The functional effects of physical exercise training in frail older people: A systematic review

Chin A Paw, Marijke J. M., van Uffelen, Jannique G. Z., Riphagen, Ingrid and van Mechelen, Willem (2008) The functional effects of physical exercise training in frail older people: A systematic review. Sports Medicine, 38 9: 781-793. doi:10.2165/00007256-200838090-00006

Author Chin A Paw, Marijke J. M.
van Uffelen, Jannique G. Z.
Riphagen, Ingrid
van Mechelen, Willem
Title The functional effects of physical exercise training in frail older people: A systematic review
Journal name Sports Medicine   Check publisher's open access policy
ISSN 0112-1642
Publication date 2008-09-01
Year available 2008
Sub-type Article (original research)
DOI 10.2165/00007256-200838090-00006
Open Access Status Not Open Access
Volume 38
Issue 9
Start page 781
End page 793
Total pages 13
Editor J. N. Shanahan
Place of publication Auckland, New Zealand
Publisher Adis International
Language eng
Subject 920205 Health Education and Promotion
111702 Aged Health Care
920502 Health Related to Ageing
111712 Health Promotion
1106 Human Movement and Sports Science
Abstract Although trials have shown that exercise has positive effects on bone mineral density (BMD), the majority of exercise trials have been conducted in older women. The aim of this study was to systematically review trials examining the effect of weight-bearing and resistance-based exercise modalities on the BMD of hip and lumbar spine of middle-aged and older men. Eight electronic databases were searched in August 2012. Randomised controlled or controlled trials that assessed the effect of weight-bearing and resistance-based exercise interventions on BMD measured by dual-energy x-ray absorptiometry, and reported effects in middle-aged and older men were included. Eight trials detailed in nine papers were included. The interventions included walking (n = 2), resistance training (n = 3), walking + resistance training (n = 1), resistance training + impact-loading activities (n = 1) and resistance training + Tai Chi (n = 1). Five of the eight trials achieved a score of less than 50% on the modified Delphi quality rating scale. Further, there was heterogeneity in the type, intensity, frequency and duration of the exercise regimens. Effects of exercise varied greatly among studies, with six interventions having a positive effect on BMD and two interventions having no significant effect. It appears that resistance training alone or in combination with impact-loading activities are most osteogenic for this population, whereas the walking trials had limited effect on BMD. Therefore, regular resistance training and impact-loading activities should be considered as a strategy to prevent osteoporosis in middle-aged and older men. High quality randomised controlled trials are needed to establish the optimal exercise prescription.
Formatted abstract
This systematic review describes the effect of exercise training on physical performance in frail older people. Randomized controlled trials were identified from searches in PubMed, EMBASE and CENTRAL from January 1995 through August 2007. Two reviewers independently screened the trials for eligibility, rated their quality, and extracted data. Randomized controlled trials that examined the effects on performance-based measures of physical function among frail older adults were included. The systematic search identified 20 studies, examining 23 different exercise programmes. The methodological quality score (0–9) of the trials ranged from 2 to 7 points. Sixteen of the studies were scored as high quality. There was a large variety in the studies concerning sample size, degree of frailty, types of interventions and types of assessments. The majority of the programmes were facility-based, group-exercise programmes that were performed three times a week for 45–60 minutes. The intervention programmes comprised resistance training (n = 9), Tai Chi training (n = 2), or multi-component training (n = 12). Six of the total selected 20 studies did not find a beneficial exercise effect on functional performance. This systematic review suggests that older adults with different levels of abilities can improve their functional performance by regular exercise training. To determine the most appropriate design of the exercise programme (type, intensity, frequency and duration of exercise) for functional improvement or prevention of loss of function, more high-quality trials are needed in which different training protocols are compared.
© 2008 Adis Data Information BV. All rights reserved.
Keyword Elderly
Endurance training
Physical performance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Mon, 23 Mar 2009, 21:20:28 EST by Deborah Noon on behalf of Faculty Of Health Sciences