Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence

Abstract

Background: Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults’ PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. Methods: Ten healthy older adults (4 females, aged 70–78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. Results: Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). Conclusions: Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.

Adherence to eHealth-Delivered Exercise in Adults with no Specific Health Conditions: A Scoping Review on a Conceptual Challenge

“…Table 1 summarizes the key characteristics in the selected studies. Issuing countries included Australia [ 30 , 31 ], Greece [ 32 ], Spain [ 33 , 34 ], The Netherlands [ 35 ], Germany [ 36 ], United States of America [ 37 , 38 ], United Kingdom [ 28 , 39 ], China [ 40 ] and Taiwan [ 41 ]. A noticeable increase in the number of publications could be seen for 2021 and 2022.…”

“…In general, this review comprised a range of technologies and measures applied to the evaluation of adherence ( Table 1 ). The technologies used included computers [ 32 ], internet or websites [ 31 , 36 , 37 ], Amazon Alexa and internet [ 30 ], video platforms [ 33 , 38 , 39 ], and mobile applications [ 28 , 34 , 35 , 40 , 41 ]. See Figure 2 .…”

“…As is customary in scoping reviews, the nature of the studies reviewed was heterogeneous, not only due to the different technologies used but also in regard to the choice of intervention, delivery, and registry mode, among other things. Most (8 out of 13) of the reviewed articles assessed adherence to exercise programs, protocols or interventions [ 30 , 32 , 33 , 35 , 37 , 38 , 39 , 41 ]; one focused on adherence to changes in PA levels [ 36 ], one focused on adherence to app-delivered prompts [ 28 ], one assessed adherence to a single exercise [ 40 ], one measured adherence to a PA intervention [ 31 ], and one focused on establishing a prediction of adherence based on a previously published pilot study [ 34 ]. In addition to measuring adherence to the exercise program, one of the studies also aimed to assess adherence to exercise volume [ 35 ] and yet another aimed to assess adherence to the exercise training dose [ 38 ].…”

“…Most (8 out of 13) of the reviewed articles assessed adherence to exercise programs, protocols or interventions [ 30 , 32 , 33 , 35 , 37 , 38 , 39 , 41 ]; one focused on adherence to changes in PA levels [ 36 ], one focused on adherence to app-delivered prompts [ 28 ], one assessed adherence to a single exercise [ 40 ], one measured adherence to a PA intervention [ 31 ], and one focused on establishing a prediction of adherence based on a previously published pilot study [ 34 ]. In addition to measuring adherence to the exercise program, one of the studies also aimed to assess adherence to exercise volume [ 35 ] and yet another aimed to assess adherence to the exercise training dose [ 38 ]. Other than that, still related to the concept of adherence, one of the reviewed papers additionally measured engagement on a website, as the number of visits and minutes spent on it [ 31 ].…”

“…The majority of the reviewed papers that focused on assessing adherence to exercise programs did so by operationalizing the term as a percentage of actual practice over the recommended or planned amount of practice [ 30 , 32 , 35 , 37 , 38 , 39 , 41 ]. Of those, one of the studies specified that calculations had only been done for those participants who had completed the intervention [ 37 ].…”