Delivery of Home-Based Exercise Interventions in Older Adults Facilitated by Amazon Alexa: A 12-week Feasibility Trial

To evaluate the feasibility of using voice-controlled intelligent personal assistants (VIPAs) to remotely deliver and monitor an individually-tailored, home-based exercise program to older adults living independently and alone.12-week, prospective single-arm feasibility study.Community residences.15 adults aged 60 to 89 years living alone.All participants were prescribed home-based muscle strengthening, weight-bearing impact and balance exercises, increasing from two to four 10-minute sessions per day over 12 weeks. Sessions were delivered using VIPAs (Amazon Alexa Echo Show 5; "Alexa") and a novel software program ("Buddy Link"). The program was individualized by an exercise physiologist based on participant voice responses to Alexa questions.Study outcomes were feasibility (rate of retention, adherence, and adverse events), usability (System Usability Scale) and changes to quality of life (European Quality of Life Scale), and lower-extremity function (30 second sit-to-stand test).All 15 participants (mean age, 70.3 years) completed the study (retention 100%). Mean adherence to the exercise program was 115% (i.e., collectively all participants were prescribed 8640 exercises but completed 9944 exercises) with no adverse events reported to be related to the intervention and usability scored as above average (75/100). Other outcomes did not significantly change across the 12-week follow-up (all P>0.05).In this feasibility study of community-dwelling older adults living alone, a home-based exercise program delivered and monitored remotely by an exercise physiologist using VIPAs was safe and feasible.