Effects of exercise programmes delivered using video technology on physical performance and falls in people aged 60 years and over living in the community: a systematic review and meta-analysis.

Objective: This systematic review and meta-analysis synthesised the evidence and evaluated the effect of exercise programmes delivered using instructional videos compared with control on physical performance and falls in community-dwelling older people aged 60 years and older.

Methods: A systematic review and meta-analysis conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Central Register of Controlled Trials, TRIP and PEDro. Grey literature sources included theses and dissertations from Ethos and ProQuest. Methods: Studies were included if they involved community-dwelling older people (aged >60 years) participating in exercise programmes delivered through instructional videos. Methods: Treatment effects were estimated using a random-effects model, reporting 95% CIs, mean differences (MD) and standardised MDs (SMD, Hedges' g) for outcomes measured in different units. The risk of bias was assessed using ROB2, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results: A total of 7487 records were screened, with 16 studies (n=1910) meeting the inclusion criteria. Meta-analysis of 11 studies revealed significant effects of video-delivered exercise programmes in lower extremity strength (SMD=0.35, 95% CI 0.11 to 0.59; I2=70.35%, p<0.001, GRADE moderate quality), balance (SMD=0.45, 95% CI 0.07 to 0.83; I2=85.07%, p=0.02, GRADE low quality), mobility (MD=0.96, 95% CI 0.46 to 1.46; I2=53.31%, p<0.001, GRADE moderate quality) and physical performance SMD=0.36, 95% CI 0.17 to 0.56; I2=13.49%, p<0.001, GRADE moderate quality). No evidence of an effect of video-delivered exercise programmes on fear of falling was found (SMD=0.5, 95% CI -0.30 to 1.29; I2=95.48%, p=0.22, GRADE very low quality). There were insufficient data for reporting falls.

Conclusions: Video-delivered exercise programmes improved physical performance, particularly lower extremity strength, balance and mobility, with low to moderate quality evidence. There is uncertainty about the effect of video-delivered exercise programmes on the number of falls, number of fallers and fear of falling. CRD42023415530.