J. Med. Internet Res. - 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.

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Resumo

CKGROUND: Home-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.OBJECTIVE: The 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.METHODS: A 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.RESULTS: The 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.CONCLUSIONS: A 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.

Resumo Limpo

ckground homebas exercis program can improv physic function health status elder peopl success implement exercis intervent older peopl present major challeng support elder peopl proper homebas exercis essenti train success develop tabletbas systemactivelifestylethat offer older adult homebas strengthbal train program incorpor motiv strategi support featuresobject goal compar differ homebas train program respect effect measur gait qualiti physic perform plan comparison tabletbas brochurebas intervent individu social motiv strategi activ inact participantsmethod total autonomousliv elder peopl mean sd year assign train group social tablet guid n individu tablet guid n brochur brochur guid n group join week progress homebas strengthbal train program outcom measur gait perform singl dual task condit dual task cost walk fall efficaci physic perform measur short physic perform batteri sppb furthermor activ program complianc inact program complianc individu compar base characterist outcom measuresresult tablet group show signific improv singl dual task walk wherea signific chang observ brochur group betweengroup comparison reveal signific differ gait veloc u p r cadenc u p r dual task walk prefer speed favor tablet group brochur group inact particip reach statist signific u p r activ particip outperform inact particip singl dual task walk dual task cost walk sppb score signific betweengroup differ seen tablet group brochur group favor tablet groupsconclus tabletbas strengthbal train program allow monitor assist autonomousliv older adult train home effect improv gait physic perform compar brochurebas program social individu motiv strategi equal effect promin differ observ activ inact particip find suggest older adult tabletbas intervent enhanc train complianc henc effect way improv gait

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