The purpose of this study was to examine the feasibility and acceptability of remotely delivered, home-based exercise programs on physical function and well-being in self-isolating older adults during the COVID-19 pandemic. In a four-arm randomized controlled trial, 63 participants (aged 65 years and older) were allocated to one of three home-based daily (2 × 10-min) exercise interventions (exercise snacking, tai chi snacking, and combination) or control (UK National Health Service Web pages). Functional assessments were conducted via video call at baseline and 4-week follow-up. A web-based survey assessed the acceptability of each exercise program and secondary psychological/well-being outcomes. Ecological momentary assessment data, collected in Weeks 1 and 4, explored feeling states as antecedents and consequences of exercise. All intervention groups saw increased physical function at follow-up and displayed good adherence with exercise snacking considered the most acceptable program. Multilevel models revealed reciprocal associations between feelings of energy and exercise engagement. Further studies are needed with larger, more diverse demographic samples.

Background Older adults are at increased risk of falls, injury, and hospitalization. Maintaining or increasing participation in physical activity during older age can prevent some of the age-related declines in physical functioning that contribute to loss of independence and low reported quality of life. Exercise snacking may overcome some commonly cited barriers to exercise and encourage older adults to engage in muscle strength and balance activity, but the best way to deliver and support this novel format remains unknown. Objective Our aim was to explore how the novel exercise snacking approach, that is, incorporating short bouts of strength and balance activities into everyday routines, could be supported by technology within a home setting and what types of technologies would be acceptable for older adults who are prefrail. Methods Following a user-centered design process, 2 design workshops (study 1) were conducted first to understand older adults’ (n=11; aged 69-89 years) attitudes toward technology aimed at supporting exercise snacking at home and to inform the design of 2 prototypes. Next, based on the findings of study 1, an exploratory pilot study (study 2) was conducted over 1 day with 2 prototypes (n=5; aged 69-80 years) at the participants’ homes. Participants were interviewed over the telephone afterward about their experience. Transcripts were analyzed using framework analysis. Results The results showed that the participants were positive toward using technology at home to support exercise snacking, but both exercises and technology would need to be simple and match the participants’ everyday routines. Workshop discussions (study 1) led to the design of 2 prototypes using a pressure mat to support resistance and balance exercises. The exploratory pilot study (study 2) participants reported the potential in using smart devices to support exercise snacking, but the design of the initial prototypes influenced the participants’ attitudes toward them. It also hampered the acceptability of these initial versions and highlighted the challenges in fitting exercise snacking into everyday life. Conclusions Older adults were positive about using technology in their homes to support strength and balance exercise snacking. However, although promising, the initial prototypes require further refinement and optimization before feasibility, acceptability, and efficacy testing. Technologies to support exercise snacking need to be adaptable and personalized to individuals, to ensure that users are snacking on balance and strengthening exercises that are appropriate for them.

Introduction: Exercise “snacking” and Tai-chi ‘snacking’ protocols are designed to overcome typical barriers to older adults’ participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function.Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed.Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious.Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals’ physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.

BACKGROUND Older adults have an increased risk of falls, injury, and hospitalization. Maintaining/increasing participation in physical activity (PA) into older age can prevent some of the age-related declines in physical functioning that may contribute to loss of independence and lower reported quality of life. ‘Exercise snacking’ has been created to overcome some commonly cited barriers to exercise and encourage older adults to engage in muscle strength and balance activity, but the best way to deliver and support this novel format remains unknown. OBJECTIVE Our aim was to explore how the novel ‘exercise snacking’ approach, i.e., incorporating short bouts of strength and balance activities into everyday routines, could be supported by technology within a home setting; and what types of technologies would be acceptable for pre-frail older adults. METHODS Two design workshops (Study 1) were conducted to understand older adults' (n=11, aged 69-89 years old) attitudes towards technology aimed at supporting exercise snacking at home, and to inform the design of interactive prototypes. Based on the findings of Study 1, a feasibility home evaluation (Study 2) was conducted over one day for two prototypes (n=5 participants, aged 69-80). Participants were interviewed over the telephone afterwards about their experience. Transcripts were analyzed using Framework analysis. RESULTS Results showed participants were positive towards using technology at home to support exercise snacking, but both the exercises and technology would need to be simple and match participants’ everyday routines. Workshop discussions (Study 1) led to the design of two prototypes using a pressure mat to support resistance and balance exercises. The home evaluation (Study 2) identified participants reported potential in using smart devices to support exercise snacking, but the low fidelity of the prototypes influenced participants’ attitudes towards them. It also hampered the acceptability of these initial versions and highlighted challenges in fitting exercise snacking into everyday life. CONCLUSIONS Older adults were positive about using technology in their homes to support strength and balance exercise snacking. We have identified key points around the suitability of the home environment for facilitating exercise snacking. While promising, the initial prototypes further refinement and optimization prior to feasibility, acceptability and efficacy testing is required. Developers and researchers can use these findings to inform the development and evaluation of more sophisticated technologies for integration in the home environment to support PA.