Physical and Functional Effects of Face-to-Face and Remotely Supervised Combined Exercise in Institutionalized Older Adults: A Non-Randomized Controlled Trial

Background/Objectives: Supervised exercise is an important strategy for maintaining physical function in older adults; however, access to structured programmes may be limited in long-term care settings. Remotely supervised exercise may provide an alternative mode of delivery. This study examined the effects of videoconference-supervised and face-to-face combined exercise on physical and functional outcomes in institutionalized older adults. Methods: This three-arm non-randomized controlled trial included 87 institutionalized older adults assigned to a face-to-face exercise group, a videoconference-supervised exercise group, or a control group. Three participants did not complete follow-up, resulting in 84 participants with complete follow-up data who were included in the final analysis (mean age 83.13 ± 7.63 years). Both intervention groups completed the same 12-week combined exercise programme twice weekly, whereas the control group maintained usual activities. Body composition, muscular strength, flexibility, functional mobility, and aerobic endurance were assessed at baseline, 6 weeks, and 12 weeks. Time, Group, and Time × Group effects were examined using a mixed-design repeated-measures analysis. Results: Both exercise groups showed significant improvements in body composition, muscular strength, flexibility, functional mobility, and aerobic endurance, with significant Time × Group interactions and moderate-to-large effect sizes across these outcomes (p ≤ 0.001; ηp2 = 0.149–0.703). In the control group, body mass and BMI remained stable, whereas fat mass percentage, several strength outcomes, functional mobility, and aerobic endurance deteriorated over time. No statistically significant differences in change scores were observed between the face-to-face and videoconference groups (p > 0.05). Conclusions: Both supervised exercise formats were associated with favourable adaptations. Videoconference supervision may represent a viable delivery strategy when access to face-to-face programmes is limited. The study protocol was registered at ClinicalTrials.gov (registration number: NCT06722976; first posted on 9 December 2024).