Review article (meta-analysis)Physical Exercise Interventions for Improving Performance-Based Measures of Physical Function in Community-Dwelling, Frail Older Adults: A Systematic Review and Meta-Analysis
Section snippets
Methods
We included randomized controlled trials (RCTs) evaluating the effect of physical exercise programs with or without other components on functional performance-based measures of physical function among community-dwelling, frail older adults. Inclusion criteria were as follows: participants should be (1) 65 years and older; (2) living in the community; and (3) defined as frail according to standardized criteria (eg, Fried's), or considered frail according to reduced physical function measured
Results
A total of 38 citations providing data from 19 trials were included in this systematic review.27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63 The flow chart of references and the causes of exclusion are presented in figure 1. We faced some challenges in assessing inclusion criteria: we included trials whose participants had moderate dependence in mobility, but we excluded trials on participants
Discussion
This systematic review has identified the available evidence on the effect of exercise in frail elderly people. When compared with control interventions, exercise has shown to improve gait speed and the SPPB in the frail elderly.
Results are inconclusive for endurance outcomes, and no consistent effect was observed on balance and functional status. The evidence comparing different modalities of exercise is scarce, and it is not possible to pinpoint which exercise characteristics (type,
Conclusions
Exercise has some benefits in frail older people, although uncertainty still exists with regard to which exercise characteristics (type, frequency, intensity, duration, setting, combinations) are most effective. When compared with control interventions, exercise has shown to improve gait speed and the SPPB in the frail elderly. However, results are inconclusive for endurance outcomes, and no consistent effect was observed on balance and functional mobility.
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Acknowledgments
We thank Àlex Domingo (Institute on Aging, Barcelona) for developing and conducting the bibliographic search strategy, and Dr. Rydwik, MD, PhD, for providing additional information on her trial. Marta Roqué-Fíguls is a doctorate candidate at the Pediatrics, Obstetrics and Gynecology and Preventive Medicine Department, Universitat Autònoma de Barcelona, Spain.
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