Background Sarcopenia is a geriatric syndrome characterised by low muscle mass, muscle
strength, and physical function. Physical exercise (PE), especially resistance exercise, has
demonstrated potential effects on sarcopenia. However, low motivation for regular PE is
always reported as a major barrier in this population. Based on the PRIME (Plans, Responses,
Impulses, Motives, and Evaluations) theory of motivation, Plan (i.e., well-planned, and
evidence-based PE protocol), Motives (anticipated pleasure, satisfaction, and relief) and
self-awareness on the present moment are the key points of human motivation and the potential
targets to change a behaviour (i.e., adhering to a PE intervention) in older people with
sarcopenia. Limited study on sarcopenia consisted of any interventional element to emphasise
motives and self-awareness on the present moment, two key points of human motivation in the
PRIME theory of motivation, although older people with sarcopenia are more likely to have
negative feelings (i.e., fatigue, depress, anxiety) and experiences (i.e., derailed by daily
life and distracted by concerns on PE). Mindfulness-based intervention (MBI) is a
psychosocial intervention which aims to increase the participants' awareness of the present
moment non-judgmentally. Increased evidence has indicated that MBI can also improve the
levels of PE and adherence to PE interventions. Based on the mindful coping model, the
positive relationship between mindfulness and PE might be that MBI has the potential to
improve motivation for PE by addressing three key points of human motivation in the PRIME
theory of motivation (focusing on the present moment, evoking positive feelings, and
increasing self-awareness). Thus, MBI has the potential to be integrated into PE training to
increase motivation and adherence to PE in older people with sarcopenia.
To address the above research gaps, we first conducted a SR on the home-based interventions
among community-dwelling older people with sarcopenia was conducted, showing that home-based
resistance exercise is feasible, suitable and has potential effects on sarcopenia, but few
studies consisted of motivation-enhancing component. Then a Delphi study was conducted to
develop the MIndfulness-based Physical Exercise (MIPE) intervention on this population.
However, the feasibility, acceptability, and effects of the HOME intervention among
community-dwelling older people with sarcopenia need to be explored.
Objective The objective of this study is to assess the feasibility, acceptability, and the
preliminary effects of the MIPE intervention among community-dwelling older people with
sarcopenia.
Methods A pilot randomised controlled trial (RCT) will be conducted to assess the
feasibility, acceptability, and the preliminary effects of the HOME intervention. In the
parallel-group, pilot RCT, 60 community-dwelling older people aged 60 years or older
diagnosed with sarcopenia will be randomised into either the intervention group receiving the
HOME intervention 2 sessions weekly over 12 weeks or the control group receiving health
educations. Each session of the HOME intervention will last about 70 minutes, including
20-min MBI, 40-min HBE (10-min warm-up, 20-min RE, and 10-min cool down) and 10-20-min
sharing and discussion. The feasibility of this programme will be determined by time spent
recruiting participants, eligibility rate and recruitment rate. The acceptability of the HOME
program will be assessed by: 1) prospective acceptability: recruitment rate and reasons for
not involving in this study; 2) concurrent acceptability: attendance rate, complete rate,
attrition rate and reasons for discontinuing; and 3) retrospective acceptability: the
participants' perspectives on the intervention after taking part. Based on our conceptual
framework, primary outcomes (muscle mass, muscle strength and physical function) and
secondary outcomes (motivation, depressive symptoms, psychological well-being, mindfulness
level and quality of life) will be assessed at baseline (T0), immediately post-intervention
week 12 (T1) and 12 weeks after completion of the intervention. The quantitative data will be
analysed by generalised estimating equations. The qualitative data will be Brun and Clark's
thematic approach.
Impact and significance The MIPE program, consisting MBI and PE, is novel in the research
field related to sarcopenia, which addresses the limitations of previous studies. This study
has the potential to improve the symptoms of sarcopenia, the motivation and adherence to PE
as well as the psychological health of this population, which finally improves the holistic
welling of this population and facilitates their "ageing in place". For researchers, this
study provides a relatively new sub-area in this field by generating insights on the
importance of the above factors and the potential effectiveness of the mindfulness-based PE.
For health professionals, the study provides a potentially effective way to improve the
motivation and adherence to PE to treat sarcopenia.