Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials.
Background Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of itsbenefits for older adults in residential care, who often have functional dependency, multimorbidity, and polypharmacy,is inconclusive. We aimed to establish the effects of exercise...
| Autores: | , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad de Castilla-La Mancha |
| Repositorio: | RUIdeRA. Repositorio Institucional de la UCLM |
| OAI Identifier: | oai:ruidera.uclm.es:10578/44210 |
| Acceso en línea: | https://hdl.handle.net/10578/44210 |
| Access Level: | acceso abierto |
| Palabra clave: | Network meta-analysis Older adults Physical exercise Physical function Randomised controlled trials Residential care Systematic review |
| Sumario: | Background Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of itsbenefits for older adults in residential care, who often have functional dependency, multimorbidity, and polypharmacy,is inconclusive. We aimed to establish the effects of exercise interventions on the physical function of this population.Methods For this systematic review and network meta-analysis, we searched PubMed, Web of Science, CochraneLibrary, Rehabilitation & Sports Medicine Source, and SPORTDiscus to identify randomised controlled trialsassessing the effects of exercise interventions (vs usual care) on physical function (ie, functional independence,physical performance, and other related measures, such as muscle strength, balance, or flexibility) in adults aged60 years or older living in residential care. Relevant studies published in English or Spanish up to Jan 12, 2023,were included in the systematic review. The quality of studies was assessed using the Tool for the Assessment ofStudy Quality and Reporting in Exercise (TESTEX) score. A network meta-analysis was performed for physicalfunction-related outcomes reported in at least ten studies, with subanalyses for specific intervention (ie, exercisetype, training volume, and study duration) and participant (eg, having cognitive impairment or dementia, pre-frailor frail status, and being functionally dependent) characteristics. The study protocol was registered on PROSPERO(CRD42021247809).Findings 147 studies (11 609 participants, with mean ages ranging from 67 years [SD 9] to 92 years [2]) were includedin the systematic review, and were rated as having overall good quality (median TESTEX score 9 [range 3–14]). In themeta-analysis (including 105 studies, n=7759 participants), exercise interventions were associated with significantlyimproved overall physical function, with a standardised mean difference [SMD] of 0·13 (95% credible interval [CrI]0·04–0·21), which was confirmed in all analysed subpopulations. The strongest association was observed with110–225 min per week of exercise, and the greatest improvements were observed with 170 min per week (SMD 0·36[95% CrI 0·20–0·52]). No significant differences were found between exercise types. Subanalyses showed significantimprovements for almost all analysed physical function-related outcomes (Barthel index, five-times sit-to-stand test,30-s sit-to-stand test, knee extension, hand grip strength, bicep curl strength, Short Physical Performance Battery,6-min walking test, walking speed, Berg balance scale, and sit-and-reach test). Large heterogeneity was found betweenand within studies in terms of population and intervention characteristics.Interpretation Exercise interventions are associated with improved physical function in older adults in residentialcare, and should, therefore, be routinely promoted in long-term care facilities |
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