Effects of Assessment and Verbal Feedback on Physical Function and Exercise Adherence in Healthy Older Adults

Overview

The goal of this pilot Randomized Controlled Trial (RCT) was to investigate whether the provision of periodic assessment and verbal feedback during an exercise program has an effect on adherence, physical function and self-perceived competence in healthy community-dwelling older adults, aged ≥65 years. An exercise program with periodic assessment and individualized verbal feedback was compared to the same exercise program delivered without individualized assessment and feedback to determine differences in adherence, functional performance, and self-perceived ability in community-dwelling older adults. Participants: * participated in a structured exercise program for 12 weeks (2times/week) * underwent periodic assessments and received verbal feedback (intervention group only).

This study is a pilot RCT that included healthy adults aged 65 years and older, with active registration in the Senior Citizens' Centers (KAPI) of the Municipality of Nikaia-Agios Ioannis Rentis, Athens, Greece. Ethical approval for the study was obtained from the Ethics Committee of the University of West Attica (Protocol No. 107620/24-10-2025) before study initiation. Prior to participation, all eligible candidates received written information about the study and their voluntary participation, and provided written informed consent in accordance with the Declaration of Helsinki. Candidates who confirmed their willingness to participate were subsequently screened for eligibility based on the inclusion and exclusion criteria and they were allocated into two groups using a randomized procedure. Group allocation was known to the participants; however, the physiotherapist delivering the exercise program was blind to group assignment (intervention or control). All participants followed the same structured and supervised exercise program, delivered by a municipal physiotherapist, with a duration of 12 weeks and a frequency of two sessions per week and a 48-hour interval between sessions. Each session lasted approximately 50 minutes and included warm-up, main exercise, and cool-down components. Exercise intensity was moderate, individually adapted based on perceived exertion, and progressively increased over time. At baseline assessment, all participants completed the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) to assess exercise motivation, the Activities-specific Balance Confidence (ABC) Scale to evaluate self-reported balance confidence during activities of daily living, and the Self-Efficacy for Exercise (SEE) Scale. Physical performance and functional mobility were assessed using the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) test. Exercise adherence was monitored throughout the intervention period by means of attendance records completed at each session. Participants allocated to the intervention group underwent three additional assessments at weeks 3, 6, and 9 using the TUG test and the ABC Scale, conducted under conditions consistent with baseline assessments by the same evaluator. Following each assessment, participants in the intervention group received brief, individualized, and encouraging verbal feedback regarding their performance and progress. The control group did not receive additional periodic assessments or feedback. After completion of the 12-week intervention, all participants underwent post-intervention assessments identical to baseline, conducted under comparable conditions to ensure data consistency and reliability.