The benefits and harms of therapeutic exercise on physical and psychosocial outcomes in people with multimorbidity: Protocol for a systematic review

Harris, Lasse K; Saracutu, Madalina; Smith, Susan M; Juhl, Carsten Bogh; Skou, Søren Thorgaard

doi:10.1177/2235042x20920458

Cited by 8 publications

(15 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This systematic review with meta-analysis has been conducted and reported according to recommended international guidelines ( Higgins et al, 2019 ; Moher et al, 2009 ) and it followed a pre-specified protocol ( Bricca et al, 2020 ). Additionally, we have contacted study authors to retrieve missing information from the included RCTs which allowed us to conduct meta-regression analyses with complete data for intervention characteristics such as mode of delivery and setting of the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…The protocol for this systematic review has been published, ( Bricca et al, 2020 ) and it was registered at PROSPERO (CRD42020150628). The statistical analysis plan was made publicly available on the Open Science Framework website ( Foster and Deardorff, 2017 ) ( https://osf.io/38fcg/ ) before the title and abstract (TIAB) screening phase was initiated.…”

Section: Methodsmentioning

confidence: 99%

“…To avoid multiplicity, we used a hierarchy of selection rules for the outcomes. We prioritised data extraction of outcome measures important for the participants ( Smith et al, 2018 ) and generic over disease-specific measures ( Bricca et al, 2020 ). For objectively measured physical function, we prioritised: 1) the 6-minute walking test, 2) Incremental Shuttle Walking Test, 3) any other outcome measure related to daily function (e.g.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials

Bricca

Harris

Jäger

et al. 2020

Ageing Research Reviews

Self Cite

View full text Add to dashboard Cite

Objectives To investigate the benefits and harms of exercise therapy on physical and psychosocial health in people with multimorbidity. Design Systematic review of randomised controlled trials (RCTs). Data sources MEDLINE, EMBASE, CENTRAL and CINAHL from 1990 to April 20th, 2020 and Cochrane reviews on the effect of exercise therapy for each of the aforementioned conditions, reference lists of the included studies, the WHO registry and citation tracking on included studies in Web of Science. Eligibility criteria for study selection RCTs investigating the benefit of exercise therapy in people with multi-morbidity, defined as two or more of the following conditions: osteoarthritis (of the knee or hip), hypertension, type 2 diabetes, depression, heart failure, ischemic heart disease, and chronic obstructive pulmonary disease on at least one of the following outcomes: Health-related quality of life (HRQoL), physical function, depression or anxiety. Summary and quality of the evidence Meta-analyses using a random-effects model to assess the benefit of exercise therapy and the risk of non-serious and serious adverse events according to the Food and Drug Administration definition. Meta-regression analyses to investigate the impact of pre-specified mediators of effect estimates. Cochrane ‘Risk of Bias Tool’ 2.0 and the GRADE assessment to evaluate the overall quality of evidence. Results Twenty-three RCTs with 3363 people, testing an exercise therapy intervention (mean duration 13.0 weeks, SD 4.0) showed that exercise therapy improved HRQoL (standardised mean difference (SMD) 0.37, 95 % CI 0.14 to 0.61) and objectively measured physical function (SMD 0.33, 95 % CI 0.17 to 0.49), and reduced depression symptoms (SMD -0.80, 95 % CI -1.21 to -0.40) and anxiety symptoms (SMD -0.49, 95 % CI -0.99 to 0.01). Exercise therapy was not associated with an increased risk of non-serious adverse events (risk ratio 0.96, 95 % CI 0.53-1.76). By contrast, exercise therapy was associated with a reduced risk of serious adverse events (risk ratio 0.62, 95 % CI 0.49 to 0.78). Meta-regression showed that increasing age was associated with lower effect sizes for HRQoL and greater baseline depression severity was associated with greater reduction of depression symptoms. The overall quality of evidence for all the outcomes was downgraded to low, mainly due to risk of bias, inconsistency and indirectness. Conclusions Exercise therapy appears to be safe and to have a beneficial effect on physical and psychosocial health in people with multimorbidity. Although the evidence supporting this was of low quality, it highlights the potential of exercise therapy in the management and care of this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials

Bricca

Harris

Jäger

et al. 2020

Ageing Research Reviews

Self Cite

View full text Add to dashboard Cite

show abstract

“…This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA Checklist: Additional file 1 ) [ 22 ] and was based on a protocol with pre-specified study selection, eligibility criteria, data extraction and strategy for data synthesis [ 23 ] in accordance with the Cochrane Handbook for Systematic Reviews of Interventions [ 24 ]. The protocol was registered at PROSPERO (CRD42020161329) and was also made publicly available via the Open Science Framework website [ 25 , 26 ] before completion of the title/abstract screening phase.…”

Section: Methodsmentioning

confidence: 99%

“…We used the same search strategy developed from our previous systematic review which investigated the effect of exercise therapy in people with multimorbidity [ 23 ]. Information was retrieved from the following sources: Searching MEDLINE via PubMed, EMBASE via Ovid, CINAHL (including preCINAHL) via EBSCO and the Cochrane Central Register of Controlled Trials (CENTRAL) up to October 12, 2019, with no restriction on language.…”

Section: Methodsmentioning

confidence: 99%

Recruitment and retention rates in randomised controlled trials of exercise therapy in people with multimorbidity: a systematic review and meta-analysis

Harris

Skou

Juhl

et al. 2021

Trials

Self Cite

View full text Add to dashboard Cite

Aim To quantify recruitment, retention and differential retention rates and associated trial, participant and intervention characteristics in randomised controlled trials (RCTs) evaluating the effect of exercise therapy in people with multimorbidity. Data sources MEDLINE, EMBASE, CINAHL and CENTRAL from 1990 to April 20, 2020. Study selection RCTs including people with multimorbidity comparing exercise therapy with a non-exposed comparator group reporting at least one of the following outcomes: physical function, health-related quality of life, depression symptoms, or anxiety symptoms. Data extraction and synthesis Recruitment rates (proportion of people randomised/proportion of people eligible), retention rates (proportion of people providing the outcomes of interest/proportion randomised) and differential retention rates (difference in proportion of people providing the outcomes in the intervention group and comparator group) were calculated. Meta-analysis using a random-effects model was used to estimate pooled proportions. Methodological quality was assessed using Cochrane ´Risk of Bias tool 2.0´ for individual studies, and the GRADE approach was used to assess the overall quality of the evidence. Results Twenty-three RCTs with 3363 people were included. The pooled prevalence for recruitment rate was 75% (95%CI 66 to 84%). The pooled prevalence for retention rate was 90% (95%CI 86 to 94%) at the end of the intervention (12 weeks; interquartile range (IQR) (12 to 12)). Meta-regression analyses showed that increasing age and including a higher proportion of people with hypertension was associated with lower retention rates. Retention rates did not differ between the intervention and comparator groups. The overall quality of the evidence was deemed very low. Conclusion Three in four eligible people with multimorbidity were randomised to RCTs using exercise therapy, of which nine out of 10 provided end of treatment outcomes with no difference seen between the intervention and comparison groups. However, the results must be interpreted with caution due to large differences between the included studies. Trial registration ClinicalTrials.govCRD42020161329. Registered on 28 April 2020.

show abstract

Exercise-based cardiac rehabilitation for coronary heart disease

Dibben

Faulkner

Oldridge

et al. 2021

Cochrane Database of Systematic Reviews

234

194

View full text Add to dashboard Cite

The benefits and harms of therapeutic exercise on physical and psychosocial outcomes in people with multimorbidity: Protocol for a systematic review

Cited by 8 publications

References 30 publications

Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials

Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials

Recruitment and retention rates in randomised controlled trials of exercise therapy in people with multimorbidity: a systematic review and meta-analysis

Exercise-based cardiac rehabilitation for coronary heart disease

Contact Info

Product

Resources

About