JMIR Publications

ABSTRACT

Background:

Exercise guidelines for older adults are predominantly “one-size-fits-all”, primarily focusing upon aerobic activity with limited emphasis upon motor components.

Objective:

We examined the hypothesis that remotely delivered, personalized multicomponent exercise—based on a simple yet highly reliable and accurate smartphone motor fitness assessment, and individually tailored using machine-learning - can improve balance, flexibility, and strength among older adults, obviating the need for a lab or professional supervision.

Methods:

This randomized controlled study recruited community-dwelling healthy older adults age ≥65 years, with normal cognition, low fall-risk, and no hospitalization within last year for cardiac/neurological illness. Participants were randomly assigned to the study experimental 8-week Personalized Exercise group (5x/week, multicomponent exercises), an 8-week Active-Control group (exercise counselling according to WHO guidelines), or Control group (no intervention). Participants were assessed at baseline, 4, 8, and 12 weeks. Measurements of balance, flexibility and strength, remotely recorded using smartphone sensors, were analyzed using machine learning to create each participant’s unique fitness profile. Primary outcomes were fitness profile changes at 8 weeks.

Results:

We assessed 317 volunteers; 239 consented and met inclusion criteria (155 women, mean age 72.63 ± 5.38 years). Compared to both Controls, the Personalized Exercise group significantly improved in Dynamic Balance (F6,404=3.232, p<0.01, 2=0.046), Total Balance – sum of all balance measurements (F6,432=3.03, p<0.05, 2=0.040), Arm Flexion (F6,448=2.527, p<0.05, 2=0.033), Arm Extension (F6,450=2.753, p<0.05, 2=0.035) and Arm Strength (F6,424=2.394, p<0.05, 2=0.033). Significant improvement was observed with adherence as low as 1.5 exercise sessions per week over 8 weeks, and often within just 4 weeks. No improvement was observed on Torso Rotation and on Sit-to-Stand.

Conclusions:

A smartphone platform for remotely assessing motor components and delivering home-based individually tailored exercises, effectively targets the often-neglected key fitness components—balance, arm flexibility, and arm strength—in older adults. This approach has the potential to generate varied movement profiles and personalized exercise programs for both healthy individuals and those with mobility or cognitive impairments. Clinical Trial: The study was registered at National Institutes of Health ClinicalTrials.gov; ID: NCT04181983