Improving prescription and delivery of resistance exercise training for older people with sarcopenia or physical frailty: results from Wave two of the Benchmarking Exercise Programme for Older People (BEPOP) quality improvement initiative

Objectives: Resistance exercise training is often not prescribed or delivered effectively for sarcopenia or frailty. BEPOP aims to improve the effectiveness of resistance exercise training for people referred to community-based UK National Health Service (NHS) physiotherapy Methods: Anonymous data collection for 20 consecutive patients by each participating physiotherapy service. Wave two data collection (2024-25) was compared with Wave one data (2021-22) against five key quality recommendations. Aggregate and service-specific data on performance against the recommendations were fed back to each participating site. Results: Twenty-eight services submitted Wave two data for 542 patients, mean age 82 (range 60-104) years. Two hundred and seventy nine (52%) participants had initial objective strength-based assessments; sarcopenia was diagnosed in 316 (58%) participants, 496 (92%) undertook resistance exercise training but only 222 (41%) had exercise intensity progressed, 205 (38%) were reassessed using the same objective strength-based assessment as baseline and 238 (44%) were signposted or referred to follow-on exercise services. For services participating in both Waves, performance for objective strength assessment improved (64% vs 52%), as did intensity progression (33% vs 11%) and onward referral (40% vs 31%). Conclusions: BEPOP was effective at improving the quality of resistance exercise training delivery in participating NHS physiotherapy services.