Effectiveness of exercise based on wearable electronic devices on lower limb strength and balance in older adults: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to evaluate the effectiveness of wearable electronic device-based exercise interventions on lower limb strength and balance in older adults.

A systematic search was conducted following PRISMA guidelines to evaluate the impact of exercise based on wearable electronic devices on health behaviors (such as muscle strength, balance, endurance, mental health, and cognitive function) in older adults. This meta-analysis included 13 two-arm, between-group studies and 4 single-arm, within-group studies, involving a total of 611 participants. The inclusion of single-arm studies in the meta-analysis was based on the limited availability of two-arm studies and to maximize the available evidence for understanding the broader effects of the intervention.

The results show that in the meta-analysis of two-arm controlled studies, exercise based on wearable electronic devices significantly improved lower limb strength (SMD = -0.60; 95% CI [-1.15, -0.05]; p < 0.001; I ² = 81%) and balance (SMD = -0.43; 95% CI [-0.81, -0.06]; I ² = 17%) in older adults. However, the high heterogeneity for lower limb strength (I ² = 81%) should be interpreted cautiously, as it suggests substantial variability across studies. Subgroup analysis found that interventions with a frequency of once per week, a session duration of 10-45 min, and a total intervention duration of 8-12 weeks showed the best improvement in lower limb strength. Additionally, in the meta-analysis of single-arm studies, exercise based on wearable electronic devices significantly improved lower limb strength (SMD = 0.51; 95% CI [0.05, 0.97]; I ² = 23.5%). However, no significant effects were found on endurance, upper limb strength, mental health, cognitive function, and waist-to-hip ratio.

The significant improvements in lower limb strength and balance, as key factors in older adults' health, may have a positive impact on physical activity function, but falls were not directly meta-analyzed in this study. The findings support the potential of wearable electronic device-based exercise to improve specific aspects of health in older adults, but further studies are needed to confirm its broader impact on fall prevention and other health outcomes.

PROSPERO, CRD420251273186.