Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Author: Kathryn Barker1, Anne E Holland2, Elizabeth H Skinner3, Annemarie L Lee4
1 Department of Chronic and Complex Care, Western Health, St Albans; Discipline of Physiotherapy, La Trobe University, Bundoora.
2 Discipline of Physiotherapy, La Trobe University, Bundoora; Central Clinical School, Monash University, Melbourne; Alfred Health, Melbourne; Institute for Breathing and Sleep, Austin Health, Heidelberg.
3 Alfred Health, Melbourne; Department of Physiotherapy, Monash University, Frankston; Department of Physiotherapy, The University of Melbourne, Parkville, Australia.
4 Institute for Breathing and Sleep, Austin Health, Heidelberg; Department of Physiotherapy, Monash University, Frankston.
Conference/Journal: J Rehabil Med
Date published: 2023 Mar 6
Other: Volume ID: 55 , Pages: jrm00377 , Special Notes: doi: 10.2340/jrm.v55.2551. , Word Count: 186

To determine the effectiveness of exercise rehabilitation in people with multimorbidity. Exercise capacity was the primary outcome. Secondary outcomes were: health-related quality of life, activities of daily living, cardiometabolic outcomes, mental health outcomes, symptom scores, resource utilization, health behaviours, economic outcomes, and adverse events.

Data sources:
A search was conducted in MEDLINE, CINHAL, EMBASE, and Cochrane Central Register of Controlled Trials databases.

Study selection and extraction:
Randomized and non-randomized controlled trials and cohort studies of exercise rehabilitation vs any comparison in people with multimorbidity.

Data synthesis:
Forty-four reports (38 studies) were included. Rehabilitation ranged from 8 weeks to 4 years, with 1-7 sessions of rehabilitation weekly. Exercise included aerobic and resistance, limb training, aquatic exercises and tai chi. Compared with usual care, exercise rehabilitation improved 6-min walk distance (weighted mean difference (WMD) 64 m, 95% CI 45-82) and peak oxygen consumption (WMD 2.74 mL/kg/min, 95% CI -3.32 to 8.79). Effects on cardiometabolic outcomes and health-related quality of life also favoured rehabilitation; however; few data were available for other secondary outcomes.

In people with multimorbidity, exercise rehabilitation improved exercise capacity, health-related quality of life, and cardiometabolic outcomes.

PMID: 36876460 DOI: 10.2340/jrm.v55.2551