Background
Methods
Search strategy and selection criteria
Data extraction and quality assessment
Synthesis
Results
Study ID country | N randomised | Intervention | Control | Intervention period Follow up period | Outcomes assessed | Main findings |
---|---|---|---|---|---|---|
USA | 119 | Balance and strength exercises | Flexibility home programme | 9 months 3, 6 and 9 months | Performance-based physical functioning Self-reported functioning Balance Muscle strength Quality of life | Significant improvements in exercise group vs control in observed and self-reported functioning. Some differences in balance, muscle strength and quality of life subscales. |
Brown 2000 [27] USA | 87 | Balance and strength exercises | Home range of motion exercises | 3 months 3 months | Performance-based physical functioning Muscle strength Balance Gait speed | Significant improvements in observed functioning and balance in exercise group and mixed improvements in muscle strength across different muscle groups. No differences in gait speed. |
Daniel 2012 [30] USA | 23 | 1. Wiifit exercise 2. Seated exercise | Usual activity | 15 weeks 15 weeks | Self-reported functioning Physical activity Timed up and go | No statistical comparison between groups; within-group improvements in some aspects of the Senior Fitness test for both exercise groups (between group changes not assessed). Wii group increased physical activity. |
Germany | 69 | 1. Power training 2. Strength training | Usual activity | 12 weeks 12, 24 and 36 weeks | Performance-based physical functioning Self-reported functioning Muscle strength | Significant differences in SPPB score changes at 12 weeks between each exercise intervention and control, but effects not maintained at 24 or 36 weeks. No differences in muscle strength or self-reported functioning at 12, 24 or 36 weeks. |
Kwon 2015 [29] Japan | 89 | 1. Strength and balance training + nutrition 2. Strength and balance training alone | General health education sessions | 12 weeks 3 and 9 months | Gait speed Balance Muscle strength | No significant differences between any groups in the majority of observed functioning and quality of life domains. |
Brazil | 32 | Resistance exercise | Usual activity | 10 weeks 10 and 20 weeks | Gait speed Timed up and go Muscle strength | Significant improvements in observed function and muscle power in exercise group when both exercise phases (n = 32) compared to first control phase (n = 16), no differences between groups at the end of the first period. |
Upatising 2013 [32] USA | 87 | Telemonitoring | Usual care | 12 months 6 and 12 months | Frailty state | No statistical comparison for pre-frail group; slightly higher transitions to non-frail and frail in usual care. |
Description of included studies
Study reference | Duration | N (post-int) | Frequency and duration of sessions | Intervention content | Professional and setting | Adherence |
---|---|---|---|---|---|---|
12 weeks. All received 8 weeks Vitamin D supplementation prior to randomisation, stratified by baseline level. | 18 | 2 × 60 minute sessions per week |
Power training (PT): Walking, balance exercises and upper and lower body progressive explosive resistance training using a “Bodyspider” machine. | Trained instructors in an exercise room in a clinical setting. | Attendance: mean 68%, median (range) 88% (25–96) | |
20 | 2 × 60 minute sessions per week |
Strength training (ST):Walking, balance exercises and upper and lower progressive resistance training using a “Bodyspider” machine. | Trained instructors in an exercise room in a clinical setting. | Attendance: mean 80%, median (range) 92% (83–96) | ||
22 | n/a |
Control: maintain current activity and invited to 2 physical activity and nutrition lectures. | n/a | n/a | ||
Daniel 2012 [30] | 15 weeks | 7 | 3 × 45 minute exercise sessions per week |
Wii-fit: Nintendo Wii basic games (e.g. bowling, tennis and boxing) plus a weight vest carried out in small groups. | Study staff, location not reported. | 86% attendance |
7 | 3 × 45 minute exercise sessions per week |
Seated exercise: Progressive exercises to increase lower and upper body strength and flexibility, seated or using chairs for support, plus walking and stretching. | group led by certified fitness instructor at study site | 86% attendance | ||
5 | n/a |
Control: usual physical activity and exercise. | n/a | n/a | ||
9 months | 66 | 3 sessions per week (duration not reported) |
Exercise: 3 progressive 3mo phases of balance, flexibility, coordination, reaction speed and strength exercises. | Group exercise sessions supervised by 3 exercise physiology technicians at university indoor exercise facility. | 100% - Participants were required to undertake all sessions before progressing to the next stage. Intervention completed in 422 ± 85 days. | |
49 | 2–3 times per week, plus monthly exercise class to enhance adherence. |
Control: low-intensity flexibility exercise programme. | Unsupervised home programme | Home participants completed the programme in 250 ± 65 days. Compliance recorded on a calendar but not rigorously monitored. | ||
Kwon 2015 [29] | 12 weeks | 26 | 1 × 1 hour exercise plus 1 × 2–3 h cooking class per week |
Exercise training and nutrition: Exercise: group strength and balance training Nutrition: cooking class including food preparation, nutrition guidance, cooking instructions, cooking practice, eating together and tidying up, focussing on protein- and vitamin D-rich foods. | Exercise supervised by a health fitness trainer (+1 physician and 2 assistants) at research centre, with materials for home practice. Cooking class run by 4 dieticians. | Not reported |
25 | 1 × 1 hour per week |
Exercise training: group strength and balance training | Supervised by a health fitness trainer (+1 physician and 2 assistants) at research centre, with materials for home practice. | Not reported | ||
28 | Monthly |
Control: group general health education sessions (physical training for falls prevention and urinary incontinence, dietary guidance for healthy ageing) | Research centre, provided by health fitness trainer, physician and dietician. | n/a | ||
10 weeks per group | 16a
| 3 × 1 hour per week |
Exercise: Small group lower limb resistance exercises. | Supervised by a physiotherapist (setting not reported) | Not reported | |
16 |
n/a
| Control: continue normal activities of daily life without training |
n/a
| n/a | ||
Brown 2000 [27] | 3 months | 48 | 3 exercise sessions per week |
Exercise: 22 progressive flexibility, balance, body handling skills, speed of reaction, coordination and strength group exercises. | Outpatient rehabilitation fitness centre (professional not reported). | 100% - Participants required to complete all sessions prior to outcome assessment. |
39 | Home frequency not reported, monthly supervised session |
Control: home range of motion exercises, plus on-site exercise once a month. | Home (unsupervised). Supervising professional not reported. | “Self report by the participants and the significant improvements in range-of-motion values indicate that home exercises were done by subjects” (p.964) | ||
Upatising 2013 [32] | 12 months | 102 | n/a |
Telemonitoring: Equipment installed in participant’s home and blood pressure, pulse, oxygen saturation, blood glucose and weight measured as per an individualised protocol. | Data reviewed by healthcare team, with person or physician contact as needed | Not reported |
103 | n/a |
Usual care: face-to-face visits, phone services and home health care as needed. | Usual services | n/a |