Objective This study aimed to assess the effectiveness of synchronous group-based tele-exercise (TE) in improving physical functioning and exercise adherence among older adults at risk of falls, comparing it to a community-based group (CB). Methods 91 community-dwelling older adults at risk of falls were recruited from 10 community centres in Hong Kong. Participants were randomly assigned to either the TE or CB group based on their community centre. Both groups received modified Otago exercise training for three months, with the difference in the mode of delivery (tele-exercise at home or face-to-face at a community centre). The primary outcomes assessed Fall Efficacy Scale (FES-I), 6-meter walk test, Timed Up and Go test (TUG), Berg Balance Scale (BBS), Functional Reach Test (FRT), Appendicular Skeletal Muscle Mass Index (ASMI) and percentage of body fat. Secondary outcomes included exercise adherence, dropout rate, and Physical Activity Enjoyment Scale (PACES). The primary analysis was conducted using a modified intention-to-treat approach, utilizing all available data. Results Both groups showed significant improvements in FES-I, 6-meter walk test, TUG, and BBS over time (p<0.05). High adherence rates (TE: 85%; CB: 90%), low dropout rates (TE: 4.4%; CB: 0%), and high PACES scores (TE: 108.6 ± 9.3; CB: 108.2 ± 7.9) were observed in both groups. TE and CB were comparable in most outcomes at baseline and at three months (p>0.05). No serious adverse events were reported. Conclusions The findings revealed synchronous group-based tele-exercise training demonstrated comparable effectiveness to face-to-face community training in terms of physical functioning, adherence, and enjoyment.

The authors have declared no competing interest.

ChiCTR2200063370

https://doi.org/10.1186/s12877-023-04535-4

The study was funded by the Health and Medical Research Fund (HMRF) under the Health Bureau of the Government of the Hong Kong Special Administrative Region of the People's Republic of China (05200028). The funder has no role on the study design, protocol preparation, data collection and management, or future data analysis and interpretation, writing of the report, and the decision to submit the report for publication. They have no authority over any of these activities.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Approval for the study was granted by the Ethics Committee of the College of Professional and Continuing Education (RC/ETH/H/0029).

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All data produced in the present study are available upon reasonable request to the authors