Effectiveness of face-to-face and web-based exercise programs on health outcomes in early postmenopausal women: a randomized trial

Oestrogen decline during menopause triggers vasomotor symptoms, weight gain, and mood disturbances. Combined aerobic and resistance exercise can alleviate these symptoms, yet many postmenopausal women face barriers to attending supervised sessions. We compared an eight-week progressive programme of combined aerobic and resistance training delivered face-to-face or via a mobile app against an education-only control in early postmenopausal women. Sixty-six early postmenopausal women (aged 45–60) were randomised into face-to-face supervised exercise (n = 22), mobile app-based exercise (n = 22), or education-only control (n = 22). Both exercise groups followed an identical eight-week home-based protocol combining aerobic walking, resistance, core stabilisation, and balance exercises three days per week. Outcomes included menopausal symptoms (MRS), quality of life (SF-36), depressive symptoms (BDI), fatigue (FSS), sleep quality (PSQI), body composition by bioelectrical impedance, and predicted VO₂max. Effect sizes were calculated as Cohen’s d. Both exercise groups showed significantly greater MRS reductions than controls (face-to-face d = − 1.16; app-based d = − 0.76). Between-group differences in body fat were negligible; muscle mass increased modestly in both exercise groups (d = 0.37–0.38). Predicted VO₂max improved in both groups (d = 1.04–1.08); the web-based group reached significance after Bonferroni correction (p = 0.007), while the face-to-face group did not. Fatigue (d = − 1.04 to − 1.66) and sleep quality (d = − 1.08 to − 1.19) improved significantly in both exercise groups. Web-based exercise significantly reduced depressive symptoms (d = − 0.92, p = 0.002); face-to-face delivery produced a medium effect (d = − 0.67) that did not reach significance after Bonferroni correction. Differences between delivery methods were negligible to small. Eight weeks of combined training reduced menopausal symptoms, improved quality of life, psychological well-being, and modestly increased muscle mass and predicted VO₂max. App-based delivery produced comparable effects to face-to-face supervision, though the absence of adherence data limits this comparison. App-based exercise may offer a practical alternative for women unable to attend in-person sessions. ClinicalTrials.gov, NCT06868134. Registered 20,250,305.