Improving physical function and quality of life in older adults with prediabetes utilizing interactive small-group resistance training through video conference technology

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Vivo is a virtual small group exercise program designed for adults 55 and over that is unique in the increasingly popular digital fitness market. Vivo offers 3 key market differentiators: 1) a personalized and individualized live training experience with feedback from a certified trainer, 2) a community of older adult exercisers which enhances motivation and social support, and increase accountability and fun, and 3) the Vivo training experience focuses on improving physical function using performance feedback, goal setting, and a system to measure perceived exertion. Most older adults experience a 30% loss in muscle mass between ages 50–70. Resistance training is the most effective strategy for improving both muscle mass and function and managing sarcopenia. Vivo’s programming is based on the scientific evidence that even in the absence of chronic disease, resistance training that is customized to meet the individual’s needs and level of functioning is a feasible and evidence-based approach to improve physical function, regulate glucose handling, reduce the risk for falls, and prolong independent living and aging in place. To date 92 people have participated in Vivo (age range 44-93). In our pilot study of 34 older adults (74% women; mean age 70.9 y; range 60-84y) after 8 weeks of participating in Vivo with a certified trainer (average of 12 hours of training per person) we observed +25.8% improvement in upper body strength as measured by the 30 second arm curl test; +25.9% improvement in lower body strength as measured by the 30 second chair stand test; and +28% improvement in endurance as measured by the 2-minute knee raise test. The aims for this SBIR FastTrack are as follows: Phase I Aim 1: Evaluate the acceptability, feasibility, and fidelity of current Vivo prototype in sedentary older adults with prediabetes Milestone 1: Assess a) attendance, benefits and barriers/facilitators of participation; b) ease of use; and c) overall satisfaction. Milestone 2: Assess trainer fidelity. Aim 2 : Design and develop a multifunctional platform prototype for Vivo 2.0 Milestone 1: Create functional specifications of the client-centered approach (results, goals, adherence, upcoming workouts), and social engagement and support. Milestone 2: Develop a clickable prototype of the platform. Phase II Aim 1: Design and build the Vivo 2.0 platform – a unified web/mobile application. Milestone 1: Assess prototype usability. Milestone 2: Iterate the design on the software and hardware to increase usage, accuracy and usability. Milestone 3: Develop and test a minimum viable software product based on the new prototype and functional design to include a mobile front-end and web front-end app and a backend database. Aim 2: Conduct a RCT to determine effectiveness of Vivo 2.0 v. wait list control. Primary outcomes will be change in lower extremity strength after 12 weeks measured by the number of chair stands in 30 seconds and average glycemic level (HgA1c). Secondary outcomes will include improvements in quality of life, and effect of adherence and social engagement on physical function outcomes.