Community-based, supervised, group exercise for people living with chronic conditions and multimorbidity: a cohort...

Exercise is a safe, effective intervention for improving health-related outcomes in people living with chronic conditions and multimorbidity. ExWell Medical is a community-based, medically designed group exercise programme for people living with chronic conditions in Ireland.

We aimed to evaluate the longitudinal association of ExWell with health-related outcomes and to explore the association of these outcomes with programme adherence.

We employed a prospective cohort study design. All participants attending an ExWell Medical induction in the Dublin/Kildare regions January-September 2023 were invited to participate. At baseline, 12 and 24 weeks we collected data on socio-demographics; health status, health behaviours; measures of physical function, patient-reported outcomes.

Of the 2219 patients referred to ExWell, 1364 attended an induction and 1289 agreed to participate, mean age 69 years (SD: 10.90 CI: 68.84-70.06), 60% female, living with a mean of 3.29 (SD: 2.17 CI: 3.17-3.40) chronic conditions. 725 (56%) completed assessments at the primary endpoint (24 weeks). There were significant improvements in body mass index, gait speed, a range of timed tests, health related quality of life, self-efficacy, stages of adopting exercise, a modest reduction in alcohol consumption, no significant change in smoking, an increase in physical activity but not sufficient to meet current guidelines, with programme adherence significantly associated with better outcomes. There were no improvements in grip strength, fear of falling, pain, smoking prevalence.

Participation in the ExWell programme was associated with significant improvements in some health-related outcomes in community-dwelling adults living with one or more chronic conditions.