Effectiveness of tele-exercise programme for elderly at risk of falls. Protocol for a randomized controlled trial.

Abstract Background: Continuous loss of muscle mass and strength are the consequences of the ageing process, increasing the risk of falls among older adults. Falls can lead to severe consequences such as bone fractures and hampered physical and psychological well-being. Regular exercise is the key to reversing muscle atrophy and relieving sarcopenia. However, the frailty of the elderly and the recent COVID-19 pandemic may affect their confidence in leaving home to attend classes in the community. A feasible and effective alternative should be explored. Methods: The primary objective is to evaluate the effectiveness of tele-exercise (TE) on physical function and exercise adherence among the community-dwelling elderly at risk of falls in comparison with a community-based group (CB). The secondary objective includes evaluating the elderly's experience with tele-exercise, emphasizing their psychological welfare, social well-being, and acceptance of the telehealth approach. The design, conduct, and report follow the SPIRIT guidelines (Standard Protocol Items: recommended items to address in a Clinical Trial Protocol and Related Documents). The elderly will be recruited from 10 local community centres in Hong Kong and randomly allocated into two groups. All participants will attend the exercise training 3 days per week for 3 months but differ in the mode of delivery, either online as the tele-exercise group (TE) or face-to-face as the community-based group (CB). The outcome measures include muscle strength, physical function, exercise adherence and dropout rate, psychological and social well-being will be assessed at baseline, the 3rd, 6th and 12th month. Some participants will be invited for focus group interviews to evaluate their overall experience of the tele-exercise training. Discussion: Tele-exercise reduces barriers to exercise, such as time constraints, inaccessibility to facilities, and the fear of the frail elderly leaving home. Promoting an online home-based exercise programme for the elderly can encourage them to engage in regular physical activity and increase their exercise adherence even when staying home. The use of telehealth can potentially result in savings in costs and time. The final findings will give insights on delivering exercise via telehealth approach to the elderly and propose exercise delivering and maintenance model for future practices. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/searchproj.aspx), registration number: ChiCTR2200063370. Registered on 5 September 2022