Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review.
Kathryn Barker, Anne E Holland, Elizabeth H Skinner and 1 others
PMID 36876460WHAT IT FOUND
Exercise rehabilitation improved walking distance and quality of life in people with two or more chronic conditions.
It did not consistently improve peak oxygen consumption or blood sugar control. Most trials lacked blinding, and the specific mix of exercise types varied widely across studies.
Key findings
01Compared with usual care, exercise rehabilitation significantly increased 6-minute walk distance by a weighted mean difference of 64 meters.
02Meta-analysis showed no significant improvement in peak oxygen consumption compared with usual care, with high heterogeneity between studies.
03Most included studies did not blind participants or therapists, and assessor blinding was unclear in a majority of randomized trials.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
High risk of bias in many included studies, with most failing to blind participants or therapists. Significant clinical and methodological heterogeneity across studies, limiting the ability to draw firm conclusions about specific exercise types or durations. Few studies reported adverse events, making it difficult to assess safety comprehensively. The review excluded non-English studies and single-joint rehabilitation programs, which may have omitted relevant data. Most participants were adults; findings may not apply to pediatric populations.
Declared interests
The authors declared no conflicts of interest. The study was not funded by a commercial sponsor.
The easy way to misread this
Do not assume that exercise rehabilitation will improve peak oxygen consumption or blood sugar control in all patients with multimorbidity, as these outcomes showed inconsistent or null results in the meta-analyses. The evidence for improved walking distance is stronger, but the lack of blinding in most trials may inflate the perceived benefits of subjective outcomes like quality of life.