title: Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.
abstract: BACKGROUND
  With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC.
  
  
  METHODS
  Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact.
  
  
  CONCLUSIONS
  The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home-based exercise programs.
  
  
  BACKGROUND
  Nederlands Trial Register (NTR); trial number 4265. The study was prospectively registered (registration date 14/11/2013).
authors.affiliation: Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. H.A.E.Geraedts@med.umcg.nl.
authors.forename: Hilde A E
authors.initials: HA
authors.lastname: Geraedts
authors.forename: Wiebren
authors.initials: W
authors.lastname: Zijlstra
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Bulstra
authors.forename: Martin
authors.initials: M
authors.lastname: Stevens
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D016330:Frail Elderly; D006299:Health Services for the Aged / Q000458:organization & administration; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009426:Netherlands; D010349:Patient Compliance; D015397:Program Evaluation; D011446:Prospective Studies; D012107:Research Design