Effectiveness of mobile health interventions on physical activity management in frail older adults: a systematic review and meta-analysis

Mobile health plays a vital role in providing personalized treatment and management for older adults with frailty by enhancing physical activity interventions. However, there is a lack of comprehensive evidence on the efficacy of mobile health interventions in this context. This study aims to assess the impact and implementation of mobile health interventions on physical activity among adults with frailty. We conducted literature searches across multiple databases from inception to October 27, 2025, including PubMed, Web of Science, The Cochrane Library, EMBASE, CINAHL, China National Knowledge Internet (CNKI), Sinomed, WanFang Data, and Cqvip. Two reviewers independently screened and selected the publications, extracted the data, and assessed risk of bias. This study included randomized controlled trials and quasi-experimental designs. Review Manager 5.4 was used for data analysis. Our systematic review identified 14 eligible studies comprising 876 participants. The modalities used in mobile health interventions included wearable devices, phone calls, internet platforms, WeChat, smartphone applications, video conferencing platform or mini programs, or a combination of technologies. The meta-analysis showed that the mobile health intervention among older adults with frailty significantly reduce frailty severity as measured by continuous indices (SMD = − 1.11, 95%CI = − 1.71, − 0.51, P < 0.001), and increased physical activity levels (daily step count (SMD = 0.89, 95%CI = 0.41, 1.38, P < 0.001), and Moderate-to-Vigorous Physical Activity (MVPA)(SMD = 0.40, 95%CI = 0.10, 0.70, P < 0.05)), physical function outcomes (gait speed (SMD = 1.25, 95%CI = 0.91, 1.59, P < 0.05), TUG (MD = − 2.21, 95%CI = − 3.63, − 0.80, P = 0.002), and Short Physical Performance Battery (SPPB) (MD = 1.32, 95%CI = 0.73, 1.92, P < 0.05)), and mental domain of quality of life (MCS) (MD = 3.34, 95%CI = 0.16, 6.52, P = 0.04). Physical activity interventions for older adults with frailty using mobile health technologies are beneficial for managing frailty, improving physical function, and increasing physical activity levels effectively. High-quality research is warranted to bolster the evidence in these fields in the future.