Comparing the effectiveness of two community-based multimodal exercise programs (CMEPs) on physical activity, performance, fall prevention, and quality of life in older adults: protocol for a multicenter, double-blind, randomized clinical trial

BACKGROUND: Aging leads to physiological decline, increasing the risk of frailty, sarcopenia, and falls, which impact older adults' physical activity, performance, and quality of life. Exercise is recommended for mitigating these effects, yet the optimal approach remains unclear. This trial will compare two community-based multimodal exercise programs-sensorimotor and strengthening exercise-to evaluate their effectiveness in enhancing physical activity, performance, fall prevention, and quality of life. The findings will guide evidence-based recommendations for promoting functional independence and healthy aging among community-dwelling older adults. METHODS: This trial will be a multicenter, double-blind, parallel, randomized clinical trial in which 140 older adults will be enrolled from July 2025 to May 2026 in Bangladesh. Eligible participants will be allocated into two groups for community-based multimodal exercise programs (CMEPs) at a 1:1 ratio: CMEP-I: sensorimotor exercise group; CMEP-II: strengthening exercise group. The exercise programs will last for 24 sessions/8-week, with a 24-week follow-up. The major outcome measurements will include physical activity, performance, fall prevention, and quality of life using a Physical Activity Scale for the Elderly (PASE), Short Physical Performance Battery (SPPB), Modified Falls Efficacy Scale (MFES), and 36-item Short Form Survey (SF-36). All outcomes will be assessed at pretest, posttest after 8 weeks, and follow-up after 32 weeks. DISCUSSION: This randomized clinical trial will investigate the comparative effectiveness of sensorimotor and strengthening exercise programs as community-based multimodal interventions for older adults. These findings will provide evidence on nonpharmacological strategies for improving physical activity, performance, fall prevention, and quality of life, particularly in resource-limited settings. The trial's robust design strengthens validity, although generalizability may be constrained. Long-term follow-up will provide insights into sustained benefits, potentially informing rehabilitation guidelines and policy recommendations to promote accessible, cost-effective exercise interventions for aging populations. TRIAL REGISTRATION: This trial is registered prospectively in the Clinical Trial Registry India CTRI/2025/03/083260. Registered on 24/03/2025.