Effects of pickleball on pre-frailty, physical fitness, 24-hour movement behaviors, and quality of life in older adults: A randomized controlled trial.
Pre-frailty is a high-risk state prevalent in older adults, representing a critical window for intervention. Pickleball, a popular paddle sport, offers a unique blend of physical activity and social engagement, but its efficacy in reversing pre-frailty remains understudied. This study aimed to investigate the effects of an 8-week pickleball training program on pre-frailty, physical fitness, 24-hour movement behaviors, and quality of life in community-dwelling older adults.
72 older adults [age: median (interquartile range) = 67 (5)] with pre-frailty were randomly assigned to either a pickleball intervention group (n = 36) or a control group (n = 36). The pickleball group participated in supervised 8-week pickleball sessions, while the control group maintained their usual lifestyle. Outcomes included frailty status, functional fitness, 24-hour movement behaviors (assessed using accelerometers and compositional data analysis), and quality of life. Analyses followed an intention-to-treat principle with multiple imputation for missing data. Between-group differences in pre-frailty reversal rates were assessed using Fisher's exact test and absolute recovery increase. Generalized estimating equation models were used to evaluate Group × Time interactions for outcomes.
After 8 weeks, 42% of the pickleball group transitioned from pre-frailty to non-frailty, compared to 8% in the control group (p < 0.001). Statistically significant improvements were observed in functional fitness, including the 30-second chair stand [β = 4.89, p < 0.001], 30-second arm curl [β = 3.70, p < 0.001], back scratch [β = 3.27, p = 0.003], and 6-minute walk distance [β = 31.10, p = 0.041]. Quality of life improved for both physical [β = 2.37, p = 0.040] and mental health scores [β = 4.83, p = 0.001]. Compositional data analysis showed a favorable shift in movement behaviors, with reduced sedentary time [β = -37.19, p = 0.028] and increased light physical activity [β = 17.43, p = 0.033] in the pickleball group.
An 8-week pickleball intervention effectively reversed pre-frailty, improved functional fitness, and enhanced quality of life. These findings suggest pickleball as a promising exercise for preventing frailty and promoting healthy aging.
Chinese Clinical Trial Registry ChiCTR2500098832. Registered March 13, 2025.
72 older adults [age: median (interquartile range) = 67 (5)] with pre-frailty were randomly assigned to either a pickleball intervention group (n = 36) or a control group (n = 36). The pickleball group participated in supervised 8-week pickleball sessions, while the control group maintained their usual lifestyle. Outcomes included frailty status, functional fitness, 24-hour movement behaviors (assessed using accelerometers and compositional data analysis), and quality of life. Analyses followed an intention-to-treat principle with multiple imputation for missing data. Between-group differences in pre-frailty reversal rates were assessed using Fisher's exact test and absolute recovery increase. Generalized estimating equation models were used to evaluate Group × Time interactions for outcomes.
After 8 weeks, 42% of the pickleball group transitioned from pre-frailty to non-frailty, compared to 8% in the control group (p < 0.001). Statistically significant improvements were observed in functional fitness, including the 30-second chair stand [β = 4.89, p < 0.001], 30-second arm curl [β = 3.70, p < 0.001], back scratch [β = 3.27, p = 0.003], and 6-minute walk distance [β = 31.10, p = 0.041]. Quality of life improved for both physical [β = 2.37, p = 0.040] and mental health scores [β = 4.83, p = 0.001]. Compositional data analysis showed a favorable shift in movement behaviors, with reduced sedentary time [β = -37.19, p = 0.028] and increased light physical activity [β = 17.43, p = 0.033] in the pickleball group.
An 8-week pickleball intervention effectively reversed pre-frailty, improved functional fitness, and enhanced quality of life. These findings suggest pickleball as a promising exercise for preventing frailty and promoting healthy aging.
Chinese Clinical Trial Registry ChiCTR2500098832. Registered March 13, 2025.