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.