a 12-week Otago Exercise Program. Developed as a fall prevention exercise program, the Otago Exercise Program is one of the most frequently used exercise programs in geriatric individuals. It is an evidence-based exercise program whose effectiveness has been demonstrated in different geriatric populations. The Otago Exercise Program includes warm-up exercises, progressive strength and balance exercises, walking sessions, and aerobic exercise. |
| Control Group | No intervention | –Participants in the control group will be evaluated at the beginning of the study and at the end of 12 weeks. They will not be included in any exercise program. |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
Key inclusion criteria (3 listed)
- Volunteering to participate in the study
- Having been diagnosed as frail according to Fried Frail Phenotype (3 or more criteria)
- Being able to walk with or without a walking aid
Key exclusion criteria (15 listed)
- Being in the terminal stage of illness
- Presence of cognitive impairment (Mini Mental State Assessment score below 24)
- Severe vision and hearing loss
- Acute myocardial infarction (within the last 3-6 months) or unstable angina;
- Uncontrolled atrial or ventricular arrhythmias;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Vivifrail Exercise ProgramFollowing an initial assessment and random assignment to exercise groups, participants will undergo a multicomponent exercise program (Vivifrail) consisting of 60 sessions, 5 days a week, for 12 weeks. Each session will last approximately 60 minutes and will be conducted on two non-consecutive days with a physiotherapist present, and on the other three days following instructions given by the physiotherapist and patient education. The program will be supervised by the institution's physician, who is also a researcher in the study, and will include an organization that can provide emergency assistance if needed. Participants will be provided with the necessary equipment for the exercises (resistance bands, towels, and water bottles). Attendance at exercise sessions will be recorded. | Other | Vivifrail Exercise Group |
| Otago Exercise ProgramThe Otago Exercise Program (OEP) consists of balance and strengthening exercises and walking exercises. Each exercise session in the OEP begins with 5-7 minutes of light warm-up exercises and continues with approximately 30-35 minutes of strengthening and balance exercises. Additionally, participants are included in moderate-paced walking sessions for 30 minutes at least twice a week on days when the exercise program is not in progress. The number of repetitions, frequency, intensity, and duration of the exercises are planned individually for each participant. In our study, balance and strengthening exercises will be performed twice a week in a group setting with a physiotherapist. Each group will consist of 4-5 participants with similar physical capacity and function. | Other | Otago Exercise Group |
Primary outcome
Mini-BESTest: Balance Evaluation Systems Test
Time frame: two weeks
Developed by Franchignoni et al. in 2010, the Mini-BESTest consists of four groups: pre-postural preparation, reactive postural responses, sensory orientation, and gait balance. The test contains 14 items, each scored between 0 and 2. '0' represents the lowest functional level, and '2' represents the highest. The lowest possible score on the Mini-BESTest is '0', and the highest is '28'.
Falls Efficacy Scale
Time frame: two weeks
This scale, developed by Yardley et al. in 2005, assesses fear of falling. The FFS consists of 16 items, each scored from 1 to 4. The total score ranges from 16 to 24, with a higher score indicating greater fear of falling.
Short Physical Performance Battery (SPPB)
Time frame: two weeks
Guralnik et al. developed this test by combining balance, timed up and go, and walking speed tests. The first test assesses static balance in three standing positions, the second test assesses lower extremity strength and power after standing and sitting in a chair, and the third test assesses walking speed at a normal pace. Each test is scored from 0 (failure to perform the task) to 4 points (best test performance). The total score is between 0 and 12. A high score is considered good performance.
3 secondary outcomes
Fear of Falling Questionnaire Revised (FFQ-R)
Time frame: two weeks
The Four Square Step Test (FSST)
Time frame: two weeks
Nottingham Health Profile
Time frame: two weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 May 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Vivifrail Exercise Program and Otago Exercise Program in people with Frail Elderly, run by Marmara University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 4 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mini-BESTest: Balance Evaluation Systems Test (time frame: two weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 May 2026.