JMIR Publications

ABSTRACT

Background:

Frail older adults face significant barriers to physical activity, and innovative solutions like synchronous telerehabilitation may provide a viable alternative to traditional face-to-face programs. However, less is known about its effectiveness compared to a face-to-face program.

Objective:

To compare the effectiveness of a synchronous telerehabilitation program versus a face-to-face physical therapy program in the primary outcome (lower body strength, cardiorespiratory fitness) and secondary outcomes (upper limb strength, dynamic balance, static balance, number of steps, functional status and quality of life) in frail older adults

Methods:

In a randomized, blinded, parallel-group controlled trial, all frail older adults aged 60 years or older of both sexes from the Los Angeles Comprehensive Center for the Older Adults (CIAM, in Spanish) will be invited to participate. A total of 58 frail older adults (aged ≥60 years) meeting eligibility criteria will be randomly assigned to either a synchronous telerehabilitation group (n=29) or a face-to-face physical therapy group (n=29). Participants will engage in 1-hour multicomponent exercise sessions twice weekly for 12 weeks. The tele-rehabilitation group will participate via videoconferencing, supervised remotely by technical staff, while the face-to-face group will attend in-person sessions. Outcomes will include lower limb strength (sit-to-stand test), cardiorespiratory fitness (2-minute step test), upper limb strength (grip strength test), balance (timed get-up-and-go, single-leg stance), quality of life (36-item brief health survey), functional status (functional independence measure), and daily steps (pedometer).

Results:

We hypothesize that synchronous telerehabilitation will yield equal or superior improvements in both primary and secondary outcomes compared to face-to-face physical therapy in frail older adults.

Conclusions:

Synchronous telerehabilitation is emerging as a viable and effective alternative to in-person physical therapy for older adults with frailty. This approach has the potential to improve physical condition and functional and quality of life indicators, overcoming geographical and logistical barriers and optimizing therapeutic resources. Clinical Trial: ClinicalTrial.gov ID NCT06784245.