Home-based exercise delivered with digital interventions can prevent falls and improve quality of life

Solis-Navarro L, Gismero A, Fernandez-Jane C, et al. Efficacité de l'exercice à domicile fourni par la santé numérique chez les personnes âgées : une revue systématique et méta-analyse 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

*Balance tests included the Berg Balance Scale, Functional Reach Test, and Short Physical Performance Battery balance score.

†Assuming a standardized mean difference of 0.77 = moderate improvement.