Systematic review and meta-analysis of digital-based exercise interventions for older adults
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Key Takeaway
Digital-based exercise interventions may improve falls efficacy and balance in older adults.
This systematic review and meta-analysis examined the effects of digital-based exercise interventions on older adults. The analysis pooled data from studies involving 2435 participants to evaluate impacts on balance function, functional mobility, physical function, and concerns about falling. The primary outcome focused on changes in concerns about falling and falls efficacy, with secondary outcomes including physical performance and balance function.
Significant effects were observed for falls efficacy, with a standardized mean difference of 0.70 and a 95% CI of 0.51-0.90. Balance function showed a mean difference of 4.03 with a 95% CI of 2.57-5.49. Functional mobility improved with a mean difference of -1.65 and a 95% CI of -2.52 to -0.77. Physical function demonstrated a mean difference of 0.57 with a 95% CI of 0.12-1.02. Concerns about falling showed no significant effect, with a standardized mean difference of -0.12 and a 95% CI of -0.28 to 0.05.
The study did not report adverse events, discontinuations, or tolerability. Follow-up duration was not reported. The authors did not specify the setting or funding sources. These findings suggest potential benefits for physical metrics but do not confirm long-term safety or efficacy beyond the reported parameters.
View Original Abstract ↓
BACKGROUND: Falls are prevalent and serious health problems among older adults. Concerns about falling and reduced falls efficacy are common fall-related psychological impairments, representing 2 distinct emotional and cognitive constructs, respectively. The impact of digital-based exercise interventions on these specific constructs remains unclear.
OBJECTIVE: This systematic review and meta-analysis aimed to synthesize current evidence on digital-based exercise interventions for concerns about falling and falls efficacy among older adults, with a specific focus on determining their differential effects on emotional and cognitive constructs and evaluating their impact on physical performance.
METHODS: The PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, CNKI, SinoMed, VIP, and Wanfang databases were systematically searched from their inception dates to May 2025. We searched for published randomized controlled trials on the effects of digital-based interventions on the fear of falling, concerns about falling, and falls efficacy among older adults. The study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was performed using Stata 17.0 software (StataCorp LLC).
RESULTS: Eighteen studies involving 2435 participants were included. Meta-analyses revealed significant effects of digital-based exercise interventions on falls efficacy (standardized mean difference 0.70, 95% CI 0.51-0.90; P<.001), balance function (mean difference [MD] 4.03, 95% CI 2.57-5.49; P<.001), functional mobility (MD -1.65, 95% CI -2.52 to -0.77; P<.001), and physical function (MD 0.57, 95% CI 0.12-1.02; P=.006) among older adults. However, digital-based exercise interventions had no significant effect on concerns about falling, which is the emotional construct related to falls (standardized MD -0.12, 95% CI -0.28 to 0.05; P>.05).
CONCLUSIONS: The meta-analysis assessed the efficacy of digital-based exercise interventions on fall-related psychological impairments among older adults and revealed that the effects differed across the constructs. These findings suggest that digital-based exercise interventions have potential benefits for improving falls efficacy and physical performance among older adults compared with controls. However, the effect of digital-based exercise interventions on concerns about falling, which is the emotional construct related to falls, remains uncertain among older adults.
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