Abstract
BackgroundMany older adults choose and prefer to exercise at home, but to attain the greatest benefits, the correct type and dose of exercise should be prescribed and adherence maintained. Advances in digital health technologies now provide the opportunity for exercise professionals to deliver and monitor personalized, evidence-based exercise programs to anyone at any time.ObjectiveThe aim of this study was to evaluate the feasibility, usability, and enjoyment of a web-based exercise prescription app as a platform for exercise professionals to remotely deliver and monitor an individually tailored, home-based multicomponent exercise program (delivered through tablet computers) to older adults living independently in the community.MethodsThis was an 8-week, prospective single-arm pilot study in 20 adults aged ≥65 years living independently in the community: 10 owned a tablet computer (tablet owners) and 10 did not own tablets (tablet nonowners). All participants were prescribed a home-based, muscle strengthening, weight-bearing impact and challenging balance/mobility program (3 days/week) using a commercial exercise prescription app on a tablet computer. Study endpoints were feasibility (retention, adherence, adverse events), usability (System Usability Scale), physical activity enjoyment (Physical Activity Enjoyment Scale), changes in lower extremity function (Short Physical Performance Battery [SPPB]), and level of physical activity (questionnaire). Process measures related to the participants' experiences and perceptions of the exercise program and web-based app were also included.ResultsA total of 19 participants (mean age, 70 years) completed the study (19/20, 95%), and mean adherence to the exercise program was 84% (95% CI 70%-97%). There were 2 minor adverse events in 2 participants from 401 completed sessions. Mean weekly walking time increased by 78 minutes (95% CI 0-156, P=.049) and moderate-to-vigorous physical activity time by 41 minutes (95% CI –8 to 90, P=.09). For SPPB scores, there was a 0.3 point (95% CI –0.1 to 0.7, P=.17) modest sized (effect size, d=0.42) improvement after 8 weeks. Mean (SD) system usability was high (86 [10] with 100 best imaginable). There was no change in the overall physical activity enjoyment scores after 8 weeks, but participants reported that they enjoyed using the web-based exercise app and the exercise program (median score 4 on a 5-point Likert scale). For all measures, there were no differences between previous tablet owners and nonowners.ConclusionsThis pilot feasibility study indicates that it is safe and feasible for community-dwelling older adults to participate in a home-based, multicomponent exercise program targeting musculoskeletal health and function that was delivered and monitored remotely by exercise professionals using a tablet-based exercise prescription app.
Highlights
Every year, around 30% of people aged over 65 years living in the community fall at least once [1], and falls are a leading cause of fragility fractures, injury-related hospitalization, mortality, and health care costs for older adults [2,3]
Mean weekly walking time increased by 78 minutes and moderate-to-vigorous physical activity time by 41 minutes
There was no change in the overall physical activity enjoyment scores after 8 weeks, but participants reported that they enjoyed using the web-based exercise app and the exercise program
Summary
Around 30% of people aged over 65 years living in the community fall at least once [1], and falls are a leading cause of fragility fractures, injury-related hospitalization, mortality, and health care costs for older adults [2,3]. The findings from several of our previous randomized controlled trials conducted within community-based health and fitness centers have shown that multicomponent exercise programs incorporating progressive resistance training combined with weight-bearing impact and challenging balance and mobility training are safe and effective for improving hip and lumbar spine BMD, muscle mass, strength, power, and function in healthy older adults and those with low BMD or at increased falls risk [9,10,11,12]. Advances in digital health technologies provide the opportunity for exercise professionals to deliver and monitor personalized, evidence-based exercise programs to anyone at any time
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