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Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial.
J Med Internet Res. 2013 Aug 12; 15(8):e159.JM

Abstract

BACKGROUND

Reaction time, coordination, and cognition performance typically diminish in older adults, which may lead to gait impairments, falls, and injuries. Regular strength-balance exercises are highly recommended to reduce this problem and to improve health, well-being, and independence in old age. However, many older people face a lack of motivation in addition to other strong barriers to exercise. We developed ActiveLifestyle, an information technology (IT)-based system for active and healthy aging aiming at improving balance and strength. ActiveLifestyle is a training app that runs on a tablet and assists, monitors, and motivates older people to follow personalized training plans autonomously at home.

OBJECTIVE

The objectives were to (1) investigate which IT-mediated motivation strategies increase adherence to physical exercise training plans in older people, (2) assess the impact of ActiveLifestyle on physical activity behavior change, and (3) demonstrate the effectiveness of the ActiveLifestyle training to improve gait speed.

METHODS

A total of 44 older adults followed personalized, 12-week strength and balance training plans. All participants performed the exercises autonomously at home. Questionnaires were used to assess the technological familiarity and stage of behavior change, as well as the effectiveness of the motivation instruments adopted by ActiveLifestyle. Adherence to the exercise plan was evaluated using performance data collected by the app and through information given by the participants during the study. Pretests and posttests were performed to evaluate gait speed of the participants before and after the study.

RESULTS

Participants were 75 years (SD 6), predominantly female (64%), held a trade or professional diploma (54%), and their past profession was in a sitting position (43%). Of the 44 participants who enrolled, 33 (75%) completed the study. The app proved to assist and motivate independently living and healthy older adults to autonomously perform strength-balance exercises (median 6 on a 7-point Likert scale). Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan, as well as to change their behavior permanently toward a more physically active lifestyle. The exercises were effective to improve preferred and fast gait speed.

CONCLUSIONS

ActiveLifestyle assisted and motivated independently living and healthy older people to autonomously perform strength-balance exercises over 12 weeks and had low dropout rates. The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention. The adoption of assistive technology devices for physical intervention tends to motivate and retain older people exercising for longer periods of time.

Authors+Show Affiliations

Department of Information Engineering and Computer Science, University of Trento, Trento, Italy. silveira@disi.unitn.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase II
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23939401

Citation

Silveira, Patrícia, et al. "Tablet-based Strength-balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: a Phase II Preclinical Exploratory Trial." Journal of Medical Internet Research, vol. 15, no. 8, 2013, pp. e159.
Silveira P, van de Langenberg R, van Het Reve E, et al. Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. J Med Internet Res. 2013;15(8):e159.
Silveira, P., van de Langenberg, R., van Het Reve, E., Daniel, F., Casati, F., & de Bruin, E. D. (2013). Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. Journal of Medical Internet Research, 15(8), e159. https://doi.org/10.2196/jmir.2579
Silveira P, et al. Tablet-based Strength-balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: a Phase II Preclinical Exploratory Trial. J Med Internet Res. 2013 Aug 12;15(8):e159. PubMed PMID: 23939401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. AU - Silveira,Patrícia, AU - van de Langenberg,Rolf, AU - van Het Reve,Eva, AU - Daniel,Florian, AU - Casati,Fabio, AU - de Bruin,Eling D, Y1 - 2013/08/12/ PY - 2013/02/14/received PY - 2013/06/08/accepted PY - 2013/04/25/revised PY - 2013/8/14/entrez PY - 2013/8/14/pubmed PY - 2014/3/8/medline KW - aged KW - delivery of health care KW - exercises KW - mobility KW - motivation KW - tablet SP - e159 EP - e159 JF - Journal of medical Internet research JO - J Med Internet Res VL - 15 IS - 8 N2 - BACKGROUND: Reaction time, coordination, and cognition performance typically diminish in older adults, which may lead to gait impairments, falls, and injuries. Regular strength-balance exercises are highly recommended to reduce this problem and to improve health, well-being, and independence in old age. However, many older people face a lack of motivation in addition to other strong barriers to exercise. We developed ActiveLifestyle, an information technology (IT)-based system for active and healthy aging aiming at improving balance and strength. ActiveLifestyle is a training app that runs on a tablet and assists, monitors, and motivates older people to follow personalized training plans autonomously at home. OBJECTIVE: The objectives were to (1) investigate which IT-mediated motivation strategies increase adherence to physical exercise training plans in older people, (2) assess the impact of ActiveLifestyle on physical activity behavior change, and (3) demonstrate the effectiveness of the ActiveLifestyle training to improve gait speed. METHODS: A total of 44 older adults followed personalized, 12-week strength and balance training plans. All participants performed the exercises autonomously at home. Questionnaires were used to assess the technological familiarity and stage of behavior change, as well as the effectiveness of the motivation instruments adopted by ActiveLifestyle. Adherence to the exercise plan was evaluated using performance data collected by the app and through information given by the participants during the study. Pretests and posttests were performed to evaluate gait speed of the participants before and after the study. RESULTS: Participants were 75 years (SD 6), predominantly female (64%), held a trade or professional diploma (54%), and their past profession was in a sitting position (43%). Of the 44 participants who enrolled, 33 (75%) completed the study. The app proved to assist and motivate independently living and healthy older adults to autonomously perform strength-balance exercises (median 6 on a 7-point Likert scale). Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan, as well as to change their behavior permanently toward a more physically active lifestyle. The exercises were effective to improve preferred and fast gait speed. CONCLUSIONS: ActiveLifestyle assisted and motivated independently living and healthy older people to autonomously perform strength-balance exercises over 12 weeks and had low dropout rates. The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention. The adoption of assistive technology devices for physical intervention tends to motivate and retain older people exercising for longer periods of time. SN - 1438-8871 UR - https://www.unboundmedicine.com/medline/citation/23939401/Tablet_based_strength_balance_training_to_motivate_and_improve_adherence_to_exercise_in_independently_living_older_people:_a_phase_II_preclinical_exploratory_trial_ L2 - https://www.jmir.org/2013/8/e159/ DB - PRIME DP - Unbound Medicine ER -