Do exercise interventions improve participation in life roles among older adults? A systematic review and meta-analysis

Marla K. Beauchamp, Annemarie Lee, Rachel Ward, Samantha Harrison, Paul A. Bain, Roger Goldstein, Dina Brooks, Jonathan F. Bean, Alan M. Jette

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    Background: The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence-base for interventions to improve participation remains inconclusive. In particular, it is unclear if exercise interventions improve participation in life roles.
    Purpose: The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles among community-dwelling older adults.
    Data sources: Pubmed, Embase, CINAHL, Cochrane and PEDro were searched from inception through March 2015.
    Study selection: Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults aged 60 and older were included in this review.
    Data extraction: Teams of two investigators independently extracted data on participation. Methodological quality was appraised using Cochrane’s tool for assessing risk of bias. The protocol was registered with PROSPERO, number CRD42014014880.
    Data synthesis: 18 randomized controlled trials with a total of 2,315 subjects met inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effect model. Meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD 0.03; 95%CI -0.10 to 0.16; p =0.63). Exercise interventions lasting 12 months or more had a small positive effect on participation (SMD 0.15; 95%CI 0.02 to 0.28; p=0.03).
    Limitations: Variability in definition and measures of participation.
    Conclusions: In general, exercise interventions do not improve participation in life roles among older adults. Our results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted.
    Original languageEnglish
    Pages (from-to)964-974
    JournalPhysical Therapy
    Issue number10
    Publication statusPublished - 3 Aug 2017

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