Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: part 2 of a phase II preclinical exploratory trial.

Eva Van Het Reve,Eling D De Bruin,Patrícia Silveira,Fabio Casati,Florian Daniel

doi:10.2196/jmir.3055

Abstract

BackgroundHome-based exercise programs can improve physical functioning and health status of elderly people. Successful implementation of exercise interventions for older people presents major challenges and supporting elderly people properly while doing their home-based exercises is essential for training success. We developed a tablet-based system—ActiveLifestyle—that offers older adults a home-based strength-balance training program with incorporated motivation strategies and support features.ObjectiveThe goal was to compare 3 different home-based training programs with respect to their effect on measures of gait quality and physical performance through planned comparisons between (1) tablet-based and brochure-based interventions, (2) individual and social motivation strategies, and (3) active and inactive participants.MethodsA total of 44 autonomous-living elderly people (mean 75, SD 6 years) were assigned to 3 training groups: social (tablet guided, n=14), individual (tablet guided, n=13), and brochure (brochure guided, n=17). All groups joined a 12-week progressive home-based strength-balance training program. Outcome measures were gait performance under single and dual task conditions, dual task costs of walking, falls efficacy, and physical performance as measured by the Short Physical Performance Battery (SPPB). Furthermore, active (≥75% program compliance) and inactive (<75% program compliance) individuals were compared based on their characteristics and outcome measures.ResultsThe tablet groups showed significant improvements in single and dual task walking, whereas there were no significant changes observable in the brochure group. Between-groups comparisons revealed significant differences for gait velocity (U=138.5; P=.03, r=.33) and cadence (U=138.5, P=.03 r=.34) during dual task walking at preferred speed in favor of the tablet groups. The brochure group had more inactive participants, but this did not reach statistical significance (U=167, P=.06, r=.29). The active participants outperformed the inactive participants in single and dual task walking, dual task costs of walking, and SPPB scores. Significant between-groups differences were seen between the tablet groups and the brochure group, in favor of the tablet groups.ConclusionsA tablet-based strength-balance training program that allows monitoring and assisting autonomous-living older adults while training at home was more effective in improving gait and physical performance when compared to a brochure-based program. Social or individual motivation strategies were equally effective. The most prominent differences were observed between active and inactive participants. These findings suggest that in older adults a tablet-based intervention enhances training compliance; hence, it is an effective way to improve gait.

Highlights

BackgroundThe primary goal of public health care is to increase the number of years of good health and maintain independence and quality of life as long as possible
Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan, as well as to change their behavior permanently toward a more physically active lifestyle
The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention

Summary

Introduction

BackgroundThe primary goal of public health care is to increase the number of years of good health and maintain independence and quality of life as long as possible. Healthy aging is characterized by the avoidance of disease and disability, the maintenance of high physical and cognitive function, and sustained engagement in social and productive activities. These 3 components together define successful aging [1]. An important part of successful aging is maximization of physical performance. The ability to fully participate in productive and recreational activities of daily life may be affected when the capacity to perform common physical functions decreases [1]. Health status is an important indicator of quality of life among older people [2,3]. ActiveLifestyle is a training app that runs on a tablet and assists, monitors, and motivates older people to follow personalized training plans autonomously at home

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