Effect of e-Health exercise interventions on physical activity and number of steps in healthy older people: A network meta-analysis of randomised controlled trials.

Objectives: e-Health physical activity interventions have been shown to promote positive changes in health behaviours that benefit both physical and mental health. The aim of this study was to determine which type of e-Health intervention was the most effective at increasing physical activity levels in older people.

Study design: Systematic review and network meta-analysis.

Methods: A literature search was conducted up to July 2025. Randomised controlled trials reporting the effects of e-Health exercise programmes on increasing physical activity and the number of steps were included. Standard pairwise meta-analysis and network meta-analysis were performed for direct and indirect comparisons between interventions to calculate the effect size (ES) and 95 % confidence interval (CI).

Results: Sixteen studies with a total study population of 2296 participants were included in this network meta-analysis. The intervention that showed the highest ES for increasing daily physical activity was the computer phone-based intervention (ES = 0.47; 95 % CI: 0.11, 0.84; compared to the control group). This intervention consists of providing participants with a tablet computer preloaded with an application (app) that offers recommendations on healthy habits and physical activity. Regarding the number of daily steps, the highest ES was observed with the wearable physical activity intervention (ES = 1.06; 95 % CI: 0.20, 1.92; compared to the control group). This intervention combines the use of devices such as pedometers and accelerometers with motivational instructions aimed at achieving a daily step goal.

Conclusions: Results showed that phone-based e-Health interventions and wearable physical activity training programmes were the most effective interventions for increasing daily physical activity and number of steps per day, respectively.