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Meta-Analysis
. 2022 Nov 2;51(11):afac243.
doi: 10.1093/ageing/afac243.

Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis

Lilian Solis-Navarro  1   2   3 , Aina Gismero  2 , Carles Fernández-Jané  2 , Rodrigo Torres-Castro  3   4   5 , Mireia Solá-Madurell  6 , Clara Bergé  7 , Laura Mónica Pérez  8 , Joan Ars  8   9 , Carme Martín-Borràs  1   10 , Jordi Vilaró  2 , Mercè Sitjà-Rabert  2
Affiliations
Meta-Analysis

Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis

Lilian Solis-Navarro et al. Age Ageing. .

Abstract

Background: regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults.

Design: systematic review and meta-analysis.

Participants: community-dwelling older adults over 65 years.

Intervention: exercises at home through DHI.

Outcomes measures: physical function, HRQoL and falls.

Results: twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, -0.56 s, 95% confidence interval, CI -1.00 to -0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD -0.23; 95% CI -0.45 to -0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004).

Conclusion: the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility.

Keywords: Home-based exercise; digital health intervention; older adults; older people; physical function; systematic review.

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Figures

Figure 1
Figure 1
Forest plot for mobility (TUG)
Figure 2
Figure 2
Forest plot for muscular strength of lower limbs (5STS)
Figure 3
Figure 3
Forest plot for balance (BBS, FRT, SPPB balance score)
Figure 4
Figure 4
Forest plot for falls events
Figure 5
Figure 5
Forest plot for health-related quality of life (HRQoL)
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