The Effect of Periodic Assessments and Verbal Feedback on Physical Function and Adherence in Healthy Adults Aged ≥65: A Pilot Randomized Controlled Trial
Danai Paleta, George Gioftsos, Stefanos Karanasios, Panagiotis Paletas, Vasiliki SakellariBackground and Objectives: Low participation rates in exercise programs among older adults highlight the need for theory-driven, biopsychosocial interventions that enhance adherence, self-efficacy, and functional outcomes. Grounded in principles of motor learning and behavioral reinforcement within physiotherapy practice, this study aimed to examine the effect of periodic assessments combined with verbal feedback on functional and psychological outcomes in community-dwelling older adults. Methods: A pilot RCT was conducted involving 54 individuals aged ≥65 years (53 women and 1 man), recruited from senior community centers. Participants were randomly allocated to an intervention group (periodic assessment and verbal feedback; n = 27) or a control group (n = 27). Both groups participated in an identical 12-week structured exercise program, delivered twice weekly, focusing on balance, gait, and lower-limb functional training. An intention-to-treat approach was applied. Data were analyzed using Linear Mixed Models, with statistical significance set at p < 0.05. Results: Significant group × time interactions were observed in favor of the intervention group for key kinesiology-related functional outcomes, including the Short Physical Performance Battery (SPPB; p < 0.001), Timed Up and Go test (TUG; p = 0.011), and Activities-specific Balance Confidence Scale (ABC; p < 0.001). No statistically significant differences were identified between groups for the Behavioral Regulation in Exercise Questionnaire–2 (BREQ-2; p = 0.164) and the Self-Efficacy for Exercise Scale (ESE; p = 0.108), indicating that the primary psychological outcome (ESE) was not confirmed. However, both ESE and BREQ-2 demonstrated significant baseline differences favoring the intervention group, and, therefore, these findings should be interpreted with caution despite statistical adjustment. Conclusions: Periodic assessments followed by verbal feedback appear to selectively improve the functional effectiveness of structured exercise programs in older women, particularly physical performance, functional mobility, and balance confidence, with no significant differential effect on the primary psychological outcome (ESE; group × time interaction: p = 0.108). These findings support assessment-informed and feedback-driven physiotherapy strategies as a promising adjunct to exercise programs in older adults, with potential implications for optimizing functional outcomes within applied kinesiology and rehabilitation contexts.