The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis

Ian Ju Liang; Oliver J. Perkin; Polly M. McGuigan; Bruno Spellanzon; Molly Robb; Chien-Yu Liu; Linda L. Lin; Dylan Thompson; Max J. Western

doi:10.1186/s12877-024-05393-4

The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis

Ian Ju Liang, Oliver J. Perkin, Polly M. McGuigan, Bruno Spellanzon, Molly Robb, Chien-Yu Liu, Linda L. Lin, Dylan Thompson, Max J. Western (Lead / Corresponding author)

Population Health and Genomics

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Abstract

BACKGROUND: Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults.

METHODS: We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes.

RESULTS: Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups.

CONCLUSIONS: This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.

Original language	English
Article number	800
Number of pages	11
Journal	BMC Geriatrics
Volume	24
Early online date	1 Oct 2024
DOIs	https://doi.org/10.1186/s12877-024-05393-4
Publication status	E-pub ahead of print - 1 Oct 2024

Keywords

Humans
Aged
Lower Extremity/physiology
Exercise Therapy/methods
Randomized Controlled Trials as Topic/methods
Exercise/physiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Liang, I. J., Perkin, O. J., McGuigan, P. M., Spellanzon, B., Robb, M., Liu, C.-Y., Lin, L. L., Thompson, D., & Western, M. J. (2024). The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis. BMC Geriatrics, 24, Article 800. Advance online publication. https://doi.org/10.1186/s12877-024-05393-4

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abstract = "BACKGROUND: Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults.METHODS: We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes.RESULTS: Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups.CONCLUSIONS: This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.",

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author = "Liang, {Ian Ju} and Perkin, {Oliver J.} and McGuigan, {Polly M.} and Bruno Spellanzon and Molly Robb and Chien-Yu Liu and Lin, {Linda L.} and Dylan Thompson and Western, {Max J.}",

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doi = "10.1186/s12877-024-05393-4",

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Liang, IJ, Perkin, OJ, McGuigan, PM, Spellanzon, B, Robb, M, Liu, C-Y, Lin, LL, Thompson, D & Western, MJ 2024, 'The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis', BMC Geriatrics, vol. 24, 800. https://doi.org/10.1186/s12877-024-05393-4

TY - JOUR

T1 - The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures

T2 - a systematic review and meta-analysis

AU - Liang, Ian Ju

AU - Perkin, Oliver J.

AU - McGuigan, Polly M.

AU - Spellanzon, Bruno

AU - Robb, Molly

AU - Liu, Chien-Yu

AU - Lin, Linda L.

AU - Thompson, Dylan

AU - Western, Max J.

PY - 2024/10/1

Y1 - 2024/10/1

N2 - BACKGROUND: Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults.METHODS: We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes.RESULTS: Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups.CONCLUSIONS: This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.

AB - BACKGROUND: Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults.METHODS: We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes.RESULTS: Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups.CONCLUSIONS: This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.

KW - Humans

KW - Aged

KW - Lower Extremity/physiology

KW - Exercise Therapy/methods

KW - Randomized Controlled Trials as Topic/methods

KW - Exercise/physiology

U2 - 10.1186/s12877-024-05393-4

DO - 10.1186/s12877-024-05393-4

M3 - Article

C2 - 39354428

SN - 1471-2318

VL - 24

JO - BMC Geriatrics

JF - BMC Geriatrics

M1 - 800

ER -

The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis

Abstract

Keywords

UN SDGs

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