This study will evaluate the effects and preliminary cost-effectiveness of the Healthy Beat Acupunch (HBA) exercise program among community-dwelling older adults in Thailand. HBA is a 40-minute exercise program that combines gentle body movements with rhythmic tapping along traditional Chinese medicine meridian points.
Older adults in the intervention group will participate in HBA exercise three times per week for 6 months. During months 1-3, the sessions will be led by trained exercise leaders. During months 4-6, participants will exercise using a prerecorded HBA video, with personnel present to monitor safety. Participants in the control group will continue their usual daily activities and usual health services without receiving the HBA program during the study period.
Physical fitness, sleep quality, and health-related quality of life will be assessed at baseline, 3 months, and 6 months. The study will also compare the direct and indirect costs of the leader-led and video-led phases and conduct a preliminary cost-effectiveness analysis to examine whether the HBA program may be a practical and sustainable health-promotion approach for older adults living in the community.
Community-dwelling adults aged 60 years or older.
Barthel Index score of 61 or higher, indicating independence or only mild dependence in activities of daily living.
Able to stand and walk without a walking aid.
Short Portable Mental Status Questionnaire (SPMSQ) score of 8 or higher.
None
Parallel
Healthy Beat Acupunch (HBA) Exercise Program
BehavioralThe Healthy Beat Acupunch (HBA) program is a non-invasive 40-minute exercise intervention performed three times per week for 6 months (approximately 72 sessions). Each session consists of a 10-minute warm-up, 20 minutes of rhythmic acupunch movements using gentle tapping along traditional Chinese medicine meridian areas, and a 10-minute cool-down and relaxation period. During months 1-3, approximately 36 sessions are delivered in a leader-led format by trained exercise leaders. During months 4-6, approximately 36 sessions are delivered using a prerecorded HBA exercise video, with personnel present to monitor participant safety.
Aerobic Endurance Assessed by the 2-Minute Step Test
Aerobic endurance will be assessed using the 2-Minute Step Test. The outcome is the number of times the participant raises the knee to the predetermined height within 2 minutes. Higher counts indicate better aerobic endurance.
Pulmonary Function Assessed by Peak Flow Meter
Pulmonary function will be assessed using a peak flow meter. Participants will inhale fully and then exhale as forcefully as possible. The recorded peak expiratory flow value will be used for analysis.
Upper-Body Flexibility Assessed by the Back Scratch Test
Upper-body flexibility will be assessed using the Back Scratch Test. The distance between the middle fingers of both hands will be measured, with negative values indicating a gap, zero indicating touching, and positive values indicating overlap.
Lower-Body Flexibility Assessed by the Chair Sit-and-Reach Test
Lower-body flexibility will be assessed using the Chair Sit-and-Reach Test. The distance between the fingertips and toes will be measured, with negative values indicating that the toes are not reached and positive values indicating that the fingertips extend beyond the toes.
Direct and Indirect Costs of the HBA Program
Direct and indirect costs of delivering the HBA program will be collected and compared between the leader-led phase and the video-led phase. Direct costs include training, video production, materials, participant-related expenses, and transportation. Indirect costs include personnel time and the use of community or health service resources. Costs will also be summarized as cost per participant.
Preliminary Cost-Effectiveness of the HBA Program
Preliminary cost-effectiveness will be evaluated by relating differences in program costs to differences in health outcomes between the leader-led and video-led phases. Incremental cost-effectiveness ratios (ICERs) will be calculated using selected health outcomes, including changes in physical fitness and health-related quality of life.
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