The Effect of Adding Elastic Resistance Training in Routine Physical Exercise on Walking Speed of Elderly People With Sarcopenia in Griya Wreda Jambangan, Surabaya

This is a randomized controlled clinical trial with a pre- and post-intervention design conducted in older adults with sarcopenia residing at Griya Wreda Jambangan, Surabaya. The study is designed to evaluate whether adding elastic resistance training (ERT) to the participants' routine physical exercise program improves physical performance, particularly walking speed, compared with routine physical exercise alone. Participants are assigned to an intervention group or a control group, and assessments are performed before and after the 8-week intervention period.

Participants in both groups continue the routine physical exercise program provided at Griya Wreda Jambangan. This program includes aerobic and flexibility components and is performed at least three times per week for approximately 30 minutes per session. Attendance is recorded to monitor adherence to the routine exercise program.

In addition to routine physical exercise, participants in the intervention group receive a structured progressive ERT program using elastic resistance bands. The ERT program is performed twice per week on nonconsecutive days for 8 weeks, with each session lasting approximately 30-45 minutes. Each session includes a warm-up, resistance exercises targeting major upper- and lower-extremity muscle groups, and a cool-down. Upper-extremity exercises include seated chest press, seated row, and seated shoulder press. Lower-extremity exercises include standing hip abduction, standing hip adduction, seated leg press, and standing leg curl.

Resistance exercises are performed for three sets of 10-20 repetitions per exercise, with 30-60 seconds of rest between sets. Exercise intensity is prescribed at a moderate perceived level using the OMNI-Resistance Exercise Scale, and resistance is progressively increased according to the participant's ability to complete the prescribed repetitions at the target perceived exertion. When a participant is able to complete 20 repetitions at the specified target exertion, progression is made by using an elastic band with greater resistance. This approach is intended to provide progressive overload while allowing the training load to be individualized according to each participant's capacity.

The control group receives the same routine physical exercise program but does not receive the additional ERT intervention during the 8-week study period. Walking performance is assessed in both groups before initiation of the intervention and again after completion of the 8-week period. The protocol specifies that baseline assessment is performed approximately 2 days before the intervention and post-intervention assessment approximately 2 days after the final intervention session.

Walking speed is assessed at the participant's usual comfortable walking speed on a 10-meter level walkway. The first 2 meters are used for acceleration and the final 2 meters for deceleration, while the middle 6 meters are timed. Participants complete two trials with a rest interval between trials, and the walking-speed value is calculated from the time required to traverse the timed 6-meter section. The protocol uses the average value from the two trials for analysis. Participants who routinely use a walking aid are permitted to use it during testing.

Participant safety is monitored throughout the exercise program. Before ERT sessions, participants undergo clinical assessment to confirm that they are fit to exercise. Blood pressure, heart rate, respiratory rate, body temperature, and oxygen saturation are assessed around the exercise sessions, and symptoms are monitored during training. The protocol includes predefined criteria for withholding or terminating exercise when symptoms or abnormal physiologic responses occur. Exercise is stopped if clinically concerning symptoms develop, if physiologic safety limits are exceeded, if oxygen saturation falls below 90% or decreases substantially from baseline, or if the participant wishes to stop.

Adherence to the ERT intervention is documented through session attendance and standardized exercise records, including vital signs, perceived exertion, symptoms, and reasons for exercise termination when applicable. The protocol also specifies withdrawal criteria for participants who discontinue participation, become unable to continue exercise because of illness, or miss the prespecified number of intervention sessions.

The statistical analysis plan includes assessment of data distribution using normality testing. Within-group pre- and post-intervention comparisons are analyzed using a paired t-test when assumptions for parametric analysis are met, with the Wilcoxon signed-rank test as the nonparametric alternative. Between-group comparisons are performed using an independent-samples t-test, with the Mann-Whitney U test used when data are not normally distributed. Statistical analyses are performed using SPSS.