Deep learning-based physical exercise assessment of older adults using single-camera videos

Regular physical activity preserves functional independence in older adults, yet care-home residents often miss out because personalized supervision is scarce. Autonomous, technology-supported exercise platforms could deliver such guidance without additional staff time-but only if sessions are automatically monitored for safety and quality. We therefore designed a deep learning (DL) system that (a) recognizes individual exercise types and (b) estimates joint angle trajectories from a standard video recording. These outputs are used to compute objective exercise performance metrics (EPMs) such as duration, repetition count, motion variability, and range of motion. Seven care-home residents (aged between 65-94 years) performed six common rehabilitation exercises in front of a single camera while wearing 17 inertial sensors (Xsens MVN Awinda) that provided ground-truth joint angles. Two-dimensional skeleton poses estimated from the video were fed into a temporal convolutional neural network to recognize the exercises and estimate three-dimensional joint angles. We evaluated exercise segmentation with F1@50 and angle regression with mean per-joint angular error (MPJAE) across nine trunk and lower-limb joints, using leave-one-subject-out cross-validation. Pearson correlations assessed agreement between estimated and ground-truth EPMs. The DL model achieved an F1@50 of 0.92 (± 0.04) for exercise recognition and an MPJAE of 7.7° (± 0.91) for joint angle estimation. The estimated EPMs aligned closely with ground truth, achieving correlation scores of 0.93 (95% CI [0.90, 0.95]) for duration, 0.86 (95% CI [0.80, 0.90]) for repetition count, and between 0.3 and 0.9 for motion variability and range of motion across exercises. The DL algorithm reliably estimates key exercise outcomes from a single video stream. This video-based monitoring pipeline could enable unsupervised, technology-supported exercise assessment in residential care homes while safeguarding session quality and safety. Future work will validate the approach in larger and more diverse cohorts.