The effects of an online, social group exercise programme on the mental, social, and physical health of older adults: a mixed methods review

Background: COVID-19 has negatively impacted many aspects of the mental, social, and physical health of older adults in the United Kingdom. Exercise is a well-known treatment to improve aspects of mental and physical health and socialising is likely one strategy to help combat loneliness in older adults. Due to COVID-19 related social distancing restrictions innovative approaches are needed to support and empower older adults to exercise and socialise. A pilot trial of the online, social group exercise course entitled ‘Walk and Talk for Your Life hosted via Zoom’ (WTL-Z) demonstrated initial efficacy at reducing depression and loneliness.

Objective: Explore the mental, social, and physical effects of the 10-week WTL-Z course on older adults and determine what factors aid or limit the efficacy of the intervention.

WTL-Z Intervention: The WTL-Z 10-week course comprises 20 online sessions delivered via Zoom. Each session is composed of 15-minutes of informal socialising, 30-minutes of strength, balance, and cardiovascular exercises, followed by a 45-minute group discussion on a health topic.

Participants: This trial evaluated data from an initial sample of 276 older adults aged 50+ (average age 66.1 years) from London, United Kingdom (UK).

Method: This trial included three studies. Study 1 was a randomised control trail of the WTL-Z intervention, which included 2 groups (intervention, n=35; control, n=43). To explore in more detail the effects of WTL-Z, Study 2 adopts a qualitative method, through interviews with a subgroup of 20 participants who completed the WTL-Z intervention. Study 3 (n=18) was a non-controlled quantitative study of WTL-Z which provided members of the control group from Study 1 the opportunity to undergo the WTL-Z intervention.

Results: Composite score analysis evaluating aspects of mental, social, and physical health revealed a statistically significant difference between the intervention and control groups (p=0.004) with a medium to large effect size (η2 = 0.12). Qualitative analysis identified seven potential factors to explain the health improvement of intervention group participants: 1) the therapeutic effects of exercise, 2) the benefits of routine and structure, 3) the positive outcomes associated with learning new skills, 4) feeling of increased social support, 5) a greater sense of belonging, 6) increased self-worth, and 7) developing a higher sense of agency in relation to their health. Lastly, Study 3 participants also improved aspects of their mental, social, and physical health confirming the quantitative results of Study 1.

Conclusion: The WTL-Z intervention is a feasible and acceptable intervention for older adults and preliminary evidence suggests the programme is effective to improve aspects of mental, social, and physical health in UK older adults.