Abstract
Objective
To conduct a systematic review to determine the efficacy of exercise-based interventions
on improving performance-based measures of physical function and markers of physical
frailty in community-dwelling, frail older people.
Data Sources
Comprehensive bibliographic searches in MEDLINE, the Cochrane Library, PEDro, and
CINAHL databases were conducted (April 2013).
Study Selection
Randomized controlled trials of community-dwelling older adults, defined as frail
according to physical function and physical difficulties in activities of daily living
(ADL). Included trials had to compare an exercise intervention with a control or another
exercise intervention, and assess performance-based measures of physical function
such as mobility and gait, or disability in ADL.
Data Extraction
Two review authors independently screened the search results and performed data extraction
and risk of bias assessment. Nineteen trials were included, 12 of them comparing exercise
with an inactive control. Most exercise programs were multicomponent.
Data Synthesis
Meta-analysis was performed for the comparison of exercise versus control with the
inverse variance method under the random-effects models. When compared with control
interventions, exercise was shown to improve normal gait speed (mean difference [MD]=.07m/s;
95% confidence interval [CI], .04–.09), fast gait speed (MD=.08m/s; 95% CI, .02–.14),
and the Short Physical Performance Battery (MD=2.18; 95% CI, 1.56–2.80). Results are
inconclusive for endurance outcomes, and no consistent effect was observed on balance
and the ADL functional mobility. The evidence comparing different modalities of exercise
is scarce and heterogeneous.
Conclusions
Exercise has some benefits in frail older people, although uncertainty still exists
with regard to which exercise characteristics (type, frequency, duration) are most
effective.
Keywords
List of abbreviations:
ADL ( activities of daily living), BBS ( Berg Balance Scale), CI ( confidence interval), MD ( mean difference), RCT ( randomized controlled trial), SPPB ( Short Physical Performance Battery), TUG ( Timed Up and Go)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: December 02, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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- CorrectionArchives of Physical Medicine and RehabilitationVol. 99Issue 1
- In BriefThere are several errors in the article Giné-Garriga M, Roqué-Fíguls M, Coll-Planas L, Sitjà-Rabert M, Salvà A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling frail older adults: a systematic review and meta-analysis, published in Archives of Physical Medicine and Rehabilitation 2014; 95: 753-69 (https://doi.org/10.1016/j.apmr.2013.11.007).
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