ObjectiveExercise has been shown to be an effective intervention; the difficulty still lies in providing exercise programs to the older adults in rural areas. Therefore, this study aimed to examine the effects of a 12-week exercise program provided with visual guidelines (prerecorded video) on frailty among older adults in rural areas.MethodsFifty participants (71.7 ± 4.9 years) from 5 different rural areas were recruited and divided into two groups: the exercise group (EX,n= 24 (male: 8, female: 18)) and the control group (CON,n= 26 (male: 7, female: 17)). With the commencement of the exercise intervention, a prerecorded high-speed power training program for frail older adults was distributed to the EX group. A new prerecorded exercise program was delivered to the EX group every 4 weeks. Frailty status was diagnosed with Fried's criteria before and after the intervention. Muscle strength was measured in the upper and lower limb strength (hand-grip strength and leg extension and flexion), and physical function was measured using a short physical performance battery and gait speed. Fasting blood was collected before and after the intervention and analyzed for blood lipid profile.ResultsAfter 12 weeks of the intervention period, a significant difference in frailty status (P< 0.01) and score (P< 0.01) favoring the EX group was observed. Physical functions (gait speed (P=0.01) and time for sit to stand (P< 0.01)) were significantly improved in the EX group with a significant increase in knee extensor strength (P< 0.01). A significant difference in serum high-density lipoprotein levels favoring the EX group (P=0.03) was also observed.ConclusionsThis study confirmed the positive effect of a visual-guided exercise program on older adults' residents in rural areas and provided alternative methods to effectively provide exercise program for the older adults with limited resources.