Telecoaching Interventions for People with Epilepsy: Enhancing Physical Activity and Quality of Life through Digital Health. A Systematic Review

People with Epilepsy exhibit low levels of physical activity compared with the general population, despite evidence suggesting potential benefits for seizure control, physical fitness and psychosocial well-being. Persistent barriers such as fear of seizures, limited access to supervised programs, transportation difficulties, and time constraints contribute to sedentary behaviour. Telecoaching (TC), which delivers structured exercise programs through digital technologies, may help overcome these barriers. This systematic review aimed to evaluate the feasibility and potential effects of TC-based training physical activity interventions in individuals with epilepsy, focusing on adherence, QoL, physical fitness and psychological outcomes. A systematic search of PubMed, Web of Science, and Scopus identified 1086 records, of which 7 studies involving 342 participants met the inclusion criteria. Interventions included remotely delivered aerobic, resistance, flexibility, and combined exercise programs. Study quality ranged from "fair" to "good". TC-based interventions were generally safe and feasible, with no major adverse events reported. Evidence suggest potential benefits for physical fitness and psychosocial outcomes, particularly in paediatric populations, although the limited number and heterogeneity of studies preclude definitive conclusions, especially regarding seizure-related outcomes. Future research should focus on standardized TC programs, long-term follow-up, and adequately powered randomized trials to confirm effectiveness and sustainability.