Geriatric Research, Education, and Clinical Center and Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
David Geffen School of Medicine at UCLA, Departments of Internal Medicine and Psychiatry, Los Angeles, California, USA.
Telemed J E Health. 2023 Jun;29(6):829-840. doi: 10.1089/tmj.2022.0175. Epub 2022 Nov 10.
Literature on telehealth interventions for older adults has been primarily on asynchronous interventions. During the COVID-19 pandemic, older adult exercise programs transitioned to an online format. This systematic review and case study examines the effectiveness of older adult live video exercise group interventions on physical health with insights from a Los Angeles VA program, Gerofit. PubMed was searched for live video older adult exercise groups from database inception to November 2021. All eligible studies included assessments of physical health and were limited to participants with an average age of 65 years or greater. Ten Veterans, who had participated in both in-person and virtual Gerofit sessions, were surveyed in the case study. Nine studies met the inclusion criteria. Four studies included an equivalent in-person group as a comparator to the live video group and reported no significant between-group differences in outcomes, including energy expenditure and 6-minute walking distance test (6MWD). The other five studies reported statistically significant in-group improvement in outcomes including isokinetic knee strength. Case study participants reported similar attendance rates and perceived benefits, such as improved balance, when comparing virtual and in-person sessions. Live video exercise groups in older adults demonstrated an improvement in physical function that was not statistically different from the comparison in-person sessions with the added benefit of averaging a higher attendance rate, providing initial support for the use of live video in older adult exercise programs. Insights from the case study supplement this by demonstrating older adults' positive attitude on these groups.
关于老年人远程医疗干预的文献主要集中在异步干预上。在 COVID-19 大流行期间,老年人锻炼计划转为在线形式。本系统评价和案例研究考察了老年人实时视频锻炼小组干预对身体健康的有效性,该研究来自洛杉矶退伍军人事务部的 Gerofit 项目。从数据库建立到 2021 年 11 月,在 PubMed 上搜索了实时视频老年人锻炼小组的相关文献。所有符合条件的研究都评估了身体健康状况,且仅限于平均年龄在 65 岁或以上的参与者。在案例研究中,对 10 名曾参加过面对面和虚拟 Gerofit 课程的退伍军人进行了调查。9 项研究符合纳入标准。其中 4 项研究将面对面小组作为实时视频组的对照组,并报告了结果无显著差异,包括能量消耗和 6 分钟步行距离测试(6MWD)。另外 5 项研究报告了与组内相比具有统计学意义的结果改善,包括等速膝关节力量。案例研究参与者报告了类似的出勤率和感知益处,例如平衡改善,将虚拟和面对面课程进行比较时。老年人的实时视频锻炼小组在身体功能方面有所改善,与面对面比较组相比无统计学差异,同时还具有更高的平均出勤率的优势,这为在老年人锻炼计划中使用实时视频提供了初步支持。案例研究的结果进一步补充了这一点,展示了老年人对这些小组的积极态度。