Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials
| العنوان: | Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials |
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| المؤلفون: | Alessio Bricca, Madalina Jäger, Søren Thorgaard Skou, Carsten Bogh Juhl, Susan M Smith, Lasse K. Harris |
| المصدر: | Ageing research reviews Bricca, A, Harris, L K, Jäger, M, Smith, S M, Juhl, C B & Skou, S T 2020, ' Benefits and harms of exercise therapy in people with multimorbidity: a systematic review and meta-analysis of randomised controlled trials ', Ageing Research Reviews, vol. 63, 101166 . https://doi.org/10.1016/j.arr.2020.101166 Ageing Research Reviews |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 0301 basic medicine, Quality of life, Aging, medicine.medical_specialty, Population, Anxiety, Biochemistry, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Adverse effect, education, Molecular Biology, Exercise, Depression (differential diagnoses), education.field_of_study, business.industry, Depression, Multimorbidity, 3. Good health, Exercise Therapy, Physical Function, 030104 developmental biology, Neurology, Meta-analysis, Relative risk, Physical therapy, Physical function, medicine.symptom, business, Psychosocial, 030217 neurology & neurosurgery, Biotechnology |
| الوصف: | 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 multimorbidity, 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. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1872-9649 1568-1637 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::09f85bbddadcdbd6e97e552987fd5507 http://europepmc.org/articles/PMC7116122 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....09f85bbddadcdbd6e97e552987fd5507 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 18729649 15681637 |
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