Feasibility and Effects of Synchronous Online vs. Face-to-Face Multicomponent Physical Exercise in Older Nursing Home...

While evidence supports the feasibility and benefits of online exercise programs for community-dwelling older adults, there is a lack of research on their use among nursing home (NH) residents. This pilot randomized controlled trial aimed to (i) evaluate the feasibility of a synchronous online (SO) group-based supervised physical exercise intervention, and (ii) explore the comparative effects of SO versus face-to-face (F2F) group-based programs on the physical, mental, and quality-of-life outcomes of older people living in NH.

Twelve older people were randomly assigned to SO (n = 6) or F2F groups (n = 6). Both interventions consisted of a 12-week moderate-intensity multicomponent supervised physical exercise program performed twice per week, including balance, strength, and aerobic exercises guided by a physiotherapist.Feasibility was assessed based on adherence (completion, attendance, and compliance) and exercise program characteristics (session mean duration, exercises per workout, intensity mean of resistance and aerobic exercises measured by OMNI scale, and dose modifications). Moreover, safety was monitored by reporting adverse events and participants' satisfaction level was assessed with a 0-10 visual analog scale and the Basic Psychological Needs in Exercise scale. The preliminary effects of the programs were evaluated including physical, mental, and quality-of-life assessments. Physical assessment measurement included the Short Physical Performance Battery (SPPB), the arm curl, the 8 Foot-Up and Go (8FUG) and the 2 Minute Walk (2MWT) tests. The mental assessment included cognitive assessment with the Trail Making Test-part A (TMTa) and the Montreal Cognitive Assessment (MoCA). Depression was evaluated by the Yesavage 15-item Geriatric Depression Scale (GDS-15) and anxiety with the Zung Self-Rating Anxiety Scale (SAS). The unpaired Student's t - and chi 2 tests were used to assess between-group differences at baseline and at completion. Between-group comparisons were performed using Student t - or chi 2 tests .Within-group comparisons were conducted using paired t -tests, and mixed-design ANCOVA (with baseline values as covariates) was used to calculate group × time interactions.

All participants in both groups completed the intervention with high levels of attendance and compliance rates. Intervention characteristics differed between groups, with significantly shorter duration of F2F sessions (49 min) compared to SO group (59 min) ( P < .001). Perceived cardiovascular intensity and satisfaction were significantly higher in the F2F group ( P = .020). Both groups showed significant improvements in the SPPB (SO P = .038; F2F P = .049) and the arm curl tests (SO P = .009; F2F P = .004), with only the F2F group showing significant improvement in the 8FUG test ( P = .041). Geriatric Depression Scale scores improved significantly only in the SO group ( P = .044) and quality of life improved significantly more in the F2F group compared to the SO group ( P = .035).

This pilot randomized controlled trial showed that a SO group-based physical exercise program is feasible and safe for older adults residing in NH. Preliminary findings suggest that both interventions could be beneficial to improve physical and mental health. However, significant within-group improvements in dynamic balance (8FUG) were observed only in the F2F intervention, along with a group × time interaction favoring F2F for quality of life.