Evaluation of the Gerofit to Home Model of Care: A Remote Clinical Exercise Program for Older Adults.

OBJECTIVE: The COVID-19 pandemic prompted a rapid shift to remote healthcare. In response, the Veteran Health Administration's (VHA) Gerofit clinical exercise program began providing supervised, group-based exercise sessions three times weekly via real-time video for older Veterans. The longer-term benefits of such remote programs, particularly their impact on mobility and physical function, remain unclear. This analysis evaluates whether the Gerofit to Home (GTH) model of care improves physical performance in older veterans with multiple chronic conditions. DESIGN: This is a retrospective, quality improvement analysis of national data collected in the VHA GTH program from April 2020 to December 2022. Physical function assessments (PFA) including the 2-min step test, 30-s chair stand test, 5 times sit to stand, and the 30-s arm curl test were completed at baseline, 3 months, 6 months, and 1 year time points. To assess functional trajectories for the PFAs, repeated measures ANCOVA, as implemented under mixed models, was applied, adjusting for age, gender, and race. RESULTS: The overall GTH sample included 626 older veterans (mean age of 75 ± 6.8 years). All PFA measures showed similar longitudinal trajectories, with significant improvements from baseline to 1 year (p < 0.01). Each follow-up differed significantly from baseline (ps < 0.01), and clinically meaningful gains were achieved and sustained across all assessments. CONCLUSION: The GTH program demonstrates that remotely delivered, medically supervised group exercise-integrated within a national healthcare system-can produce and sustain meaningful improvements in physical function for older adults. As one of the first large-scale, health care system-supported remote exercise programs for older adults, GTH offers a novel, scalable model for delivering effective, accessible care to high-risk populations.

Duke Scholars

Author Katherine Shepherd Hall Medicine, Geriatrics and Palliative Care