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      The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis

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          Abstract

          Background

          Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults.

          Methods

          We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises’ effects on physical function in older adults through English and Mandarin databases. Studies’ methodological quality was assessed using the Cochrane’s Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes.

          Results

          Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10–40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand ( p = 0.05; I 2 = 0%), maximal knee extension strength ( p = 0.61; I 2 = 71%), 10 m maximal walking speed ( p = 0.22; I 2 = 30%), timed-up-to-go ( p = 0.54; I 2 = 0%), and short physical performance battery ( p = 0.32; I 2 = 98%) between exercise and control groups.

          Conclusions

          This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12877-024-05393-4.

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                Author and article information

                Contributors
                m.j.western@bath.ac.uk
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                1 October 2024
                1 October 2024
                2024
                : 24
                : 800
                Affiliations
                [1 ]Department for Health, University of Bath, ( https://ror.org/002h8g185) 1 West 5.108, Bath, BA2 7AY UK
                [2 ]Centre for Nutrition, Exercise and Metabolism, University of Bath, ( https://ror.org/002h8g185) Bath, UK
                [3 ]Department of Physical Education and Sport Sciences, National Taiwan Normal University, ( https://ror.org/059dkdx38) Taipei, Taiwan
                [4 ]Graduate Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, ( https://ror.org/01b8kcc49) Tainan, Taiwan
                [5 ]Centre for Motivation and Health Behaviour Change, University of Bath, ( https://ror.org/002h8g185) Bath, UK
                Article
                5393
                10.1186/s12877-024-05393-4
                11443890
                39354428
                2eeda2e6-6739-42ef-8ce6-e87f0876e0eb
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 5 June 2024
                : 18 September 2024
                Categories
                Systematic Review
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Geriatric medicine
                unsupervised exercise intervention,home-based activities,lower extremity physical performance,ageing population,independent living

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