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Community-based exercise programs as a strategy to optimize function in chronic disease: a systematic review.

Laura Desveaux1, Marla Beauchamp, Roger Goldstein

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Community-based exercise (CBE) programs show similar structures across chronic diseases. While effective for osteoarthritis, their broader impact on functional capacity and quality of life needs further study.

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Area of Science:

  • Exercise Science
  • Public Health
  • Rehabilitation Medicine

Background:

  • Chronic diseases represent a significant global health burden, leading to death and disability.
  • Preliminary evidence suggests community-based exercise (CBE) can enhance functional capacity (FC) and health-related quality of life (HRQL).

Purpose of the Study:

  • To delineate the structural components and delivery methods of CBE programs for diverse chronic disease populations.
  • To compare the efficacy of CBE interventions against standard care in improving FC and HRQL.

Main Methods:

  • A systematic review and meta-analysis of randomized trials involving individuals with stroke, COPD, osteoarthritis, diabetes, and cardiovascular disease.
  • Quality assessment using the Cochrane risk of bias tool and meta-analyses performed using Review Manager 5.1.
  • Protocol registered on PROSPERO (CRD42012002786).

Main Results:

  • Sixteen studies (2198 participants, mean age 66.8 years) described comparable CBE program structures across diseases, primarily using aerobic and resistance training (85%).
  • Meta-analysis of nine studies indicated significant improvements in FC (6-minute walk test: 41.7 m; standardized mean difference: 0.18).
  • Significant improvements were observed in the physical component of HRQL (standardized mean difference: 0.21) and total HRQL score (standardized mean difference: 0.38).

Conclusions:

  • CBE programs exhibit consistent structures across various chronic disease populations.
  • These programs demonstrate superiority over standard care for improving FC and HRQL in osteoarthritis patients.
  • Further research is needed to establish the effectiveness of CBE in other chronic disease populations and assess long-term program sustainability.