This scoping review summarized the evidence regarding the impact of acute exacerbations of COPD (AECOPD) on patients' health status beyond pulmonary function. PubMed, Embase, and Web of Science were searched. Prospective cohort studies assessing the health status of patients with COPD in a stable phase of the disease and after a follow-up period (where at least one AECOPD occurred) were included. An integrated assessment framework of health status (i.e., physiological functioning, complaints, functional impairment, quality of life) was used. Twenty-two studies were included. AECOPD acutely affected exercise tolerance, quadriceps muscle strength, physical activity levels, symptoms of dyspnoea and fatigue, and impact of the disease. Long-term effects on quadriceps muscle strength, symptoms of dyspnoea and depression, and quality of life were found. Repeated exacerbations negatively impacted the fat-free mass, levels of dyspnoea, impact of the disease and quality of life. Conflicting evidence was found regarding the impact of repeated exacerbations on exercise tolerance and physical activity levels. AECOPD have well-established acute and long-term adverse effects on health status beyond pulmonary function; nevertheless, the recovery trajectory and the impact of repeated exacerbations are still poorly studied. Further prospective research is recommended to draw firm conclusions on these aspects.

Background: With increasing evidence supporting the benefits of physical activity (PA) for older adults, there is a critical need for effective interventions to promote activity in this population. Mobile health (mHealth) technologies offer innovative approaches to enhance engagement in PA, yet evidence of their effectiveness remains varied and insufficiently synthesized. This systematic review and meta-analysis aims to evaluate the effectiveness of mHealth interventions in improving physical health, quality of life, cognitive function, and mental well-being among community-dwelling older adults aged 65 years and over. Methods: This systematic review and meta-analysis followed the PRISMA guidelines, focusing on studies that utilized mHealth interventions to promote PA among community-dwelling older adults aged 65 years and older. The literature search included electronic databases like PubMed, Web of Science and CENTRAL, with studies published from 2014 onwards. Eligible studies were randomized controlled trials (RCTs), non-RCTs, and single-group studies that provided quantitative and qualitative data on physical health outcomes. Results: The search yielded 4,453 studies, with 22 meeting the inclusion criteria. These studies involved a total of 3,055 participants, primarily from high-income countries. The interventions included the use of an application (n=5), websites (n=7), wearable device (n=3), website + wearable device (n=3), and application + wearable device (n=3). Meta-analysis of 11 RCTs, representing 2,204 participants, showed an overall significant effect of the mHealth intervention [standardized mean difference =0.23; 95% confidence interval: 0.08–0.38], subgroup analysis shows varied effects on PA levels, with some studies reporting significant improvements in PA metrics, while others showed minimal impact. Conclusions: mHealth interventions have the potential to promote PA among older adults, but the effectiveness is highly variable. This variability may be influenced by intervention design, technology used, and participant engagement. Future research should focus on personalized, adaptable mHealth solutions that address the specific needs and preferences of older adults to enhance sustained engagement and effectiveness.

Background: Advancements in mobile technology have paved the way for innovative interventions aimed at promoting physical activity (PA). Objective: The main objective of this feasibility study was to assess the feasibility, usability, and acceptability of the More In Action (MIA) app, designed to promote PA among older adults. MIA offers 7 features: personalized tips, PA literacy, guided peer workouts, a community calendar, a personal activity diary, a progression monitor, and a chatbot. Methods: Our study used a mixed methods approach to evaluate the MIA app’s acceptability, feasibility, and usability. First, a think-aloud method was used to provide immediate feedback during initial app use. Participants then integrated the app into their daily activities for 5 weeks. Behavioral patterns such as user session duration, feature use frequency, and navigation paths were analyzed, focusing on engagement metrics and user interactions. User satisfaction was assessed using the System Usability Scale, Net Promoter Score, and Customer Satisfaction Score. Qualitative data from focus groups conducted after the 5-week intervention helped gather insights into user experiences. Participants were recruited using a combination of web-based and offline strategies, including social media outreach, newspaper advertisements, and presentations at older adult organizations and local community services. Our target group consisted of native Dutch-speaking older adults aged >65 years who were not affected by severe illnesses. Initial assessments and focus groups were conducted in person, whereas the intervention itself was web based. Results: The study involved 30 participants with an average age of 70.3 (SD 4.8) years, of whom 57% (17/30) were female. The app received positive ratings, with a System Usability Scale score of 77.4 and a Customer Satisfaction Score of 86.6%. Analysis showed general satisfaction with the app’s workout videos, which were used in 585 sessions with a median duration of 14 (IQR 0-34) minutes per day. The Net Promoter Score was 33.34, indicating a good level of customer loyalty. Qualitative feedback highlighted the need for improvements in navigation, content relevance, and social engagement features, with suggestions for better calendar visibility, workout customization, and enhanced social features. Overall, the app demonstrated high usability and satisfaction, with near-daily engagement from participants. Conclusions: The MIA app shows significant potential for promoting PA among older adults, evidenced by its high usability and satisfaction scores. Participants engaged with the app nearly daily, particularly appreciating the workout videos and educational content. Future enhancements should focus on better calendar visibility, workout customization, and integrating social networking features to foster community and support. In addition, incorporating wearable device integration and predictive analytics could provide real-time health data, optimizing activity recommendations and health monitoring. These enhancements will ensure that the app remains user-friendly, relevant, and sustainable, promoting sustained PA and healthy behaviors among older adults. Trial Registration: ClinicalTrials.gov NCT05650515; https://clinicaltrials.gov/study/NCT05650515

Physical activity (PA) is essential for healthy aging, but its accurate assessment in older adults remains challenging due to the limitations and biases of traditional clinical assessment. Mobile technologies and wearable sensors offer a more ecological, less biased alternative for evaluating PA in this population. This study aimed to optimize digital phenotyping strategies for assessing PA patterns in older adults, by integrating ecological momentary assessment (EMA) and continuous wearable sensor data collection. Over two weeks, 108 community-dwelling older adults provided real-time EMA responses while their PA was continuously monitored using Garmin Vivo 5 sensors. The combined approach proved feasible, with 67.2% adherence to EMA prompts, consistent across time points (morning: 68.1%; evening: 65.4%). PA predominantly occurred at low (51.4%) and moderate (46.2%) intensities, with midday activity peaks. Motivation and self-efficacy were significantly associated with low-intensity PA (R = 0.20 and 0.14 respectively), particularly in the morning. However, discrepancies between objective step counts and self-reported PA measures, which showed no correlation (R = −0.026, p = 0.65), highlight the complementary value of subjective and objective data sources. These findings support integrating EMA, wearable sensors, and temporal frameworks to enhance PA assessment, offering precise insights for personalized, time-sensitive interventions to promote PA.

Background: Patients with early stage (I–IIIA) nonsmall cell lung cancer (NSCLC) are typically treatedviasurgery, often accompanied by (neo-)adjuvant therapy. These interventions impose a significant burden on patients and potentially impact their physical functioning (PF). The impact on PF remains uncertain and existing evidence has not yet been systematically outlined.Objective: This scoping review aimed to synthesise evidence concerning the effects of lung surgery, with or without (neo-)adjuvant therapy, on the PF of patients with NSCLC.Methods: PubMed, Web of Science and Cochrane databases were systematically searched from inception until 1 July 2023. A comprehensive framework based on the International Classification of Functioning, Disability, and Health was used to define various aspects of PF. Longitudinal studies, reporting PF prior to and after NSCLC treatment, and cross-sectional studies reporting PF after treatment were included.Results: 85 included studies assessed the effects of surgery with (n=7) or without (n=78) (neo-) adjuvant therapy on body function (n=29), activity (n=67) and/or participation (n=15). 98% of reported outcomes within the longitudinal studies indicate a decline in PF, with 52% demonstrating significant deteriorations, with follow-up times ranging from immediately post-operative up to 1 year after treatment. Cross-sectional studies show impaired PF in 71% of reported outcomes.Conclusion: PF of patients with NSCLC tends to deteriorate following lung surgery, irrespective of additional (neo-)adjuvant therapy. While the negative impact of lung surgery on ICF categories of “body function” and “activity” have been described to some depth, insights into the impact on “participation” are lacking.