Peer Review #2 of "The interplay of physical and social wellbeing in older adults: investigating the relationship between physical training and social interactions with virtual social environments (v0.1)"

Abstract

Background. Regular physical activity can substantially improve the physical wellbeing of older adults, preventing several chronic diseases and increasing cognitive performance and mood. However, research has shown that older adults are the most sedentary segment of society, spending much of their time seated or inactive. A variety of barriers make it difficult for older adults to maintain an active lifestyle, including logistical difficulties in going to a gym (for some adults, leaving home can be challenging), reduced functional abilities, and lack of motivation. In this paper, we report on the design and evaluation of Gymcentral. A training application running on tablet was designed to allow older adults to follow a personalized home-based exercise program while being remotely assisted by a coach. The objective of the study was to assess if a virtual gym that enables virtual presence and social interaction is more motivating for training than the same virtual gym without social interaction. Methods. A total of 37 adults aged between 65 and 87 years old (28 females and 9 males, mean age = 71, s.d. = 5.8) followed a personalized home-based strength and balance training plan for eight weeks. The participants performed the exercises autonomously at home using the Gymcentral application. Participants were assigned to one of the two training groups: the social group used an application with persuasive and social functionalities, while the Control group used a basic version of the service with no persuasive and social features. We further explored the effects of social facilitation, and in particular of virtual social presence, in user participation to training sessions. Outcome measures were adherence, persistence and co-presence rate. Results. Participants in the social group attended significantly more exercise sessions than the control group, providing evidence of a better engagement in the training program. Besides the focus on social persuasion measures, the study validates if a virtual gym service is effective for supporting individually tailored home-based physical training for older adults. The study also confirms that social facilitation tools motivate users to train together in a virtual fitness environment. Discussion. The study confirms that Gymcentral increases the participation of older adults in physical training as compared to a similar version of the application without social and persuasive features. In addition, a significant increase in the co-presence of the social group indicates that social presence motivates the participants to join training sessions at the same time with the other participants. These results are encouraging, as they motivate further research into using home-based training programs as an opportunity to stay physically and socially active, especially for those whom for various reasons are bound to stay at home.