Trial reportThe journals of gerontology. Series A, Biological sciences and medical sciences2026
Cluster randomized trial of reablement strategies targeting sarcopenia (ReStart-S) in long-term care settings.
Trial report in The journals of gerontology. Series A, Biological sciences and medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundSarcopenia prevalence is high in long-term care settings (LTCS), yet existing guidelines often overlook this population. The Reablement Strategies targeting Sarcopenia (ReStart-S) program was developed to address this gap. This study evaluated its effects on muscle outcomes, physical performance, quality of life (QoL), and a blood biomarker.
methodsA cluster-randomized trial was conducted in LTCS across Udupi and neighboring districts. Sarcopenic older adults (≥ 60 years, Barthel Index ≥ 60, Mini-Cog ≥ 3, AWGS-2019 criteria) were recruited. LTCS were randomized into intervention (IG) and control (CG) groups. IG received a 6-week ReStart-S program, while CG continued usual activities. Outcomes at baseline, 6, 12, and 18 weeks included handgrip strength (HGS, primary outcome), skeletal muscle index (SMI), Short Physical Performance Battery (SPPB), SarQoL, and C-terminal Agrin Fragment (CAF; not assessed at 12 weeks). Linear mixed models evaluated group*time interactions with Bonferroni correction.
resultsOf 12 LTCS screened, 7 were eligible; 78 participants enrolled (IG = 39; CG = 39). CG was older than IG (74.3 ± 9.4 vs 67.9 ± 6.0; p < .001). Significant group*time interaction was observed for HGS (F = 5.524; p = .001), improving at 12 (2.49; 95% CI, 1.16-3.82; p < .001) and 18 weeks (2.14; 0.79-3.48; p = .002). SPPB improved at 6, 12, and 18 weeks (all p < .001). SarQoL improved at all follow-ups (all p < .001). SMI improved at 18 weeks (0.20; p = .011). CAF decreased at 18 weeks (-61.77; p < .001).
conclusionReStart-S improved muscle strength, physical performance, and QoL, reduced CAF, and showed delayed muscle mass gains, supporting its role in sarcopenia care in LTCS. CLINICAL
trial registrationThe study was prospectively registered on October 20, 2022 on the Clinical Trial Registry-India (CTRI) platform. Trial registration number CTRI/2022/10/046680. The trial can be accessed at: https://ctri.nic.in/Clinicaltrials/showallp.php? mid1=71007&EncHid=&userName=CTRI/2022/10/046680.
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