Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: A systematic review and meta-analysis of randomized controlled trials

Zhang, Yixiong; Zhang, Yuqun; Du, Shizheng; Wang, Qiuling; Xia, Haozhi; Sun, Rong

doi:10.1016/j.gerinurse.2019.10.006

Cited by 60 publications

(53 citation statements)

References 34 publications

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“…It has been suggested that exercise and physical activity significantly contributes to physical and mental well-being, which leads to an improved quality of life [64]. These results are consistent with previous studies, which reported that HRQOL was improved following exercise intervention in frail and pre-frail older adults [65,66].…”

Section: Discussionsupporting

confidence: 89%

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

Chittrakul

Siviroj

Sungkarat

et al. 2020

IJERPH

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Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.

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Section: Discussionsupporting

confidence: 89%

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

Chittrakul

Siviroj

Sungkarat

et al. 2020

IJERPH

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“…Herein, gait speed and TUG were used to measure the physical performance in this review study. Our meta-analysis found that exercise's benefit is improving gait speed and TUG, and the positive effects can be supported by a previous review study targeting older adults ( 55 ). These meaningful results are of great importance because there is a close relationship between muscle strength and physical performance ( 56 ).…”

Section: Discussionsupporting

confidence: 79%

“…This result may be inconclusive due to the small number of included studies investigating vigorous intensity exercise and the different methods on coding intensity exercise in the subgroup. Actually, a recent systematic review study has documented that both moderate and vigorous intensity exercises can improve functional ability in frail older adults ( 55 ). Future research is warranted to determine the effect of exercise at different intensities on physical performance.…”

Section: Discussionmentioning

confidence: 99%

Effects and Moderators of Exercise on Sarcopenic Components in Sarcopenic Elderly: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Sarcopenia is a muscle disease in loss of muscle strength, mass, and function associated with aging. Although protective effects of exercise on muscle mass and function are generally recognized, research findings in sarcopenic adults are inconsistent. It is necessary to conduct a systematic review to determine the effects of exercise on muscle strength, body composition, and physical performance in older adults with sarcopenia, and to examine the potential moderators including sociodemographic characteristics and exercise-related factors.Methods: Six electronical academic databases (Medline, Embase, CINAHL, Scopus, Cochrane Library, and SPORTDiscus) were used to retrieve the eligible studies from inception to May 2020. Two reviewers independently selected and extracted the data from each included study, and effect sizes were calculated by employing random-effect models with 95% confidential interval (CI). The Physiotherapy Evidence Database (PEDro) scale was used to assess study quality.Results: Seventeen studies (985 participants with sarcopenia, aged 67.6–86 years) were included in this review study. The meta-analytic results showed significant improvements in muscle strength [grip strength, SMD = 0.30, 95% CI (0.15, 0.45), I2 = 6%, p < 0.01; knee extension, SMD = 0.32, 95% CI (0.15, 0.50), I2 = 0%, p < 0.01; and chair and stand, SMD = 0.56, 95% CI (0.30, 0.81), I2 = 36%, p < 0.01], in physical performance [timed up and go, SMD = 0.74, 95% CI (0.48, 1.00), I2 = 0%, p < 0.01; and gait speed, SMD = 0.59, 95% CI (0.35, 0.82), I2 = 62%, p < 0.01], and in body composition [skeletal muscle mass index, SMD = 0.37, 95% CI (0.15, 0.58), I2 = 16%, p < 0.01; and appendicular skeletal muscle, SMD = 0.31, 95% CI (0.13, 0.49), I2 = 20%, p < 0.01]. However, there were no significant differences in other body composition (SMD = 0.20–0.36). Additionally, meta-regression revealed that the higher percent of female participants was significantly associated with improved gait speed (β = 0.0096, p = 0.03) and decreased skeletal muscle mass index (β = −0.0092, p = 0.01).Conclusions: The current meta-analysis suggests that exercise is a beneficial therapy, which has protective effects for older adults with sarcopenia. Some beneficial effects may be moderated by gender and exercise intensity.

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“…Due to the metabolic stress of the surgery, more patients were expected to experience problems within this area; however, problems with exhaustion, weakness, and slowness dominated the frail population. Previous studies have demonstrated how the most effective way to improve the status of frail patients is exercise and physical rehabilitation, as it improves balance (and prevent falls), increase gait speed and improve overall performance in ADL functions [25] , [26] . Currently, the PERFORM-TAVR trial is testing an intervention consisting of a home-based exercise programme in combination with nutritional supplements on physical performance [27] .…”

Section: Discussionmentioning

confidence: 99%

Association between frailty and self-reported health following heart valve surgery

Borregaard

Dahl

Lauck

et al. 2020

IJC Heart & Vasculature

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Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: A systematic review and meta-analysis of randomized controlled trials

Cited by 60 publications

References 34 publications

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

Effects and Moderators of Exercise on Sarcopenic Components in Sarcopenic Elderly: A Systematic Review and Meta-Analysis

Association between frailty and self-reported health following heart valve surgery

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