Summary: In 30 older adults with obesity completing a 12-week exercise and dietary weight-loss programme, those forced by COVID-19 lockdowns to switch to unsupervised home-based training (n=13) lost more fat mass than those who continued supervised gym-based training (n=17), a between-group difference of -3.1 kg (95% CI -6.0 to -0.3). Physical function improved only in the gym group. Because allocation followed lockdown circumstance rather than randomisation, these are associations, not proof that home training is superior.
PICO Summary
| Element | Detail |
|---|---|
| Population | 30 older adults with obesity, aged 60 to 89 years, drawn from the supervised gym-based high-intensity resistance and impact training (HiRIT) arm of a 12-week exercise and dietary weight-loss trial. Single-centre, Australia (ANZCTR ACTRN12618001146280). Eight home participants also completed qualitative interviews. |
| Intervention | Transition to unsupervised home-based bodyweight resistance training plus aerobic training during COVID-19 lockdowns, with the dietary weight-loss intervention maintained (HOME, n=13). |
| Comparison | Continued supervised gym-based HiRIT under professional guidance (GYM, n=17). Group assignment was determined by lockdown circumstance, not randomisation. |
| Outcome | Body mass fell significantly in both groups (GYM -4.4 ± 0.4 kg; HOME -6.2 ± 1.2 kg). HOME showed greater fat-mass loss: mean difference -3.1 kg (95% CI -6.0 to -0.3; Cohen’s d = 0.8, large effect). Physical function improved only in GYM (all P < 0.05). No between-group p value or confidence interval was reported for body mass, and no efficacy testing applied to the qualitative themes. |
Home vs gym exercise in older adults with obesity
Secondary analysis · type 2 obesity, age 60-89 · 12 weeks
Home-based training preserved greater fat-mass loss than supervised gym training, but allocation followed lockdown circumstance not randomisation, so this is an association in 30 people, not proof. Physical function improved only in the gym group.
Expert Commentary
This is a small secondary, mixed-methods analysis of a single trial arm, and it should be read as hypothesis-generating rather than practice-changing. The headline that home training produced greater fat-mass loss is real within the data, but allocation to home or gym was dictated by lockdown circumstance, not randomisation, so the comparison is observational and open to confounding by who happened to be locked down. With only 13 home and 17 gym participants, the fat-mass confidence interval (-6.0 to -0.3 kg) sits close to the null, and no between-group statistic was reported for total body mass, which tempers how much weight the figure can bear. The most weighed limitation is therefore the non-randomised, underpowered design: a large effect size in 30 people can shrink markedly in a properly randomised study. The qualitative strand is the more durable contribution, surfacing accessibility, accountability, and the recurring frustrations of limited equipment and digital support. Notably, physical function improved only in the supervised gym group, a clinically important signal that unsupervised home programmes may protect weight loss while underdelivering on strength and function. Can I use this with my patients? Cautiously, for a motivated older adult with obesity who cannot reach a gym and is already on a structured diet, home training is a reasonable bridge for weight management, but not a substitute when functional gains are the goal. Larger randomised trials with telehealth support and progressive resistance should be the priority.
References
Glavas C, Mesinovic J, Gandham A, Cervo MM, Ng CA, Ebeling PR, et al. Experiences and outcomes of older adults with obesity transitioning from gym- to home-based resistance training due to COVID-19 lockdowns: a mixed-methods analysis of a RCT. BMC Geriatr. 2025;25(1):556. doi:10.1186/s12877-025-06247-3