Technology-assisted physical activity interventions for older people in their home-based environment: a scoping review (Preprint)

Abstract

Technology-assisted physical activity interventions for older adults in their home-based environment have been used to promote physical activity. While previous reviews focused on health-related outcomes of such interventions, this scoping review explores the characteristics of the technology in relation to the characteristics of populations, exercise types and usability in terms of adverse events, drop-outs, adherence and user experience. We identified 8496 sources. After title and abstract screening, 455 full texts were assessed, and 148 were included, representing 12,717 participants aged 74 (SD 6) years. In total, 93 (63%) sources reported on the population’s health status. The main purpose of the interventions was balance (51%), and strength and power (43%) and intervention purposes were not related to embedded technology. In studies where the participant’s health status was reported as healthy, 53% implemented exergames compared to only 27% in studies with participants with a clinical condition. Mobile apps (20%) and trackers (11%) were implemented likewise in both groups. The technology was embedded to provide continuous exercise information (27%) and exercise feedback (27%) or to record real-time movement data (26%). Adverse events were reported in 68 (46%) of the sources with three quarters (49 sources) reporting no adverse events. Only 2 mild events were related to technology. Dropout rates were reported in 100 (68%) studies, with no differences between intervention (16±16%) and control (14±12%) groups. Dropout reasons related to technology in 3%. Adherence was reported in 78 studies (53%) and was slightly higher in the intervention group (80±18%) compared to the control group (71±25%). A significantly higher adherence was found between interventions that were tailored (83 ± 15%) versus those that were not (75±21%). General enjoyment of the technology was captured in 55 studies (37%) and was rated positive (91%), neutral (7%) or negative (2%). Occasionally reported wishes were related to goal setting, feedback, technical support, exercise variation, and social setting. In conclusion, various technologies were successfully used in healthy and clinical older populations. The embedded technology was not a reason for additional dropouts, lead to slightly better adherence, and adverse events were rarely related to technology. When assessed, the technology was well accepted and positively enjoyed.