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Got It, Hide thisHome-based exercise delivered with digital interventions can prevent falls and improve quality of life
Solis-Navarro L, Gismero A, Fernandez-Jane C, et al. Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis. Age Ageing. 2022;51(11):afac243.
Review questions
In older people, does exercise done at home (home-based exercise) delivered by digital health interventions improve physical function? Does it prevent falls or improve quality of life?
Background
Regular physical exercise can help older people stay healthy. It may prevent falls and help people maintain their ability to do everyday activities. People may be more likely to exercise if they can do it at home with support through a digital intervention.
This review looks at the effects of home-based exercise programs delivered with digital support to older people.
How the review was done
The researchers did a systematic review based on studies available up to December 2021. They found 26 randomized controlled trials (RCTs) with 5,133 people (66% women).
The key features of the RCTs were:
· people were 65 years of age or older and living in the community;
· some people were generally healthy, and others had heart or breathing problems, balance disorders, or other health conditions;
· exercise programs were done at home and delivered with digital health interventions;
· most exercise programs included several types of exercise, such as endurance, strength, or balance training;
· exercise had varied intensity, was usually done 2 to 3 times per week, and mostly continued for 6 months or less;
· digital health interventions mostly used phone calls, smartphone apps, or websites;
· some digital health interventions included communication with a therapist, and others included automated feedback;
· trials compared exercise with different interventions, including usual care, lifestyle interventions, waiting lists, or education.
What the researchers found
Compared with control, home-based exercise delivered with digital health interventions:
- has a moderate improvement in quality of life;
- reduces risk for falls;
- has a small improvement in lower limb strength and functional ability; and
- does not improve mobility, physical performance scores, balance, or walk speed.
Conclusions
In older people, home-based exercise delivered with digital health interventions can prevent falls and improve quality of life. It also improves lower limb strength and functional ability by a small amount.
Home-based exercise delivered with digital health interventions vs control in older people
| Outcome types | Outcome measures | Number of trials analyzed (number of people) | Effect of home-based exercise |
| Physical function | Mobility (Timed Up and Go test) | 11 trials (1481 people) | No difference in effect |
|
| Physical performance (Short Physical Performance Battery) | 7 trials (639 people) | No difference in effect |
|
| Lower limb strength (Five times Sit-to-Stand test) | 7 trials (1120 people) | Small improvement Exercise reduced the time to do the Five times Sit-to-Stand test by an average of 0.56 seconds. |
|
| Balance tests* | 7 trials (974 people) | No difference in effect |
|
| Gait (walk) speed | 5 trials (579 people) | No difference in effect |
| Functional ability | Barthel Index | 3 trials (311 people) | Small improvement Exercise improved the Barthel Index score by an average of 5 points out of 100. |
| Falls | Fall events | 7 trials (2131 people) | About 5 fewer people out of 100 would fall. |
| Quality of life | Quality of life scores | 6 trials (1099 people) | Moderate improvement† |
Related Topics
Glossary
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
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