Effectiveness of Synchronous Telerehabilitation Versus Face-to-Face Physical Therapy in Older Adults Who Are Frail: Protocol for a Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Older adults who are frail face significant barriers to physical activity, and innovative solutions such as synchronous telerehabilitation (STR) may provide a viable alternative to traditional face-to-face programs. However, less is known about its effectiveness compared to a face-to-face program. OBJECTIVE: This study aims to compare the effectiveness of an STR program versus a face-to-face physical therapy (FPT) program in the primary outcomes (lower body strength and cardiorespiratory fitness) and secondary outcomes (upper limb strength, dynamic balance, static balance, number of steps, functional status, and quality of life) in older adults who are frail. METHODS: In a randomized, blinded, parallel-group controlled trial, all older adults who are frail and aged ≥60 years of both sexes from the Los Angeles Comprehensive Center for Older Adults will be invited to participate. A total of 58 older adults who are frail (aged ≥60 years) meeting the eligibility criteria will be randomly assigned to either an STR group (n=29, 50%) or an FPT group (n=29, 50%). Participants will engage in 1-hour multicomponent exercise sessions twice weekly for 12 weeks. The telerehabilitation group will participate via videoconferencing, supervised remotely by technical staff, while the face-to-face group will attend in-person sessions. Outcomes will include lower limb strength (sit-to-stand test), cardiorespiratory fitness (2-minute step test), upper limb strength (grip strength test), balance (Timed Up and Go, and single-leg stance), quality of life (36-item brief health survey), functional status (functional independence measure), and daily steps (pedometer). RESULTS: Recruitment will be conducted from April to May 2025. The intervention will run from June to August 2025, follow-up assessments will be completed by September 2025, and data analysis will be finalized by December 2025. Manuscript drafting and submission are planned for March 2026. We hypothesize that STR will yield equal or superior improvements in both primary and secondary outcomes compared to FPT in older adults who are frail. CONCLUSIONS: STR is emerging as a viable and effective alternative to in-person physical therapy for older adults with frailty. This approach has the potential to improve physical condition and functional and quality of life indicators, overcoming geographical and logistical barriers and optimizing therapeutic resources. TRIAL REGISTRATION: ClinicalTrials.gov NCT06784245; https://clinicaltrials.gov/study/NCT06784245. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/72318.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.036 |
| Meta-epidemiology (narrow) | 0.008 | 0.003 |
| Meta-epidemiology (broad) | 0.017 | 0.009 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.008 | 0.010 |
| Insufficient payload (model declined to judge) | 0.071 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".