Physical exercise is a vital factor in aging well and healthily. The World Health Organization recommends that older people do 150 minutes of moderate aerobic physical activity per week, although a quarter of them do not reach this level. Fitness apps can be a good tool to encourage movement, give practice tips, and record workout data. However, researchers from the Open University of Catalonia (UOC) and the Pere Virgili Health Park have discovered that this technology is not adapted to the needs of the elderly.
The work, published last December in the journal
Age and Aging
, from the British Geriatrics Society, only found one of the 15 applications examined to be really useful. This is Vivifrail and is suitable for both users who want to use it on their own and for professionals who prescribe physical activity to their patients. The app met the scientists' requirements, is based on scientific evidence and adjusts to the content and use needs of the elderly. It does not need a professional prescription, it is free, it adapts to all types of users, it allows you to level up and the information is available both in written and audiovisual form.
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Low availability is not the only obstacle on this path. It must also be taken into account that these types of tools are out of reach for many older people because they do not have digital literacy nor do they have a smartphone. In the article, the authors recognize that there are many apps that do not meet the needs of the elderly, even though they are aimed at this audience. A fact as simple as requiring registration can be a big obstacle, since many older people do not even have an email address to do so.
The authors recognize in the work that an application for older adults must be simple, intuitive and focused on their needs. The individualization in this type of services “is total,” explains Carme Carrión, one of the authors of the work and researcher at the UOC eHealth Center research center. It is necessary that they adapt to your needs and your possibilities within the practice of sport. David Rodriguez-Ruiz, coordinator of the Physical Exercise Group for Older People of the Spanish Society of Geriatrics and Gerontology (SEGG), also emphasizes that this is an aspect that, precisely, current applications do not have and that should be incorporated. Of course, to achieve this it would be essential to carry out a prior evaluation of each user, he adds.
It is not just about adapting the scheduled physical activity, but these apps also allow other adaptations such as, for example, increasing the size of the font, buttons and icons for older adults who have impaired vision, says the geriatrician Nicolás González, from the Gregorio Marañón Hospital in Madrid. In addition, they must have multiple options that also allow them to choose the activities that motivate them the most, he adds. To achieve this adaptability, it is necessary to include older people in the processes of creation, development and implementation of applications for physical exercise, according to Carrión. “Users have to be listened to and, as far as possible, respond to their needs,” he explains.
One of the problems, according to Rodríguez-Ruiz, is that the apps cannot be completely controlled. It is the user who records the progress he makes and whether he does the exercises properly. All experts agree that the practice of exercise and the use of these applications must be supervised by a Physical Activity and Sports Sciences (CAFD) professional or a doctor. For Antonio Clavero, predoctoral researcher and teacher in the CAFD degree at the University of Granada (UGR), the ideal would be for the app to allow the elderly to have contact with the specialist to be able to resolve their doubts. In this sense, González, a geriatrician at Gregorio Marañón in Madrid, highlights that the most suitable for this monitoring are specialists in physical activity and sports: "They are experts in this matter and their role can be very relevant."
Carme Carrión, from the UOC and author of the research, affirms that the best way for these interventions to work is to carry them out in a hybrid way. It is about having a group part accompanied by a professional (healthcare or physical activity specialist) who prescribes the exercises to the users, corrects them and helps them. In parallel, the application is used on a daily basis, at times when this group cannot meet or professionals cannot be present. Rodriguez-Ruiz, from the SEGG, maintains that this supervision will also help them maintain adherence to this sport practice.
This hybrid use can also help them have greater social interaction and combat unwanted loneliness, a factor that in addition to reducing their quality of life also increases mortality, explains Carrión. The researcher continues by stating that it is a two-way street because, at the same time, this socialization is likely to increase adherence to physical activity.
The UOC's work emphasizes that training and support are crucial when prescribing a physical exercise app to the elderly. Professionals must also be included in this process so that they know these services, know how to use them and can apply them appropriately with users, adds Carrión. Rodriguez-Ruiz also highlights that with generational evolution, there are more and more older people who use technology and who have more and more training to be able to use these services without problems.
Clavero, researcher and teacher at the UGR, affirms that these applications are just another tool to work with older people who are not familiar with the use of smartphones or tablets. He suggests starting by using other, simpler methods, such as bracelets that measure physical activity and heart rate. Carrión, on the other hand, recognizes that there is a digital divide in terms of age, but senses that these apps can have a direct impact on the quality of life of the elderly if they manage to reduce their sedentary lifestyle.
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