Exercise therapy and self-management support for individuals with multimorbidity: a randomized and controlled trial

Area of Science:

• Gerontology
• Clinical Medicine
• Rehabilitation Science

Background:

• Multimorbidity presents a growing challenge with limited evidence for effective management strategies.
• Exercise therapy and self-management support are recognized as promising interventions for chronic conditions.

Purpose of the Study:

• To evaluate the effectiveness of a personalized exercise therapy and self-management support program compared to usual care alone in improving health-related quality of life (HRQoL) in adults with multimorbidity.

Main Methods:

• A pragmatic, multicenter, assessor-blinded randomized controlled trial (MOBILIZE) involving 228 adult patients with two or more long-term conditions.
• Participants were randomized to either a 12-week intervention (exercise therapy and self-management support) plus usual care, or usual care alone.
• The primary outcome was HRQoL assessed using the EQ-5D-5L at 12 months, with secondary outcomes including functional performance, physical activity, and patient-reported outcomes.

Main Results:

• The intervention group showed a statistically significant improvement in HRQoL compared to the usual care group (adjusted mean difference: 0.064 points; 95% CI: 0.014-0.115).
• Self-rated health also significantly improved in the intervention group (adjusted mean difference: 6.9 points; 95% CI: 1.8-12.1).
• No significant difference in serious adverse events was observed between the groups, indicating comparable safety profiles.

Conclusions:

• Personalized exercise therapy combined with self-management support is an effective strategy for improving HRQoL in adults with multimorbidity at 12 months.
• The intervention demonstrated a favorable safety profile, comparable to usual care.
• Further research is needed to clarify the clinical relevance of these findings.