JMIR Publications

ABSTRACT

Background:

A decline in physical functioning can result into a loss of independence, particularly in older adults. Information and communications technologies supporting physical activity, such as fitness apps, are perceived as promising tools to increase activity levels. However, only little is known about fitness apps’ impact on older people’s abilities and skills to accomplish activities of daily living.

Objective:

In this study, we investigated whether an app-based physical activity program can improve self-perceived physical functioning or prevent a functional decline in older adults.

Methods:

We targeted older adults in their early years of retirement and conducted a randomized waitlist-controlled trial in Austria. The intervention group (IG) received the app-based program for a period of 14 weeks first, the control group (CG) after the IG returned the devices. Both groups had three appointments with a fitness coach. The app comprised three functions, a multi-component fitness exercise program, recommendations for outdoor activities and e-learning courses. Self-perceived physical functioning was measured by four common daily life activities rated on six-point scales. Data were collected by online surveys at three time points, eight weeks before intervention start (t-1), at intervention start (t0) and 14 weeks later at the end of the intervention (t1). We estimated generalized linear mixed models and derived average marginal effects. The effects are presented as differences in percentage points resulting from differences in estimated probabilities between groups before and after the intervention.

Results:

A total of 219 participants between 60 and 72 years old, 96 in the IG and 123 in the CG, were analyzed. The intervention significantly increased the self-perceived abilities of ‘climb up stairs and carry something (OR 2.67; 95% CI: 1.37, 5.18; P=.004) and of ‘lift and carry groceries’ (OR 1.99; 95% CI: 1.02, 3.89; P=.04). On the contrary, no significant impact on the ability of ‘walk 1km’ (OR 1.91; 95% CI: 0.85, 4.30; P=.12) and ‘stretch to the toes’ (OR 1.31; 95% CI: 0.62, 2.76; P=.48) was revealed. The probability of rating ‘climb up stairs and carry something’ as ‘very easy’ increased by 8.8 percentage points (95% CI: 2.6, 14.9; P=.005) and ‘lift and carry groceries’ by 7.9 percentage points (95% CI: 0.5, 15.3; P=.04). Predicted probabilities showed that outcome levels increased in the IG and remained unchanged in the CG.

Conclusions:

Although the fitness app was designed as a multi-component program, it supported only selected capabilities relevant for independent living. The app-based physical activity program increased self-perceived physical functioning related to strength, endurance and balance, but not to flexibility. Future research should thus focus on the specific contribution of fitness apps to support physical functioning in older adults and should not only focus on adults in their early years of retirement.