Feasibility and effectiveness of physical exercise for older adults delivered remotely via videoconferencing-systematic review and meta analysis

Background Physical activity promotes healthy ageing. Videoconferencing enables delivery of accessible exercise therapy, supporting older adults in engaging in structured physical activity. Objectives To investigate the feasibility and effectiveness of remotely supervised videoconferencing exercise therapy for adults over 65. Data sources Nine databases were searched, with manual search completed in March 2025. Study selection Randomised controlled trials assessing remote exercise effectiveness or feasibility, delivered via videoconference with professional real-Time interaction. Data extraction and synthesis Two authors independently screened studies, extracted data, and assessed methodological quality. Meta-Analysis used random effects models, with primary conclusions based on high methodological quality studies. Results Twenty-eight studies (n = 2086) were analysed. Results are given for the 18 high-quality studies, including 7 low and 11 moderate risks of bias studies. Average attendance and completion rates were 79.7% and 92.8%, respectively. In videoconference exercise, the number of adverse events was comparable to control groups. Videoconference exercise showed significant improvements over no intervention in: physical function [standardised mean difference (SMD) = 0.82; 95% CI 0.46-1.19; P <. 00001], muscle strength (SMD = 0.86; 95% CI 0.46-1.26; P <. 0001), emotional status (SMD = 0.72; 95% CI 0.35-1.09; P =. 0001) and quality-of-life (SMD = 0.61; 95% CI 0.19-1.03; P =. 004). High-quality studies showed comparable effectiveness to alternative delivery methods across all measures. Limitations Only 25% of studies met the highest methodological standards. High heterogeneity in outcome measures and small sample sizes may affect generalizability. Conclusion Videoconference exercise therapy appears safe, feasible and effective for improving physical function, strength, emotional status and quality-of-life compared to no intervention. Its equivalence to alternative delivery is established for all measures.