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. 2025 Sep 16:14:e72318.
doi: 10.2196/72318.

Effectiveness of Synchronous Telerehabilitation Versus Face-to-Face Physical Therapy in Older Adults Who Are Frail: Protocol for a Randomized Controlled Trial

Igor Cigarroa  1 , Daniel Reyes-Molina  2 , Felipe Vargas-Rios  1 , Gustavo López-Alarcón  1 , Sergio Jara-Aceituno  1 , Cristobal Riquelme-Hernández  3 , Rafael Zapata-Lamana  2   4 , María Antonia Parra-Rizo  5   6
Affiliations

Effectiveness of Synchronous Telerehabilitation Versus Face-to-Face Physical Therapy in Older Adults Who Are Frail: Protocol for a Randomized Controlled Trial

Igor Cigarroa et al. JMIR Res Protoc. .

Abstract

Background: Older adults who are frail face significant barriers to physical activity, and innovative solutions such as synchronous telerehabilitation (STR) may provide a viable alternative to traditional face-to-face programs. However, less is known about its effectiveness compared to a face-to-face program.

Objective: This study aims to compare the effectiveness of an STR program versus a face-to-face physical therapy (FPT) program in the primary outcomes (lower body strength and cardiorespiratory fitness) and secondary outcomes (upper limb strength, dynamic balance, static balance, number of steps, functional status, and quality of life) in older adults who are frail.

Methods: In a randomized, blinded, parallel-group controlled trial, all older adults who are frail and aged ≥60 years of both sexes from the Los Angeles Comprehensive Center for Older Adults will be invited to participate. A total of 58 older adults who are frail (aged ≥60 years) meeting the eligibility criteria will be randomly assigned to either an STR group (n=29, 50%) or an FPT group (n=29, 50%). Participants will engage in 1-hour multicomponent exercise sessions twice weekly for 12 weeks. The telerehabilitation group will participate via videoconferencing, supervised remotely by technical staff, while the face-to-face group will attend in-person sessions. Outcomes will include lower limb strength (sit-to-stand test), cardiorespiratory fitness (2-minute step test), upper limb strength (grip strength test), balance (Timed Up and Go, and single-leg stance), quality of life (36-item brief health survey), functional status (functional independence measure), and daily steps (pedometer).

Results: Recruitment will be conducted from April to May 2025. The intervention will run from June to August 2025, follow-up assessments will be completed by September 2025, and data analysis will be finalized by December 2025. Manuscript drafting and submission are planned for March 2026. We hypothesize that STR will yield equal or superior improvements in both primary and secondary outcomes compared to FPT in older adults who are frail.

Conclusions: STR is emerging as a viable and effective alternative to in-person physical therapy for older adults with frailty. This approach has the potential to improve physical condition and functional and quality of life indicators, overcoming geographical and logistical barriers and optimizing therapeutic resources.

Trial registration: ClinicalTrials.gov NCT06784245; https://clinicaltrials.gov/study/NCT06784245.

International registered report identifier (irrid): PRR1-10.2196/72318.

Keywords: fragility; functional status; older person; physical fitness; quality of life; telerehabilitation.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of the synchronous telerehabilitation (STR) intervention [41]. FPT: face-to-face physical therapy.
Figure 2
Figure 2
Study design of the synchronous telerehabilitation intervention program.
See this image and copyright information in PMC

References

    1. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012 Aug;60(8):1487–92. doi: 10.1111/j.1532-5415.2012.04054.x. - DOI - PubMed
    1. Da Mata FA, Pereira PP, Andrade KR, Figueiredo AC, Silva MT, Pereira MG. Prevalence of frailty in Latin America and the Caribbean: a systematic review and meta-analysis. PLoS One. 2016;11(8):e0160019. doi: 10.1371/journal.pone.0160019. https://dx.plos.org/10.1371/journal.pone.0160019 PONE-D-16-02605 - DOI - PMC - PubMed
    1. Troncoso-Pantoja C, Concha-Cisternas Y, Leiva-Ordoñez AM, Martínez-Sanguinetti MA, Petermann-Rocha F, Díaz-Martínez X, Martorell M, Nazar G, Ulloa N, Cigarroa-Cuevas I, Albala C, Márquez C, Lera L, Celis-Morales C. Prevalencia de fragilidad en personas mayores de Chile: resultados de la Encuesta Nacional de Salud 2016-2017. Rev Méd Chile. 2020 Oct;148(10):1418–26. doi: 10.4067/s0034-98872020001001418. - DOI - PubMed
    1. Whitson HE, Duan-Porter W, Schmader KE, Morey MC, Cohen HJ, Colón-Emeric CS. Physical resilience in older adults: systematic review and development of an emerging construct. J Gerontol A Biol Sci Med Sci. 2016 Apr 29;71(4):489–95. doi: 10.1093/gerona/glv202. https://europepmc.org/abstract/MED/26718984 glv202 - DOI - PMC - PubMed
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146–56. doi: 10.1093/gerona/56.3.m146. - DOI - PubMed

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