Technological and Non-Technological Innovation for Exercise Adherence: A Narrative Review Informed by Umbrella Reviews

Background/Objective: Noncommunicable diseases (NCDs) are a leading cause of death today, and regular physical exercise is considered the best way to address this challenge. However, adherence to physical exercise remains a major barrier. Innovation can play a decisive role in overcoming the well-known barriers to physical exercise adherence among people living with NCDs. Therefore, this narrative review examines adherence-related factors reported in umbrella reviews involving older adults, including chronic-condition populations and people with overweight or obesity, and explores potential applications of technological and non-technological innovation. Methods: This paper adopted a narrative literature review method to detect both the barriers and the innovations. The search strategy covered the databases PubMed, EMBASE, Web of Science and Google Scholar (gray literature) in December 2025 and again in January 2026. In this study, the PCC (Population = people with NCDs and relevant chronic-condition populations represented in the evidence; Concept = use of innovation, Context = with NCDs) framework was used with the intention of presenting to the reader possibilities, paths, and/or recommendations for overcoming these barriers via innovations (technological and non-technological), grounded in deep theoretical and practical foundations. The Scale for the Assessment of Narrative Review Articles (SANRA) was employed to ensure transparency and quality in the review process. Results: Two umbrella reviews were identified as directly relevant in the literature search and reported 14 and 47 adherence-related factors (61 source-reported factor entries before assessment of overlap), which were organized into behavioral strategies, contextual and social factors, individual factors, and technological tools. These factors are presented as a qualitative conceptual synthesis of potential opportunities for technological and non-technological innovation, without deriving a quantitative percentage from the authors’ classification. Conclusion: Technological and non-technological innovations may offer complementary ways to address barriers to exercise adherence in the populations represented by the evidence. Their effectiveness for sustained adherence and applicability to other NCD populations require direct evaluation.