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Evidence for exercise-based interventions across 45 different long-term conditions: an overview of systematic reviews.

Dibben, Grace O; Gardiner, Lucy; Ml, Hannah; Wells, Young Valerie; Evans, Rachael A; Ahmed, Zahira; Barber, Shaun; Dean, Sarah; Doherty, Patrick; Gardiner, Nikki; Greaves, Colin; Ibbotson, Tracy; Jani, Bhautesh D; Jolly, Kate; Mair, Frances S; McIntosh, Emma; Ormandy, Paula; Simpson, Sharon A; Ahmed, Sayem; Krauth, Stefanie J; Steell, Lewis; Singh, Sally J; Taylor, Rod S

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Authors

Grace O Dibben

Lucy Gardiner

Hannah Ml

Young Valerie Wells

Rachael A Evans

Zahira Ahmed

Shaun Barber

Sarah Dean

Patrick Doherty

Nikki Gardiner

Colin Greaves

Tracy Ibbotson

Bhautesh D Jani

Kate Jolly

Frances S Mair

Emma McIntosh

Sharon A Simpson

Sayem Ahmed

Stefanie J Krauth

Lewis Steell

Sally J Singh

Rod S Taylor



Abstract

Almost half of the global population face significant challenges from long-term conditions (LTCs) resulting in substantive health and socioeconomic burden. Exercise is a potentially key intervention in effective LTC management. In this overview of systematic reviews (SRs), we searched six electronic databases from January 2000 to October 2023 for SRs assessing health outcomes (mortality, hospitalisation, exercise capacity, disability, frailty, health-related quality of life (HRQoL), and physical activity) related to exercise-based interventions in adults (aged >18 years) diagnosed with one of 45 LTCs. Methodological quality was assessed using AMSTAR-2. International Prospective Resister of Systematic Reviews (PROSPERO) ID: CRD42022319214. Forty-two SRs plus three supplementary RCTs were included, providing 990 RCTs in 936,825 people across 39 LTCs. No evidence was identified for six LTCs. Predominant outcome domains were HRQoL (82% of SRs/RCTs) and exercise capacity (66%); whereas disability, mortality, physical activity, and hospitalisation were less frequently reported (≤25%). Evidence supporting exercise-based interventions was identified in 25 LTCs, was unclear for 13 LTCs, and for one LTC suggested no effect. No SRs considered multimorbidity in the delivery of exercise. Methodological quality varied: critically-low (33%), low (26%), moderate (26%), and high (12%). Exercise-based interventions improve HRQoL and exercise capacity across numerous LTCs. Key evidence gaps included limited mortality and hospitalisation data and consideration of multimorbidity impact on exercise-based interventions. This study was funded by the National Institute for Health and Care Research (NIHR; Personalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (multimorbidity)-NIHR202020). [Abstract copyright: © 2024 The Authors.]

Journal Article Type Article
Acceptance Date Mar 28, 2024
Online Publication Date Apr 30, 2024
Publication Date 2024-04
Deposit Date Apr 4, 2024
Publicly Available Date Apr 30, 2024
Journal EClinicalMedicine
Electronic ISSN 2589-5370
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 72
Pages 102599
DOI https://doi.org/10.1016/j.eclinm.2024.102599
Keywords Physical activity, Long-term conditions, Overview, Exercise, Systematic review
Publisher URL https://www.journals.elsevier.com/eclinicalmedicine