medicina

Article
The Combined Effects of Sports Smart Bracelet and
Multi-Component Exercise Program on Exercise Motivation
among the Elderly in Macau
Cheuk Kei Lao 1,2,† , Bing Long Wang 3,4, *,† , Richard S. Wang 5 and Hsiao Yun Chang 6

1 Doctorate Degree of Public Health, Faculty of Medicine, Macau University of Science Technology,
Macau 999078, China; joelao818@gmail.com
2 Physiotherapist, Principal, Department of Physiotherapy Rehabilitation, Centro Hospitalar Conde de São
Januário, Macau Health Bureau, Macau 999078, China
3 School of Public Health, Peking Union Medical College, Beijing 100730, China
4 School of Healthcare Management, University of Sanya, Sanya 572022, China
5 Affiliation Program of Data Analytics and Business Computing, Stern School of Business,
New York University, New York, NY 10012, USA; r851126@gmail.com
6 Department of Athletic Training and Healthy, National Taiwan Sport University, Taoyuan 333019, Taiwan;
yun1130@ntsu.edu.tw
* Correspondence: billwang1203@gmail.com; Tel.: +86-980-794951
† This first two authors shared first authorship.

Abstract: Background and objectives: Faced with the serious problem of an aging population, exer-
cise is one of the most effective ways to maintain the health of the elderly. In recent years, with
the popularization of smartphones, the elderly have increasingly accepted technological products
that incorporate artificial intelligence (AI). However, there is not much research on using artificial
intelligence bracelets to enhance elders’ motivation and participation in exercise. Therefore, the





 purpose of this study is to evaluate the effectiveness of the combination of sports smart bracelets
and multi-sport training programs on the motivation of the elderly in Macau. Materials and Methods:
Citation: Lao, C.; Wang, B.; Wang,
R.S.; Chang, H. The Combined
The study was conducted with a randomized trial design in a 12 week multi-sport exercise training
Effects of Sports Smart Bracelet and intervention. According to the evaluation, a total of sixty elders’ pre- and post-test data were included
Multi-Component Exercise Program in this study. Results: After 12 weeks of multi-sport exercise training, the evaluation scores on the
on Exercise Motivation among the exercise motivation scale (EMS) increased significantly in the group wearing exercise bracelets and
Elderly in Macau. Medicina 2021, 57, those taking part in the multi-component exercise program, and the degree of progress reached a
34. https://doi.org/10.3390/ statistically significant level, but the control group did not show any statistically significant difference.
medicina57010034 The influence of the combination of sports smart bracelets and multi-sport training programs on
elders’ motivation is clearer. Conclusions: The use of sports smart bracelets by elderly people in
Received: 10 November 2020
conjunction with diverse exercise training can effectively enhance elders’ motivation and increase
Accepted: 25 December 2020
their participation in regular exercise. The combination of sports smart bracelets and multi-sport
Published: 2 January 2021
training programs is worth promoting in the elderly population.
Publisher’s Note: MDPI stays neu-
Keywords: sports smart bracelet; multi-component exercise program; exercise motivation;
tral with regard to jurisdictional clai-
ms in published maps and institutio-
elderly; Macau
nal affiliations.

1. Introduction
Copyright: © 2021 by the authors. Li-
Population aging is a pervasive global problem. According to the United Nations
censee MDPI, Basel, Switzerland.
(UN), by the end of 2018 there were approximately 705 million people over the age of 65
This article is an open access article
in the world [1]. Macau has a very high score in the human development index (HDI)
distributed under the terms and con-
ditions of the Creative Commons At-
and has the fourth-highest life expectancy in the world [2]. With the increase in age,
tribution (CC BY) license (https://
the physical functions of the body decline [3], including muscle strength, muscle endurance,
creativecommons.org/licenses/by/
joint mobility, balance, agility, etc., which leads to the elderly’s inability to take care of
4.0/). themselves in their daily lives. Therefore, they may need medical care, long-term care, and

Medicina 2021, 57, 34. https://doi.org/10.3390/medicina57010034 https://www.mdpi.com/journal/medicina

Medicina 2021, 57, 34 2 of 9

personal assistance from caregivers [4,5]. The literature suggests that regular exercise has
a positive effect on delaying the aging process and helping to prevent chronic diseases,
reduce the risk of falls, improve quality of life, and promote the physical and mental health
of the elderly [6,7]. Thus, participation in sports and proper physical activity are important
parts of healthy aging [8]. The types of sports that are beneficial to the elderly should be
diversified, including aerobic, resistance, flexibility, and balance training [9–12].
In recent years, with the popularization and acceptance of artificial intelligence (AI)
and other technological products by the elderly, several studies have shown that AI sports
devices with exercise programs may improve motivation and related outcomes [13,14].
Macau is transforming into a smart city, and smart bracelets are commonly used to monitor
the physiological data generated from body movement; users can have a better under-
standing of their physical condition during the exercise process. Kononova and coworkers
monitored physical activity by using wearable activity trackers for the elderly [15]. The
results suggested that wearable activity trackers may improve physical activity levels and
internal motivation. They also encouraged older adults to participate in the exercise and
compete with other users [15]. Rupp et al. examined the impact of several user charac-
teristics (i.e., personality, age, computer self-efficacy, physical activity level) and device
characteristics (trust, usability, and motivational affordances) on the behavioral intentions
to use a wearable fitness device. They found computer self-efficacy and physical activity
level, as well as personality traits, indirectly increased the desire to use a fitness device and
the saliency of perceived motivational affordances [16]. Kononova et al. suggested that
activity trackers may be an effective technology for encouraging physical activity among
older adults, especially those who have never tried it [15]. Maintenance depended on
recognizing the long-term benefits of tracker use, social support, and internal motivation.
Non-adoption and relapse may occur because of technology’s limitations and gaining
awareness of one’s physical activity without changing the physical activity level itself [15].
Swartz et al. studied older adults with and without involvement in a 12 week tracker-
based activity intervention designed to identify related factors associated with weekly
adherence. Achieving step goals and receiving virtual support were the important factors
that contributed to improved weekly adherence. The authors have suggested the tracker-
based activity intervention may promote active lifestyles [17]. Artificial intelligence sports
bracelets are smart wearable devices commonly used in exercises today [18]. By collecting
data and browsing health records, they can monitor physiological data during physical
exercise, and users can have a better understanding of their physical condition during
exercise [19].
However, limited empirical research has been conducted using artificial intelligence
bracelets to promote elders’ motivation to and participation in exercise. The effects on
elderly people of wearing sports smart bracelets are unknown. Thus, this study is the first
time that Macau has explored the effects of the combined use of sports smart bracelets
by the elderly on the motivation to exercise. According to the innovation and motivation
theory [19], the hypothesis was that the use of smart bracelets by the elders in conjunc-
tion with diverse exercise training can effectively enhance the elders’ motivation in the
community and increase their participation. Therefore, the purpose of this study is to
study the effectiveness of the combined use of sports smart bracelets and multi-sports
training programs on the motivation for the elderly in the Macau community. This study
also provides the Macau Government with recommendations for its future promotion of
the Smart and Elderly Campaign to formulate policies and implement programs for the
elderly regarding health, achieving the realization of the Macau government’s vision of
active aging.

2. Methods
2.1. Study Design and Sample
The study involved elderly people over 65 years of age in Macau in a randomized
controlled trial (RCT) study of the experimental group and control group in a before–after
Medicina 2021, 57, 34 3 of 9

test design. A total of 75 elderly people who received services from the Elderly Centre in
Macau were recruited as the study subjects, regardless of gender. Anyone could participate
in the study as long as they met the inclusion and exclusion criteria. The inclusion criteria
included: no major diseases, normal physical activity, participation in sports, access to all
relevant tests for the study, and willingness to participate in sports. In addition, those who
were interested in participating in the study, willing to continue to participate in the study,
and had no major plans or work arrangements (e.g., immigration, exoduses, surgery, etc.)
during the trial period were included. However, those who may have terminated their
participation in the study program at the time of recruitment were excluded, reducing
the total proportion of sample loss. The intervention period of the elderly’s pluralistic
movement was 12 weeks, during which other sports planners could not participate in order
to avoid affecting the effectiveness of the intervention of the campaign in this study. The
exclusion criteria were as follows: (1) subjects who suffered from problems such as severe
heart disease, severe hypertension, etc., which may have made exercise difficult; (2) subjects
suffering from any neuroskeletal muscle problems in the limbs, such as amputations and
other physical disorders, which may have resulted in the inability to complete the test or to
engage in the exercise performed,; and (3) subjects with any neurological disease resulting
in the inability to complete the test or to engage in the exercises to be carried out, such as
stroke, spinal cord injury, etc.
An appropriate sample size was estimated using power analysis to control for Type II
errors. This study used Statistical Software Sample Power 2.0, with the power set at 0.8 to
limit the risk of a Type II error to 20%, the Alpha value was set at 0.05, and the covariate’s
R2 was set at 0.13. This was based on the results of one study found in the literature;
after a 12 week targeted, multiple intervention, researchers found a mean difference in
the exercise motivation scale (EMS) between the two experimental and control groups of
2.0, with a pooled standard deviation of 3.6 [20]. Therefore, the effect size of the covariate
adjustment in this study was set at 0.37. Sixty subjects were randomly divided into the
exercising while wearing exercise bracelets group, the exercising only group, and the
control group, with 20 people in each group. The experimental period was 12 weeks. The
group that exercised while wearing exercise bracelets and group that did exercise only were
involved in elder diversity training. One group exercised while wearing sports bracelets
during the intervention, while another group exercised without using sports bracelets; the
control group did not receive any intervention. Before and after the experimental period
of 12 weeks, the three groups were compared using the pre-test evaluation of the exercise
motivation scale (EMS) scores [21], and relevant data of the pre- and post-assessment
tests were systematically analyzed and evaluated. In the study, only the participants who
completed the pre-test and post-test of the exercise motivation scale were selected, and the
participants in the exercising while wearing exercise bracelets group and the exercising
only group required 12 weeks of exercise intervention. The attendance rate reached more
than 80%, which met the above conditions as the object of the study.
We undertook the following preparation before the start of the experiment: before the
start of the experiment, the first 75 elderly participants in the study were randomly divided
into 3 groups of 25 people each. After collecting basic personal information, including age
and gender, each elderly person voluntarily signed an informed consent form for the study.
The researchers (five registered physiotherapists and five activity coordinators in Macau)
were trained in functional physical ability testing, and each experimental group was tested
by the same group of researchers in order to complete the elderly motor motivation scale
and collect basic data and pre-test scores. To prevent interference with the exercise inter-
vention effect of this study, participants were required not to participate in similar sports
training and intervention activities during the study period. The experiment intervention
phase involved wearing sports smart bracelets during the 12 weeks of prescription exercise,
which involved exercising three times a week for one hour at a time (including warm-up
and strain relaxation). The exercise prescription was designed according to the U.S. Depart-
ment of Health and Human Services [9] and the British Department of Health [10] exercise
Medicina 2021, 57, 34 4 of 9

prescription recommendations (Schedule 3-3-5). The exercise only group (25 people) were
involved in 12 weeks of elderly prescription exercise, which was the same as for the group
exercising while wearing the bracelet. The control group (25 people) involved in the experi-
ment for 12 weeks did not do any exercise, nor were they equipped with any sort of sports
smart bracelets and products.

2.2. Research Tools

2.2.1. Assessment Tool
This study used the Exercise Motivation Scale (EMS) [21]. Assessing the overall
reliability shows that the EMS has four related subscales relating to the motivation of
the elderly to participate in sports. They are: (1) fitness/health management, with a
Cronbach’s Alpha level of 0.78, (2) appearance/weight management, with a level of 0.84,
(3) stress/emotional management, and (4) social/leisure, with a measure of 0.84 in four
components, or, in short: the four degrees of confidence range was Cronbach Alpha 0.78.
The full-measurement scale had Cronbach’s Alpha 0.79. The pre-confidence measurement
used in this study was Cronbach’s Alpha of 0.955, and the post-confidence measurement
was Cronbach’s Alpha of 0.852. The study used the senior motor motivation scale with two
alpha confidence coefficients of 0.955 and 0.852, showing good reliability in the elderly’s
motor motivation scale. Because the four subscales have a high correlation coefficient range
from 0.82–0.93, this study is focused on the overall motivation scale change that occurred
after wearing sports bracelets, and we do not analyze the experimental effects on each
subscale. In the screening of exercise intensity, the study used the Borg Ratings of Perceived
Exertion Scale (RPE scale) rating the continuous intensity of exercise on a scale of 1 to 10.
Higher Borg ratings indicate higher intensity [22]. Participants were required to reach at
least level 5–6 on the scale or more; that is, they had to at least to reach the “a little hard”
moderate exercise intensity [23]. During the study period, participants had to maintain
their original living habits in addition to maintaining their original exercise habits and not
participating in moderate-intensity or above sports training activities.

2.2.2. Intervention Tool

The sports smart bracelet used in this study was the Mi 3 bracelet, and the 12 week
multi-sport exercise for the elderly was based on the recommendations of the US De-
partment of Health and Human Services [9] and the UK Department of Health [10]. The
exercise prescription included cardiopulmonary endurance training (25%), muscle strength
training (25%), flexibility training (25%), and balance training (25%). Exercise training
was carried out 3 times a week for a duration of 60 min each time. Members of the group
who wore smart bracelets while exercising were equipped with Mi 3 bracelets. Before
the start of the experiment, the functions of the Mi 3 bracelet (heartbeat monitoring, step
counting) were introduced to ensure that the team members had a basic understanding
of the ring’s components and simple usage techniques. Daycare center staff regularly
charged the elderly’s bracelets while downloading bracelet-related data to ensure that
the participants were wearing the bracelets throughout the duration of the experiment.
The Institute used the Mi 3 smart bracelet. The Mi 3 bracelet was used because it is small,
lightweight, cheap ($26), waterproof, durable, easy to wear and use, and convenient to
charge. The smart bracelet’s motion sensors automatically detect the user’s activity status
and prompt the user to get up when he or she is sedentary. The number of heartbeats was
monitored after various activities, which helped us to record and track the frequency of
each user’s heartbeat and temperature changes. The OLED display screen on the bracelet
shows physical activity data such as current time, number of steps, heart rate, calorie
consumption, and more by taping the circular button. The Mi 3 bracelet itself cannot
analyze, process, and store large amounts of data. By connecting to Mi 3’s mobile app
through the network or Bluetooth, the following data can be learned: 1. Walking distance:
records the number or distance of walks per day, which can be converted into calories
burned; 2. Exercise Time: records the time spent exercising per day, which can also produce
 activity data such as current time, number of steps, heart rate, calorie consumption, and
more by taping the circular button. The Mi 3 bracelet itself cannot analyze, process, and
store large amounts of data. By connecting to Mi 3’s mobile app through the network or
Medicina 2021, 57, 34 Bluetooth, the following data can be learned: 1. Walking distance: records the number 5 ofor
9
distance of walks per day, which can be converted into calories burned; 2. Exercise Time:
records the time spent exercising per day, which can also produce sedentary or immobile
time data; or
sedentary 3. immobile
Collect sleep
timestatus:
data; Records
3. Collectdaily
sleepsleep status
status: and assesses
Records body
daily sleep state;
status and 4.
assesses body state; 4. Calories Burned: calculates calories burned based on the amount ofit
Calories Burned: calculates calories burned based on the amount of exercise each day;
alerts you
exercise when
each targeted
day; it alertscalories
you when burned is not
targeted met. burned is not met.
calories

2.3. Statistical Analysis

For descriptive statistics, we analyzed variables including age, height,
height, weight,
weight, and
and
percentage of study participants in each group withwith the
the arithmetic
arithmetic mean
mean andand standard
standard
deviation of descriptive statistics. We conducted ANOVA
ANOVA and and the
the paired
paired t-test
t-test to
to compare
compare
the changes in the scores on the Exercise Motivation Scale before andand after
after each
each group
group of
of
experiments. All statistical tests were two-sided with the alpha
alpha level
level set
set at
at 0.05.
0.05. Analyses
Analyses
done with
were done with SPSS,
SPSS, version
version 22.
22.

3. Results
3. Results
The
The data
data of 60 subjects
of 60 subjects were
were collected,
collected, and
and the
the factors
factors of
of subject
subject withdrawal
withdrawal included
included
physical discomfort, absence due to illness, death, failure to complete 12 weeks of training,
physical discomfort, absence due to illness, death, failure to complete 12 weeks of training,
failure
failure to complete pre and post-tests, reluctance to wear the sports smart bracelets and
to complete pre and post-tests, reluctance to wear the sports smart bracelets and
other
other factors
factors (Figure
(Figure 1).
1).

Figure 1.
Figure 1. The
The flowchart
flowchart of
of the
the study
studyof
ofsample
sampleselection
selectionfrom
froma amulti-component
multi-componentexercise program
exercise among
program thethe
among elderly in
elderly
Macau.
in Macau.

The background data of the three groups of subjects

subjects was
was similar
similar inin age,
age, height,
height, and
and
before and
and after
afterweight,
weight,and
andthere
therewas
wasnono significant
significant difference
difference (p >(p0.05);
> 0.05); in terms
in terms of
of gen-
gender ratio,
der ratio, thethe three
three groups
groups were
were thethe same
same with1 1male
with maleand
and1919females,
females, andand the male toto
female
female ratio
ratio was
was the
the same
same with
with no
no significant
significant difference
difference (Table
(Table1).
1).
Medicina 2021, 57, 34 6 of 9

Table 1. Characteristics of the study at baseline.

Exercising
Wearing the Exercising Control
F p-Value
Bracelet
Mean (n = 20) Mean (n = 20) Mean (n = 20)
Age (years) 80.00 ± 5.38 78.40 ± 6.75 76.75 ± 10.64
0.845 0.435
Age range(y/o) 67–90 68–97 68–92
Heights (cm) 149 ± 0.06 152 ± 0.09 150 ± 0.05 1.274 0.287
Pre-Weight(kg) 55.68 ± 10.05 58.36 ± 11.08 56.55 ± 6.89 0.413 0.664
Post-Weight(kg) 55.33 ± 9.86 56.92 ± 11.23 56.90 ± 6.87 2.705 0.075
Gender 20 20 20
Male 1 1 1
Female 19 19 19

The Cronbach’s Alpha reliability coefficients of the Elderly Exercise Motivation Scale
were 0.955 > 0.8 and 0.852 > 0.8, indicating that the Elderly Exercise Motivation Scale
has good overall reliability. According to whether there was any change on the Elderly
Motivation Scale before and after the experiment, an analysis was conducted to find the
average of the scale before and after the experiment for each group, and the paired sample
t-test was performed.
Table 2 shows the influence of exercising while wearing the bracelet, exercising with-
out a bracelet, and being in the control group on the elders’ motivation of exercise. Before
the experiment there was no statistically significant difference between the three groups
(p > 0.05). For the group who exercised while wearing sports bracelets, there was a signifi-
cant change in the exercise motivation scale. The average value before the experiment was
3.556, and the average value after the experiment was 4.703. After the 12 week intervention
in the group who exercised without bracelets, there was a statistically significant change
in the exercise motivation scale of the elderly; the average value before the experiment
was 3.146, and the average value after the experiment was 4.165. The post-average value
is significantly greater than the pre-test average value, and the level of progression is
significantly different (p < 0.05).
Before and after the 12th week, the average value of the control group subjects was
4.090 before the experiment and 4.053 after the experiment. The mean value table of
the exercise motivation of the elderly before and after the experiment did not produce a
significant change, and the change did not reach a statistically significant level (p > 0.05).

Table 2. The differences between the combined use of sports smart bracelets and multi-exercise
training programs on the motivation of the elderly.

Group Intervention Mean SD t Value F p-Value

All pre-test 2.867 p > 0.069
exercising wearing pre-test 3.556 0.623 −8.257 p < 0.001
the bracelet post-test 4.703 0.085
pre-test 3.146 0.574 −7.978 p < 0.001 *
exercising
post-test 4.165 0.146
pre-test 4.090 0.629 0.589 0.563
Control
post-test 4.053 0.470
* significantly different at p < 0.001.

The analysis of variance (ANOVA) was also used to compare the average values of
the group who exercised while wearing the bracelet, the group who exercised without
bracelets, and the control group before and after the experiment, as shown in Table 3. There
are significant differences between the three groups (p < 0.001). The average value of the
group who exercised while wearing the bracelet is slightly higher than the average value
for the group who just exercised.
Medicina 2021, 57, 34 7 of 9

Table 3. Differences between the sports bracelet exercise group and exercise only group.

SS Df MS F p-Value
SSB 2.889 1 2.889 200.319 p < 0.001
SSW 0.548 38 0.014
SST 3.437 39
SS: Sum of Squares; MS: Mean Square; SSB: Between-group SUM of Squares Error; SSW: Within-group SUM of
Squares Error; SST: Total SUM of Squares Error.

The study found that the elderly are concerned about their health and suggested that
they should be encouraged to participate in interventional programs of sports courses.
Before the start of the exercise training course for the elderly, they should first understand
the positive effects and benefits of regular exercise on the body. This would have a positive
effect on the recruitment of subjects, on the interventional research program, and on the
implementation of the exercise program for the elderly.

4. Discussion
After 12 weeks of multi-sport exercise training, the evaluation scores on the elderly’s
exercise motivation scale all increased significantly, and the degree of progress reached a
significant difference (p < 0.05); the control group did not produce significant changes, and
the degree did not show a significant difference (p > 0.05). From this, it can be inferred that
being involved in 12 weeks of multi-sport exercise training can significantly enhance the
elderly’s motivation to exercise.
A systematic analysis was conducted based on the comparison of the average before
and after the experiment performed on the group who exercised while wearing the bracelet
and those who just exercised. The average of the two groups before and after the experiment
was significantly different (p < 0.05), while the average value of the bracelet-wearing group
is slightly higher than that of non-bracelet-wearing group. It can be inferred that in
the group who wore bracelets had a significant improvement over the group who just
exercised. Wearing sports smart bracelets can significantly improve the elderly’s motivation
to exercise.
Motivation is a very important psychological factor in exercise participation. Motiva-
tion can be the driving force for elders to participate in fitness activities. It is pointed out
that the factors that determine the motivation to participate in exercise include physical,
psychological, and social considerations. Physiological factors include height, weight, and
health; psychological aspects include self-esteem, emotions and fun, and social aspects
include competition and environment.
The participation of elders in fitness exercises can enrich life in their later years.
Exercise brings happiness, relaxation, excitement, and other feelings to elders [17]. It is an
important source of motivation. Exercises provide elders with interpersonal relationships
and friendships, and expand their lives. At the same time, exercises can cultivate the
habit of exercise, shift the focus of life, and help elders gain a sense of accomplishment.
It helps them with overcoming loneliness, releasing stress, enhancing positive emotions,
and overcoming negative emotions such as depression. It also helps the elderly maintain
physical fitness and slow down the rate of degradation and disease. The promotion
of exercise participation motivation encourages the elderly to participate in exercises,
including internal stimuli such as physical fitness and health and external stimuli such as
physical performance, psychological emotions, and social interaction [15].
There are several limitations to this research: this research is based on elderly people
over 65 years of age, and the ages of the participants ranged from 65 to 95 years of age.
There is a large age gap among the elderly, and their physical conditions, functional
statuses, and functional levels are very different. Future research should be subdivided
into several groups based on the age of the elderly to avoid variation. It is also of note
that due to the constraints of time, funding, and human resources, the study was only able
to conduct a 12 week analysis of the exercise plan and could not follow more subjects for
longer periods. This study adopts the method of free recruitment and random grouping,
Medicina 2021, 57, 34 8 of 9

so it is difficult to control the homogeneity of the sample grouping. In the future, when
similar studies are conducted, the group’s homogeneity should be controlled. Future
research directions can explore the retention effect of exercises, such as the differences
among different exercise intervention methods and the effects of different sports training.
The sports smart bracelet records personalized exercise status, and the accumulated data
recording daily exercise volume are also worthy of further study. Future smart wearable
device technology products will be designed from the perspective of the elderly, which
is likewise worthy of further discussion. The research meets the actual use and market
needs of the elderly. One of the major limitations was that the available data were unable
to perform detailed analysis to tease out the dose–response relationship of the experiment.
Therefore, the future study should explore the dose–response relationship between the
intensity of AI sports smart bracelets usage and motivational outcomes. Lastly, no objective
measures of exercise motivation are available from the study subjects. Future AI research
could also benefit from gathering detailed and validated information on compliance with
prescribed exercises.

5. Conclusions
Exercise has a positive impact on the physical, psychological and social development
of the elderly. This study confirms that the elderly can further improve their activity and
aging patterns by using smart sports bracelets and a 12 week exercise program to enhance
their motivation to exercise, thereby enhancing their level of concern for their health. It was
also shown that a 12 week, 60-min exercise program enhanced the motivation of the elderly
to exercise in order to achieve an active lifestyle and slow down aging. Therefore, we see
that the use of training programs has a positive impact on the promotion of movement
for the elderly in Macao, regardless of which training program is used. Wearing sports
smart bracelets had an even more significant effect on the elders’ motivation to exercise
than exercise alone had.

Author Contributions: Contribution of authors: conception and design: C.K.L., B.L.W.; analysis
and interpretation: C.K.L.; drafting of the article: C.K.L.; critical revision of the article for important
intellectual content: B.L.W., R.S.W., and H.Y.C.; final approval of the article: B.L.W.; statistical
expertise: C.K.L., R.S.W.; administrative, technical or logistic support: C.K.L. and H.Y.C.; collection
and assembly of data: C.K.L. All authors have read and agreed to the published version of the
manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement: Ethical review and approval were waived for this study, due
to the Macau University of Science Technology don’t’ have the institutional review board.
Informed Consent Statement: Patient consent was conducted.
Data Availability Statement: The study followed MDPI research data policies.
Conflicts of Interest: The authors declare no conflict of interest.

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