PEDroCast is the official podcast of the Physiotherapy Evidence Database (PEDro).
Launched on 8 April 2025, PEDroCast showcases interviews with physiotherapists from around the world, PEDro World-Wide Journal Club summaries and discussions, systematic review summaries, information to inform evidence-based practice, and PEDro’s Top 25 Trials.
PEDroCast is currently available on Spotify, Amazon Music and iHeart Radio.
This season we are diving into PEDro's Top Trials.
In this episode we are looking at Rosendahl E et al., High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living. Australian Journal of Physiotherapy 2006;52(2):105-13. Watch the summary video here.
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Anne Moseley spoke with Dr Erik Rosendahl (Umeå University, Sweden) whose trial evaluating exercise for older persons is one of the most significant trials in physiotherapy.
Anne: Could you explain what you did in the study
Erik: The Frail Older People – Activity and Nutrition Study in Umeå (the FOPANU Study) evaluated a high-intensity functional exercise program in older people living in residential care facilities.
Anne: What was the main finding?
Erik: In the FOPANU Study it was demonstrated that the exercise program had important positive effects on, for example, gait, lower-limb strength, balance, and dependency in activities of daily living when compared to a control activity program. In addition, the exercise program used in the trial (the High-Intensity Functional Exercise Program, the HIFE Program) was shown to be as applicable for people with dementia as for people without.
Anne: Why do you think your study is important?
Erik: The FOPANU Study was the first trial evaluating a high-intensity functional exercise program in older people with severe cognitive and physically impairment including those with dementia. Among the 191 participants, all living in residential care facilities; mean age was 85 years, half had a dementia diagnosis and two thirds were not able to rise up from a chair independently. Rehabilitation for older people with impairments is an important and expanding working field in clinical practice and research for physiotherapists, especially considering that the world population is aging rapidly. Today around 35 million people have dementia and this number is estimated to double by 2030 and more than triple by 2050. According to the World Health Organisation (WHO), dementia is defined as the leading course of disability and dependency among older people and should be considered as a public health priority.
Anne: What lead you to do the study?
Erik: Nina Lindelöf, and Håkan Littbrand and I developed the HIFE Program based on the experiences from clinical work and a previous study. We wanted to develop an exercise program that could easily be implemented due to well-described exercises, standardized instructions, and portable exercise equipment. We knew from the literature that high intensity and functional exercises were important for the exercise effect and wanted to evaluate if it was feasible and effective also for older people with severe cognitive and physically impairments.
Anne: What studies are you conducting now?
Erik: One example is the Umeå Dementia and Exercise (UMDEX) Study. In the UMDEX Study, we are evaluating the effect of the HIFE Program among 186 older people with dementia on several outcomes. Hopefully, the first results from this study will be published in the beginning of next year.
Anne: Erik, thank you for making such a valuable contribution to physiotherapy.
