Online vs on-site Otago exercise pilot trial in adults aged 60+ in Sweden
In this 26-week pilot trial, 35 community-dwelling adults aged 60+ in Sweden were cluster-randomized by site to online or on-site Otago exercise; attrition was 37% with no significant difference between modes, and the study was not powered to test effectiveness. [1]
Automatic summary · not editorially reviewed
The key findings
The pilot study evaluated feasibility of a 26-week physical activity intervention delivered online or on-site to older adults. [1]
Thirty-five community-dwelling adults aged 60 or older from three Swedish residential areas were cluster-randomized by site to online or on-site Otago exercises. [1]
Overall attrition was 37%, with no significant difference between delivery modes, and most dropouts occurred within the first two weeks. [1]
The source at a glance
- Study type / format
- 26-week pragmatic pilot randomized controlled trial with cluster randomization by site and an embedded convergent mixed methods design; abstract only.
- Population / context
- Community-dwelling adults aged 60 years or older (N=35) from three residential areas in Sweden.
- Summary based on
- Study abstract
- Original publication
- October 13, 2026
Feasibility question in 35 older adults in Sweden
The study asked whether a 26-week physical activity program could feasibly be delivered to older adults in two ways: online or on-site. Feasibility was judged mainly by attrition (how many stopped), adherence (how much they took part) and participants' own accounts of why they continued or withdrew. Preliminary patterns in activity levels and physical and mental health were also explored to help plan a larger trial. The authors note that exercise programs for older adults often show substantial attrition and variable adherence, and that it remains unclear whether digital formats sustain engagement better than traditional on-site formats.
Supporting source [1]
Cluster-randomized by site; interviews with completers and dropouts
Community-dwelling adults aged 60 or older (N=35) from three residential areas in Sweden were cluster-randomized by site, without blinding, to online delivery (prerecorded video-based Otago exercises; n=12) or on-site delivery (group-based, in-person Otago exercises; n=23). Exploratory outcomes were physical activity level, lower-body strength, depressive symptoms and health-related quality of life, assessed at baseline, at 14 weeks and at 26 weeks. Semistructured interviews were conducted with 17 completers and 7 dropouts and analyzed with qualitative content analysis; findings were integrated using the COM-B framework (Capability, Opportunity, Motivation-Behavior).
Supporting source [1]
37% attrition, mostly early; adherence not significantly different
Overall attrition was 37% (13/35), with no significant difference between delivery modes (P=.29). Most dropouts occurred within the first two weeks. Mean adherence appeared higher with online delivery (mean 17.0, SD 6.7) than with on-site delivery (mean 12.1, SD 10.1) but did not differ significantly (P=.15). In interviews, attrition was mainly attributed to physical health issues and a perceived lack of fit, while adherence was supported by appeal and reward, routine and commitment, flexibility, feedback and an overview of activity, and often social presence. No intervention-related adverse events were reported. The authors stress that the study was not powered to evaluate effectiveness, so the between-group comparisons cannot show whether one mode works better.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This was a small pilot (N=35) not powered to evaluate effectiveness, so between-group differences in adherence and exploratory outcomes cannot establish which mode works better. Findings come from three Swedish residential areas and may not generalize.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Nilstomt A, Gustavsson J, Bäccman C, Beckman L, Nilson F, Wästlund E. · europepmc.org · October 13, 2026