The effect of chair-based exercise on physical functioning in postmenopausal women: a meta-analysis

Following menopause, women commonly experience accelerated losses in muscular strength, flexibility, and balance, predisposing them to falls and osteoporotic fractures. Guidelines suggest that chair-based exercise (CBE) has shown the potential to prevent loss of physical functioning. Theoretically, it is a safe and effective alternative for postmenopausal women to exercise while seated. However, its efficacy in postmenopausal women has not been comprehensively quantified. This systematic review addresses this gap by focusing exclusively on postmenopausal women, synthesizing evidence on the effects of CBE on their physical functioning.

A search was conducted in CNKI, WanFang, PubMed, EMBASE, EBSCO, Web of Science, and Cochrane Library databases from inception to July 2024. All literature was screened for eligibility according to the inclusion and exclusion criteria. The Cochrane bias risk tool was used to assess the included literature's quality, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences or mean differences. The statistical heterogeneity between studies was tested using the I² index, and a fixed or random effect model was selected, respectively. Publication bias was examined using Egger's test. All analyses were performed using Stata 16.0 and Revman 5.4.

10 randomized controlled trials with 509 participants were finally included. Compared to the control group, the CBE group improved significantly in upper limb muscle endurance (SMD = 0.70, 95% CI [0.45, 0.95], P < 0.001), lower limb muscle endurance (SMD = 0.41, 95% CI [0.02, 0.79], P = 0.04), upper body flexibility (MD = 6.25, 95% CI [3.52, 8.98], P < 0.001), lower body flexibility (MD = 3.15, 95% CI [0.88, 5.42], P < 0.001), and dynamic balance (MD = -0.69, 95% CI [-1.32, -0.06], P = 0.03). However, there were no significant changes noted in activity of daily living, falls efficacy scales, handgrip strength, or static balance.

According to the meta-analysis results, CBE is associated with improvements in physical functioning parameters among postmenopausal women regarding muscle endurance, flexibility, and balance. The findings suggest that CBE is influential and should be promoted as simple and easily implemented activities for postmenopausal women to maintain and develop physical functioning.

The study was registered on the International Prospective Registry of Systematic Reviews--PROSPERO database (CRD42024587169).