To analyze the effects of a 6-week multidomain walking training program (MWTP) with mHealth technology on health status, cognitive performance, and physical function in older adults.
Design
Controlled longitudinal intervention study with pre- and post-intervention assessments.
Setting
Community-based, autonomous outdoor environments.
Sample
Forty-nine sedentary older adults (mean age 69.9 ± 3.7 years) allocated to an experimental (n = 21) or control group (n = 28).
Intervention
The experimental group followed a 6-week mHealth-supported MWTP combining endurance, strength, and dual-task cognitive exercises, with progressive intensity and volume. The control group maintained usual routines.
Measures
Physical fitness (lower limb strength, walking speed, cardiorespiratory capacity), cognitive function (executive function), and health variables (anthropometric and psychosocial) were assessed using standardized tests.
Analysis
Data were analyzed using SPSS v.19.0. Descriptive statistics, normality and homogeneity tests, and appropriate parametric (2 × 2 repeated-measures ANOVA, ANCOVA) and non-parametric (Mann–Whitney U, Wilcoxon) tests were applied (α < 0.05).
Results
The experimental group showed significant improvements in lower limb strength, walking speed, and cardiorespiratory capacity. Executive function was preserved in the experimental group but declined in the control group. No significant changes were found in anthropometric or psychosocial measures.
Conclusion
The MWTP enhances physical fitness and preserves executive function in older adults. Its autonomous, mHealth-supported format offers a scalable and cost-effective strategy for promoting healthy aging.
AmbroseAFPaulGHausdorffJM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51-61. doi:10.1016/j.maturitas.2013.02.009
4.
BaiXSohKGOmarDRD, et al.Aerobic exercise combination intervention to improve physical performance among the elderly: a systematic review. Front Physiol. 2022;12:798068.
5.
CloustonSAPBrewsterPKuhD, et al.The dynamic relationship between physical function and cognition in longitudinal aging cohorts. Epidemiol Rev. 2013;35(1):33-50. doi:10.1093/epirev/mxs004
6.
SofiFValecchiDBacciD, et al.Physical activity and risk of cognitive decline: a meta-analysis of prospective studies: physical activity and risk of cognitive decline. J Intern Med. 2011;269(1):107-117. doi:10.1111/j.1365-2796.2010.02281.x
7.
PayetteHGueyeNRGaudreauPMoraisJAShatensteinBGray-DonaldK. Trajectories of physical function decline and psychological functioning: the Quebec longitudinal study on nutrition and successful aging (NuAge). J Gerontol B Psychol Sci Soc Sci. 2011;66(Supplement 1):i82-90. doi:10.1093/geronb/gbq085
8.
SantosACWillumsenJMeheusFIlbawiABullFC. The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis. Lancet Glob Health. 2023;11(1):e32-e39.
9.
CunninghamCO’sullivanRCaserottiPTullyMA. Consequences of physical inactivity in older adults: a systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020;30:816-827.
10.
NotthoffNReischPGerstorfD. Individual characteristics and physical activity in older adults: a systematic review. Gerontology. 2017;63(5):443-459. doi:10.1159/000475558
11.
LoritoDLongCByrneAHarwoodAGladmanRHSchneiderJ. Exercise interventions for older adults: a systematic review of meta-analyses. J Sport Heal Sci. 2021;10(1):29-47.
12.
de LabraCGuimaraes-PinheiroCMasedaALorenzoTMillán-CalentiJC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015;15(1):154. doi:10.1186/s12877-015-0155-4
13.
CokoriloNRuiz-MonteroPJGonzález-FernándezFTMartín-MoyaR. An intervention of 12 weeks of nordic walking and recreational walking to improve cardiorespiratory capacity and fitness in older adult women. J Clin Med. 2022;11(10):2900. doi:10.3390/jcm11102900
14.
MasukiSMorikawaMNoseH. High-intensity walking time is a key determinant to increase physical fitness and improve health outcomes after interval walking training in middle-aged and older people. Mayo Clin Proc. 2019;94(12):2415-2426. doi:10.1016/j.mayocp.2019.04.039
15.
GomeñukaNAOliveiraHBSilvaES, et al.Effects of nordic walking training on quality of life, balance and functional mobility in elderly: a randomized clinical trial. PLoS One. 2019;14(1):e0211472. doi:10.1371/journal.pone.0211472
16.
HarrisTKerrySMLimbES, et al.Physical activity levels in adults and older adults 3–4 years after pedometer-based walking interventions: long-term follow-up of participants from two randomised controlled trials in UK primary care. PLoS Med. 2018;15(3):e1002526.
17.
DehiMAghajariPShahshahaniMTakfallahLJahangiriL. The effect of stationary walking on the quality of life of the elderly women: a randomized controlled trial. J Caring Sci. 2014;3(2):103-111. doi:10.5681/jcs.2014.011
18.
BakhshalipourVAziziBSareshkehSK. The effect of a 6-months moderate-intensity walking exercise program on mental health, quality of life, and sleep subjective quality in non-active elderly people with type 2 diabetes. RBNE-Revista Brasileira de Nutrição Esportiva. 2018;12:905-914.
19.
LawLLFBarnettFYauMKGrayMA. Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: a systematic review. Ageing Res Rev. 2014;15:61-75. doi:10.1016/j.arr.2014.02.008
20.
TaitJLDuckhamRLMilteCMMainLCDalyRM. Influence of sequential vs. simultaneous dual-task exercise training on cognitive function in older adults. Front Aging Neurosci. 2017;9:368. doi:10.3389/fnagi.2017.00368
21.
ZhuXYinSLangMHeRLiJ. The more the better? A meta-analysis on e_ects of combined cognitive and physical intervention on cognition in healthy older adults. Ageing Res Rev. 2016;31:67-79.
22.
NishiguchiSYamadaMTanigawaT, et al.A 12-week physical and cognitive exercise program can improve cognitive function and neural efficiency in community-dwelling older adults: a randomized controlled trial. J Am Geriatr Soc. 2015;63(7):1355-1363. doi:10.1111/jgs.13481
23.
CraikFIMDirkxE. Age-related differences in three tests of visual imagery. Psychol Aging. 1992;7(4):661-665.
24.
FabreCChamariKMucciPMassé-BironJPréfautC. Improvement of cognitive function by mental and/or individualized aerobic training in healthy elderly subjects. Int J Sports Med. 2002;23(6):415-421. doi:10.1055/s-2002-33735
25.
BaeSHaradaKLeeS, et al.The effect of a multicomponent dual-task exercise on cortical thickness in older adults with cognitive decline: a randomized controlled trial. J Clin Med. 2020;9(5):1312. doi:10.3390/jcm9051312
26.
WeuveJKangJHMansonJEBretelerMMBWareJHGrodsteinF. Physical activity, including walking, and cognitive function in older women. JAMA. 2004;292(12):1454-1461.
27.
AlvesCRGualanoBTakaoPP, et al.Effects of acute physical exercise on executive functions: a comparison between aerobic and strength exercise. J Sport Exerc Psychol. 2012;34(4):539-549. doi:10.1123/jsep.34.4.539
28.
MavrosYGatesNWilsonGC, et al.Mediation of cognitive function improvements by strength gains after resistance training in older adults with mild cognitive impairment: outcomes of the study of mental and resistance training. J Am Geriatr Soc. 2017;65(3):550-559. doi:10.1111/jgs.14542
29.
SeifertASchlomannARietzCSchellingHR. The use of mobile devices for physical activity tracking in older adults’ everyday life. Digit Health. 2017;3:2055207617740088.
30.
Lucerón-Lucas-TorresMIValera-OrtínJ. Health technology tools used to increase physical activity and improve cardiovascular parameters in older adults: a review. Enferm Clín (Engl Ed). 2022;32(3):171-183. doi:10.1016/j.enfcle.2021.05.004
31.
MuellmannSForbergerSMöllersTBröringEZeebHPischkeCR. Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review. Prev Med. 2018;108:93-110.
32.
DasguptaDChaudhryBKohEChawlaNV. A survey of tablet applications for promoting successful aging in older adults. IEEE Access. 2016;4:9005-9017.
33.
FaulFErdfelderELangAGBuchnerA. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-191.
34.
AssumpçãoDFranciscoPMSBBorimFSAYassudaMSNeriAL. Which anthropometric measures best identify excess weight in older adults?Geriatrics, Gerontology and Aging. 2021;15:1-9.
35.
Ramírez-VélezRPérez-SousaMÁIzquierdoM, et al.Validation of surrogate anthropometric indices in older adults: what is the best indicator of high cardiometabolic risk factor clustering?Nutrients. 2019;11(8):1701.
36.
MilagresLCMartinhoKOMilagresDCFrancoFSRibeiroAQNovaesJF. Waist-to-height ratio and the conicity index are associated to cardiometabolic risk factors in the elderly population. Cien Saude Colet. 2019;24:1451-1461.
37.
AshwellMHsiehSD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56(5):303-307.
38.
JonesCJRikliREBeamWC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2):113-119. doi:10.1080/02701367.1999.10608028
39.
RikliREEdwardsDJ. Effects of a three-year exercise program on motor function and cognitive processing speed in older women. Res Q Exerc Sport. 1991;62(1):61-67. doi:10.1080/02701367.1991.10607519
40.
TakaiYOhtaMAkagiRKanehisaHKawakamiYFukunagaT. Sit-to-stand test to evaluate knee extensor muscle size and strength in the elderly: a novel approach. J Physiol Anthropol. 2009;28(3):123-128.
Martínez de la IglesiaJOnís VilchesMDueñas HerreroRAlbert ColomerCAguado TabernéCLuque LuqueR. Versión española del cuestionario de Yesavage abreviado (GDS) para el despistaje de depresión en mayores de 65 años: adaptación y validación. Medifam. 2002;12(10):26-40.
46.
JakobssonU. Using the 12-item short form health survey (SF-12) to measure quality of life among older people. Aging Clin Exp Res. 2007;19:457-464.
47.
JenkinsonCLayteRJenkinsonD, et al.A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies?J Public Health. 1997;19(2):179-186.
48.
LawtonMP. Assessment of older people; self-maintaining and instrumental activites of dialy living. Gerontol. 1969;9:279-286.
49.
BijurPESilverWGallagherEJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-1157. doi:10.1111/j.1553-2712.2001.tb01132.x
50.
ReitanRM. Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills. 1958;8(3):271-276.
51.
TombaughTN. Trail making test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004;19(2):203-214.
52.
Rubio CastañedaFJTomás AznarCMuro BaqueroC. Medición de La Actividad Física En Personas Mayores de 65 Años Mediante El IPAQ-E: validez de Contenido, Fiabilidad y Factores Asociados. Revista Espanola de Salud Pública. 2017;91:201701004.
53.
CraigCLMarshallALSjöströmM, et al.International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395.
54.
HelmerhorstHHJFBrageSWarrenJBessonHEkelundU. A systematic review of reliability and objective criterion-related validity of physical activity questionnaires. Int J Behav Nutr Phys Act. 2012;9:1-55.
55.
Balboa-CastilloTMuñozSSerónPAndrade-MayorgaOLavados-RomoPAguilar-FariasN. Validity and reliability of the international physical activity questionnaire short form in Chilean adults. PLoS One. 2023;18(10):e0291604.
56.
Hurtig-WennlöfAHagströmerMOlssonLA. The International physical activity questionnaire modified for the elderly: aspects of validity and feasibility. Public Health Nutr. 2010;13(11):1847-1854.
57.
TranDVLeeAAuTNguyenCHoangDV. Reliability and validity of the International physical activity questionnaire–short form for older adults in Vietnam. Health Promot J Austr. 2013;24(2):126-131.
58.
SemberVMehKSorićMStarcGRochaPJurakG. Validity and reliability of international physical activity questionnaires for adults across EU countries: systematic review and meta analysis. Int J Environ Res Public Health. 2020;17(19):7161.
59.
de la Casa-PérezALatorre RománPMuñoz JiménezMLucena ZuritaMLaredo AguileraJPárraga MontillaJ. Is the Xiaomi Mi band 4 an accuracy tool for measuring health-related parameters in adults and older people? An original validation study. Int J Environ Res Public Health. 2022;19(3):1593.
60.
de la Casa-PérezAConceiçãoFAVPárraga-MontillaJACabrera-LinaresJCLatorre-RománPÁ. Is walking enough to promote health benefits in older adults? A systematic review. Educ Gerontol. Published online. 2025;1-30.
61.
GudlaugssonJGudnasonVAspelundT, et al.Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: a randomized-controlled cross-over design. Int J Behav Nutr Phys Act. 2012;9(1):107. doi:10.1186/1479-5868-9-107
62.
YorozuyaKKuboYTomiyamaNYamaneSHanaokaH. A systematic review of multimodal non-pharmacological interventions for cognitive function in older people with dementia in nursing homes. Dement Geriatr Cogn Disord. 2019;48(1-2):1-16. doi:10.1159/000503445
63.
Chodzko-ZajkoWJProctorDNSinghMAF, et al.Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510-1530.
64.
KarvonenMKentalaEMustalaO. The effects of training on heart rate: a longitudinal study. Ann Med Exp Biol Fenn. 1957;35:307-315.
65.
CohenJ. Statistical Power Analysis for the Behavioral Sciences. routledge; 2013.
66.
RamosAMMarcos-PardoPJValeRGde SVieira-SouzaLMCamiloBde FMartin-DantasEH. Resistance circuit training or walking training: which program improves muscle strength and functional autonomy more in older women?Int J Environ Res Public Health. 2022;19(14):8828. doi:10.3390/ijerph19148828
67.
MonteagudoPRoldánACordellatAGómez-CabreraMCBlasco-LafargaC. Continuous compared to accumulated walking-training on physical function and health-related quality of life in sedentary older persons. Int J Environ Res Public Health. 2020;17(17):1-15. doi:10.3390/ijerph17176060
68.
OzakiHNakagataTYoshiharaT, et al.Effects of progressive walking and stair-climbing training program on muscle size and strength of the lower body in untrained older adults. J Sports Sci Med. 2019;18(4):722-728.
69.
HendersonRMLengXIChmeloEA, et al.Gait speed response to aerobic versus resistance exercise training in older adults. Aging Clin Exp Res. 2017;29(5):969-976. doi:10.1007/s40520-016-0632-4
70.
MagistroDLiubicichMECandelaFCiairanoS. Effect of ecological walking training in sedentary elderly people: act on aging study. Gerontol. 2014;54(4):611-623.
71.
JardimNYVBento-TorresNVOCostaVO, et al.Dual-task exercise to improve cognition and functional capacity of healthy older adults. Front Aging Neurosci. 2021;13:589299.
72.
MachadoISousaNParedesHFerreiraJAbrantesC. Combined aerobic and resistance exercise in walking performance of patients with intermittent claudication: systematic review. Front Physiol. 2019;10:1538. doi:10.3389/fphys.2019.01538
73.
GaoJYuL. Effects of concurrent training sequence on VO2max and lower limb strength performance: a systematic review and meta-analysis. Front Physiol. 2023;14:1072679. doi:10.3389/fphys.2023.1072679
74.
Font-JutglàCMurGEBort RoigJGomes da SilvaMMilà VillarroelR. Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática. Rev Esp Geriatr Gerontol. 2020;55(2):98-106. doi:10.1016/j.regg.2019.10.007
75.
KahyaMMoonSRanchetM, et al.Brain activity during dual task gait and balance in aging and age-related neurodegenerative conditions: a systematic review. Exp Gerontol. 2019;128(110756):110756. doi:10.1016/j.exger.2019.110756
76.
MerchantRAChanYHHuiRJY, et al.Possible sarcopenia and impact of dual-task exercise on gait speed, handgrip strength, falls, and perceived health. Front Med. 2021;8:660463. doi:10.3389/fmed.2021.660463
77.
Sepulveda-LoyolaWValdebenito CastilloDMonroy CárcamoSRojas MoralesEÁlvarez-BustosA. Efecto del entrenamiento de tarea dual sobre las manifestaciones clínicas de la sarcopenia: una revisión exploratoria. Nutr Clínica Dietética Hosp. 2023;43(3):143-152. doi:10.12873/433sepulveda
78.
FranciscoMCarrataláM. La Marcha Humana: biomecánica, Evaluación y Patología. Editorial Médica Panamericana. 2020;43:268. Published online.
79.
BlainHJaussentAPicotMC, et al.Effect of a 6-month brisk walking program on walking endurance in sedentary and physically deconditioned women aged 60 or older: a randomized trial. J Nutr Health Aging. 2017;21:1183-1189.
80.
MalatestaDSimarDSaadHBPréfautCCaillaudC. Effect of an overground walking training on gait performance in healthy 65-to 80-year-olds. Exp Gerontol. 2010;45(6):427-434.
81.
GarberCEBlissmerBDeschenesMR, et al.American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-1359.
82.
BaiXSohKGDevRDOTalibOXiaoWCaiH. Effect of brisk walking on health-related physical fitness balance and life satisfaction among the elderly: a systematic review. Front Public Health. 2021;9:829367.
83.
DustmanRERuhlingRORussellEM, et al.Aerobic exercise training and improved neuropsychological function of older individuals. Neurobiol Aging. 1984;5(1):35-42. doi:10.1016/0197-4580(84)90083-6
84.
KramerAFHahnSCohenNJ, et al.Ageing, fitness and neurocognitive function. Nature. 1999;400(6743):418-419. doi:10.1038/22682
85.
YokoyamaHOkazakiKImaiD, et al.The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial. BMC Geriatr. 2015;15(1):60. doi:10.1186/s12877-015-0058-4
86.
AliNTianHThabaneL, et al.The effects of dual-task training on cognitive and physical functions in older adults with cognitive impairment; A systematic review and meta-analysis. J Prev Alzheimers Dis. 2022;9(2):359-370. doi:10.14283/jpad.2022.16
87.
ChenYLTsengCHLinHTWuPYChaoHC. Dual-task multicomponent exercise–cognitive intervention improved cognitive function and functional fitness in older adults. Aging Clin Exp Res. 2023;35(9):1855-1863.
88.
GregoryMABoaSSNCGillDP, et al.Combined dual-task gait training and aerobic exercise to improve cognition, mobility, and vascular health in community-dwelling older adults at risk for future cognitive Decline1. J Alzheimers Dis. 2017;57(3):747-763. doi:10.3233/JAD-161240
89.
AwickEAWojcickiTROlsonEA, et al.Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial. Qual Life Res. 2015;24(2):455-462. doi:10.1007/s11136-014-0762-0
90.
Kirk-SanchezNJMcGoughEL. Physical exercise and cognitive performance in the elderly: current perspectives. Clin Interv Aging. 2014;9:51-62. Published online.
91.
EricksonKIVossMWPrakashRS, et al.Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108(7):3017-3022.
92.
WangJWZhuZShulingZ, et al.Effectiveness of mHealth app-based interventions for increasing physical activity and improving physical fitness in children and adolescents: systematic review and meta-analysis. JMIR MHealth UHealth. 2024;12(1):e51478. doi:10.2196/51478
93.
OhtaTOsukaYShidaT, et al.Feasibility, acceptability, and potential efficacy of a mobile health application for community-dwelling older adults with frailty and pre-frailty: a pilot study. Nutrients. 2024;16(8):1181. doi:10.3390/nu16081181
94.
ChildCEKellyMLSizeloveH, et al.A remote monitoring-enabled home exercise prescription for patients with interstitial lung disease at risk for exercise-induced desaturation. Respir Med. 2023;218(107397):107397. doi:10.1016/j.rmed.2023.107397
95.
KwanRYLeeDLeePH, et al.Effects of an mHealth brisk walking intervention on increasing physical activity in older people with cognitive frailty: pilot randomized controlled trial. JMIR MHealth UHealth. 2020;8(7):e16596. doi:10.2196/16596
96.
LyonsEJSwartzMCLewisZHMartinezEJenningsK. Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: a randomized controlled pilot trial. JMIR MHealth UHealth. 2017;5(3):e28. doi:10.2196/mhealth.6967
97.
AsheMCWintersMHoppmannCA, et al.“Not just another walking program”: everyday activity supports you (EASY) model-a randomized pilot study for a parallel randomized controlled trial. Pilot Feasibility Stud. 2015;1:4. doi:10.1186/2055-5784-1-4
98.
WarrenBSMaleyMSugarwalaLJWellsMTDevineCM. Small steps are easier together: a goal-based ecological intervention to increase walking by women in rural worksites. Prev Med. 2010;50(5-6):230-234. doi:10.1016/j.ypmed.2010.02.006
99.
HollerPJaunigJAmortFM, et al.Holistic physical exercise training improves physical literacy among physically inactive adults: a pilot intervention study. BMC Public Health. 2019;19(1):393. doi:10.1186/s12889-019-6719-z
