The Benefits of a Digital Exercise Intervention for Older Adults: Findings from the Fittle Trial (Preprint)

BACKGROUND : It is well established that physical activity (PA) is important to health, quality of life, and well-being. Yet, most older adults do not engage in physical activity on a regular basis or meet the recommended physical activity guidelines. OBJECTIVE This study evaluated the feasibility, acceptability, and efficacy of a digital exercise program, the Fittle Senior System (FSS). The FSS intervention was designed to provide customized behavior-change programs to increase engagement in physical activity and foster online social interaction and support from small teams pursuing similar goals. METHODS : One hundred and eighty-one adults aged 60 to 95, including males and females, participated in the study. Participants were randomized into the FSS intervention condition or a Tablet Education (TE) control condition using cluster randomization. Participants in the FSS condition were provided a tablet with the Fittle app, a Misfit Flare activity tracker, and a resistance band. The trial duration was six months. The initial three months of the trial was the active intervention phase, followed by the three month maintenance phase. Participants in the TE condition were also provided with a tablet, the Misfit Flare, a resistance band, and introduced to websites containing exercise programs for aging adults. Measures include measures of usability, acceptability, health outcomes, and psychosocial outcomes. Assessments occurred at baseline and 3- and 6- months post randomization. RESULTS Fittle was usable and acceptable to the participants assigned to the FSS condition. Participants in both conditions experienced increased physical activity, exercise self-efficacy, health-related quality of life, social support, and decreased social isolation and loneliness. Participants who used the Fittle app to a greater extent reported higher self-ratings of health, better health compared to a year ago, higher exercise self-efficacy, and lower social isolation. Participants in the FSS condition also reported that the Fittle app was easy to use and motivating with respect to engaging in exercise. CONCLUSIONS Our findings indicate that digital exercise programs are feasible for and usable for older adults. These programs can result in improvements in health and psychosocial outcomes. Further, despite the disruptions of the COVID-19 pandemic, attrition in the trial was low, indicating that these types of interventions are valuable to aging adults, including those with multiple chronic conditions. CLINICALTRIAL NCT03538158