Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials
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Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trialsAuthor(s)
Date
2015-12-02Citation
de Labra C, Guimaraes-Pinheiro C, Maseda A, Lorenzo T, Millán-Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015 Dec 2;15:154.
Abstract
[Abstract] Background: Low physical activity has been shown to be one of the most common components of frailty, and
interventions have been considered to prevent or reverse this syndrome. The purpose of this systematic review
of randomized, controlled trials is to examine the exercise interventions to manage frailty in older people.
Methods: The PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched
using specific keywords and Medical Subject Headings for randomized, controlled trials published during the period of
2003–2015, which enrolled frail older adults in an exercise intervention program. Studies where frailty had been defined
were included in the review. A narrative synthesis approach was performed to examine the results. The Physiotherapy
Evidence Database (PEDro scale) was used to assess the methodological quality of the selected studies.
Results: Of 507 articles, nine papers met the inclusion criteria. Of these, six included multi-component exercise
interventions (aerobic and resistance training not coexisting in the intervention), one included physical comprehensive
training, and two included exercises based on strength training. All nine of these trials included a control group receiving
no treatment, maintaining their habitual lifestyle or using a home-based low level exercise program. Five investigated the
effects of exercise on falls, and among them, three found a positive impact of exercise interventions on this
parameter. Six trials reported the effects of exercise training on several aspects of mobility, and among them, four
showed enhancements in several measurements of this outcome. Three trials focused on the effects of exercise
intervention on balance performance, and one demonstrated enhanced balance. Four trials investigated functional ability,
and two showed positive results after the intervention. Seven trials investigated the effects of exercise intervention on
muscle strength, and five of them reported increases; three trials investigated the effects of exercise training on body
composition, finding improvements in this parameter in two of them; finally, one trial investigated the effects of exercise
on frailty using Fried’s criteria and found an improvement in this measurement. Exercise interventions have demonstrated
improvement in different outcome measurements in frail older adults, however, there were large differences between
studies with regard to effect sizes.
Conclusions: This systematic review suggested that frail older adults seemed to benefit from exercise interventions,
although the optimal program remains unclear. More studies of this topic and with frail populations are needed to select
the most favorable exercise program.
Keywords
Exercise
Frail elderly
Physical activity
Functional capacity
Systematic review
Randomized controlled trial
Frail elderly
Physical activity
Functional capacity
Systematic review
Randomized controlled trial
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Creative Commons Attribution 4.0 International License (CC-BY 4.0)