Effects of a 12-week unsupervised and adapted physical activity prescription on physical performance in geriatric outpatients with overweight or obesity: the PACE tool

Background

Sarcopenia and obesity often coexist in older adults and are associated with higher functional decline, disability, and reduced quality of life. Although physical activity (PA) is protective, prescription and adherence to exercise programs remains low in this population. Pragmatic and scalable interventions are therefore needed. Thus, we evaluated the effects of a 12-week unsupervised PA prescription program on physical performance in overweight/obese frail geriatric outpatients.

Methods

A single-arm interventional study was conducted among geriatric outpatients aged ≥60 years. Thirty-seven overweight/obese participants (20 women) completed the 12-week home-based PACE prescription which included individualized functional and resistance exercises with walking. Physical performance [i.e. functional capacity (SPPB), walking speed, Timed Up and Go (TUG), lower-limb muscle endurance (30-STS) and function (5-STS)], clinical status (probable sarcopenia, fall risk, walking speed) and clinically meaningful changes were assessed.

Results

Participants achieved 238 ± 140 min/week of PA on average, with 65% meeting recommended PA guidelines. Significant improvements were observed in lower-limb muscle function ( p =0.033) and endurance ( p =0.006) and in absolute ( p =0.038) or relative ( p =0.045) estimated muscle power. The prevalence of probable sarcopenia decreased significantly following the intervention ( p =0.011). Clinically meaningful improvements were observed in muscle endurance ( p <0.001) and functional status ( p =0.040).

Conclusion

In overweight/obese frail geriatric outpatients, the prescription of PACE achieved high PA adherence and improved lower-limb muscle function. Integrating this pragmatic and personalized PA strategy into routine geriatric care may support healthy aging and help prevent sarcopenia-obesity related functional decline.

Key points

• A 12-week unsupervised and adapted PA prescription (PACE tool) is feasible in frail geriatric outpatients with overweight or obesity.

• High adherence was achieved, with 65% of participants meeting or exceeding PA recommendations, alongside significant improvements observed in lower-limb muscle function (power and endurance).

• The intervention led to a clinically meaningful reduction in probable sarcopenia prevalence.

• PACE could represent a pragmatic and scalable strategy to improve functional outcomes in overweight/obese geriatric population.