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

PERFORM Research Team

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Abstract

Background 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.
Methods 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, healthrelated 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.
Findings 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%).- Interpretation 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.
Original languageEnglish
Article number102599
Number of pages14
JournalEClinicalMedicine
Early online date29 Apr 2024
DOIs
Publication statusE-pub ahead of print - 29 Apr 2024

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