Article type
Year
Abstract
Background:Physical activity/exercise is increasingly being recommended and offered in various healthcare systems and for a variety of health conditions/outcomes.
Objectives:The objectives of this research was to: (i) find all the available evidence from Cochrane systematic reviews (CSRs) of the effectiveness of physical activity/ exercise for various health outcomes; (ii) evaluate the strength and quality of the existing evidence; and (iii) create recommendations for future researchers, patients, clinicians.
Methods:The Cochrane Handbook for Systematic Reviews of interventions and Preferred Reporting Items for Overviews of Reviews were adhered to while writing and reporting this overview. We included Cochrane systematic reviews of randomized controlled trials (RCTs) involving both healthy individuals and medically compromised patients of any age and gender. Only reviews assessing physical activity/exercise as a stand-alone intervention were included. Reviews evaluating any type of health-related outcome measures; and any types of controls were deemed eligible. Complex interventions assessing exercise or physical activity and diet, lifestyle/behavioural changes were excluded. The methodological quality of the CSRs was independently evaluated by two reviewers using the Amstar-II tool.
Results:Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2=26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES)= 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2=74.3%; PI -0.18, 0.53], MES=0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions.
Conclusions:There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns.
Patient or healthcare consumer involvement:None
Objectives:The objectives of this research was to: (i) find all the available evidence from Cochrane systematic reviews (CSRs) of the effectiveness of physical activity/ exercise for various health outcomes; (ii) evaluate the strength and quality of the existing evidence; and (iii) create recommendations for future researchers, patients, clinicians.
Methods:The Cochrane Handbook for Systematic Reviews of interventions and Preferred Reporting Items for Overviews of Reviews were adhered to while writing and reporting this overview. We included Cochrane systematic reviews of randomized controlled trials (RCTs) involving both healthy individuals and medically compromised patients of any age and gender. Only reviews assessing physical activity/exercise as a stand-alone intervention were included. Reviews evaluating any type of health-related outcome measures; and any types of controls were deemed eligible. Complex interventions assessing exercise or physical activity and diet, lifestyle/behavioural changes were excluded. The methodological quality of the CSRs was independently evaluated by two reviewers using the Amstar-II tool.
Results:Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2=26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES)= 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2=74.3%; PI -0.18, 0.53], MES=0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions.
Conclusions:There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns.
Patient or healthcare consumer involvement:None