Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Authors

  • Kathryn Barker Department of Chronic and Complex Care, Western Health, St Albans; Discipline of Physiotherapy, La Trobe University, Bundoora
  • Anne E. Holland Discipline of Physiotherapy, La Trobe University, Bundoora; Central Clinical School, Monash University, Melbourne; Alfred Health, Melbourne; Institute for Breathing and Sleep, Austin Health, Heidelberg
  • Elizabeth H. Skinner Alfred Health, Melbourne; Department of Physiotherapy, Monash University, Frankston; Department of Physiotherapy, The University of Melbourne, Parkville, Australia
  • Annemarie L. Lee Institute for Breathing and Sleep, Austin Health, Heidelberg; Department of Physiotherapy, Monash University, Frankston

DOI:

https://doi.org/10.2340/jrm.v55.2551

Keywords:

rehabilitation, exercise, multimorbidity, comorbidity, chronic disease

Abstract

Objective: To determine the effectiveness of exercise rehabilitation in people with multimorbidity. Exercise capacity was the primary outcome. Secondary outcomes were: health-related quality of life, activities of daily living, cardiometabolic outcomes, mental health outcomes, symptom scores, resource utilization, health behaviours, economic outcomes, and adverse events.
Data sources: A search was conducted in MEDLINE, CINHAL, EMBASE, and Cochrane Central Register of Controlled Trials databases. Study selection and extraction: Randomized and non-randomized controlled trials and cohort studies of exercise rehabilitation vs any comparison in people with multimorbidity.
Data synthesis: Forty-four reports (38 studies) were included. Rehabilitation ranged from 8 weeks to 4 years, with 1–7 sessions of rehabilitation weekly. Exercise included aerobic and resistance, limb training, aquatic exercises and tai chi. Compared with usual care, exercise rehabilitation improved 6-min walk distance (weighted mean difference (WMD) 64 m, 95% CI 45–82) and peak oxygen consumption (WMD 2.74 mL/kg/min, 95% CI –3.32 to 8.79). Effects on cardiometabolic outcomes and health-related quality of life also favoured rehabilitation; however; few data were available for other secondary outcomes.
Conclusion: In people with multimorbidity, exercise rehabilitation improved exercise capacity, health-related quality of life, and cardiometabolic outcomes.

LAY ABSTRACT
Chronic disease is a common health problem worldwide. It is increasingly common for people to have more than 1 chronic disease, which is called multimorbidity, and the interaction of their multiple health problems may worsen their health outcomes. Exercise rehabilitation is an effective and established treatment to improve health for people with different chronic diseases, such as heart and lung disease; however, the benefit of structured rehabilitation in people with multimorbidity has not been systematically reviewed. A literature search was performed to investigate the clinical outcomes following exercise rehabilitation in people with multimorbidity. Compared with usual medical care, the results showed that exercise rehabilitation improved exercise capacity, measured by walking distance in a formal test, health-related quality of life and the body’s ability to use oxygen, in people with multimorbidity. There were few data regarding the benefit of rehabilitation on other outcomes, and more well-designed robust trials are needed.

Downloads

Download data is not yet available.

References

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012; 380: 37-43. DOI: 10.1016/S0140-6736(12)60240-2

https://doi.org/10.1016/S0140-6736(12)60240-2 DOI: https://doi.org/10.1016/S0140-6736(12)60240-2

Smith SM, Wallace E, O'Dowd T, Fortin M. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database Syst Rev 2016; 3: CD006560. DOI: 10.1002/14651858.CD006560.pub4 DOI: https://doi.org/10.1002/14651858.CD006560.pub3

https://doi.org/10.1002/14651858.CD006560.pub4 DOI: https://doi.org/10.1002/14651858.CD006560.pub4

Nunes BP, Flores TR, Mielke GI, Thume E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr 2016; 67: 130-138. DOI: 10.1016/j.archger.2016.07.008

https://doi.org/10.1016/j.archger.2016.07.008 DOI: https://doi.org/10.1016/j.archger.2016.07.008

Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GAM. Causes and consequences of comorbidity: a review. J Clin Epidemiol 2001; 54: 661-674. DOI: 10.1016/s0895-4356(00)00363-2.

https://doi.org/10.1016/S0895-4356(00)00363-2 DOI: https://doi.org/10.1016/S0895-4356(00)00363-2

Caughey GE, Ramsay EN, Vitry AI, Gilbert AL, Luszcz MA, Ryan P, et al. Comorbid chronic diseases, discordant impact on mortality in older people: a 14-year longitudinal population study. J Epidemiol Comm Health 2010; 64: 1036-1342. DOI: 10.1136/jech.2009.088260

https://doi.org/10.1136/jech.2009.088260 DOI: https://doi.org/10.1136/jech.2009.088260

Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS. Descriptions of barriers to self-care by persons with comorbid chronic diseases. Ann Family Med 2003; 1: 15-21. DOI: 10.1370/afm.4

https://doi.org/10.1370/afm.4 DOI: https://doi.org/10.1370/afm.4

Fortin M, Hudon C, Dubois M-F, Almirall J, Lapointe L, Soubhi H. Comparative assessment of three different indices of multimorbidity for studies on health-related quality of life. Health Qual Life Outcomes 2005; 3: 1-7. DOI: 10.1186/1477-7525-3-74

https://doi.org/10.1186/1477-7525-3-74 DOI: https://doi.org/10.1186/1477-7525-3-74

Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430-439. DOI: 10.1016/j.arr.2011.03.003

https://doi.org/10.1016/j.arr.2011.03.003 DOI: https://doi.org/10.1016/j.arr.2011.03.003

Salisbury C. Multimorbidity: redesigning health care for people who use it. Lancet 2012; 380: 7-9. DOI: 10.1016/S0140-6736(12)60482-6

https://doi.org/10.1016/S0140-6736(12)60482-6 DOI: https://doi.org/10.1016/S0140-6736(12)60482-6

Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188: e13-e64. DOI: 10.1164/rccm.201309-1634ST

https://doi.org/10.1164/rccm.201309-1634ST DOI: https://doi.org/10.1164/rccm.201309-1634ST

World Health Organization (WHO). Rehabilitation in health systems. Geneva: World Health Organization; 2017. (accessed 5 May 2020) Available from: https://apps.who.int/iris/handle/10665/254506

Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, et al. Exercise as a prescription for patients with various diseases. J Sports Health Sci 2019; 8: 422-441. DOI 10.1016/j.jshs.2019.04.002

https://doi.org/10.1016/j.jshs.2019.04.002 DOI: https://doi.org/10.1016/j.jshs.2019.04.002

Dhalwani NN, O'Donovan G, Zaccardi F, Hamer M, Yates T, Davies M, et al. Long terms trends of multimorbidity and association with physical activity in older English population. Int J Behav Nutr Phys Act 2016; 13: 8. DOI: 10.1186/s12966-016-0330-9

https://doi.org/10.1186/s12966-016-0330-9 DOI: https://doi.org/10.1186/s12966-016-0330-9

Britt HC, Harrison CM, Miller GC, Knox SA. Prevalence and patterns of multimorbidity in Australia. Med J Aust 2008; 189: 72-77. DOI: 10.5694/j.1326-5377.2008.tb01919.x

https://doi.org/10.5694/j.1326-5377.2008.tb01919.x DOI: https://doi.org/10.5694/j.1326-5377.2008.tb01919.x

Tinetti ME, Fried TR, Boyd CM. Designing health care for the most common chronic condition-multimorbidity. JAMA 2012; 307: 2493-2494. DOI: 10.1001/jama.2012.5265

https://doi.org/10.1001/jama.2012.5265 DOI: https://doi.org/10.1001/jama.2012.5265

Lacasse Y, Goldstein RS, Lasserson T, Martin S. Pulmonary rehabilitation for chronic obstructive pulmonary disease (Review). Cochrane Database Syst Rev 2006: 4: CD003793. DOI: 10.1002/14651858.CD003793.pub2

https://doi.org/10.1002/14651858.CD003793.pub2 DOI: https://doi.org/10.1002/14651858.CD003793.pub2

Oldridge N. Exercise-based cardiac rehabilitation in patients with coronary heart disease: meta-analysis outcomes revisited. Future Cardiol 2012; 8: 729-751. DOI: 10.2217/fca.12.34

https://doi.org/10.2217/fca.12.34 DOI: https://doi.org/10.2217/fca.12.34

Piepoli MF, Davos C, Francis DP, Coats AJS, ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004; 328: 189. DOI: 10.1136/bmj.37938.645220.EE

https://doi.org/10.1136/bmj.37938.645220.EE DOI: https://doi.org/10.1136/bmj.37938.645220.EE

Davies E, Moxham T, Rees K, Singh S, Coats AJ, Ebrahim S, et al. Exercise based rehabilitation for heart failure (Review). Cochrane Database Syst Rev 2010; 4: CD003331. DOI: 10.1002/14651858.CD003331.pub3

https://doi.org/10.1002/14651858.CD003331.pub3 DOI: https://doi.org/10.1002/14651858.CD003331.pub3

Multimorbidity: assessment, prioritisation and management of care for people with commonly occurring multimorbidity. National Institute for Health Care Excellence; 2016. (accessed 5 May 2020) Available from: https://www.ncbi.nlm.nih.gov/books/NBK385543/

Holland AE, Harrison SL, Brooks D. Multimorbidity, frailty and chronic obstructive pulmonary disease: are the challenges for pulmonary rehabilitation in the name? Chron Respir Dis 2016; 13: 372-382. DOI: 10.1177/1479972316670104

https://doi.org/10.1177/1479972316670104 DOI: https://doi.org/10.1177/1479972316670104

Moher D, Liberati A, Tetzlaff J, Altman DG,PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med 2009; 6: e1000097. DOI: 10.1371/journal.pmed.1000097

https://doi.org/10.1371/journal.pmed.1000097 DOI: https://doi.org/10.1371/journal.pmed.1000097

Innovative care for chronic conditions: building blocks for action: global report. Geneva: World Health Organization; 2002. (accessed 29 January 2019) Available from: https://apps.who.int/iris/handle/10665/42500

McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2015; 2: CD003793. DOI: 10.1002/14651858.CD003793.pub3

https://doi.org/10.1002/14651858.CD003793.pub3 DOI: https://doi.org/10.1002/14651858.CD003793.pub3

Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2016; 1: CD001800. DOI: 10.1002/14651858.CD001800.pub3

https://doi.org/10.1002/14651858.CD001800.pub3 DOI: https://doi.org/10.1002/14651858.CD001800.pub3

Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on exercise reporting template (CERT): explanation and elaboration statement. Br J Sports Med 2016; 50: 1428-1437. DOI: 10.1136/bjsports-2016-096651

https://doi.org/10.1136/bjsports-2016-096651 DOI: https://doi.org/10.1136/bjsports-2016-096651

Rohatgi A. WebPlotDigitizer San Francisco, California, USA2019 [4.2:]. Pacifica, California, USA. Available from: https://automeris.io/WebPlotDigitizer

Joanna Briggs Institute Reviewer's Manual: The Joanna Briggs Institute; 2017. (accessed 7 January 2019) Available from: https://reviewersmanual.joannabriggs.org/

Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 The Cochrane Collaboration; 2011 [updated March 2011. (accessed 28 February 2019) Available from: http://handbook.cochrane.org

Social Science Statistics [Available from: https://www.socscistatistics.com/effectsize/default3.aspx (accessed 4 March 2019)

Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989; 27: S178-S189. DOI: 10.1097/00005650-198903001-00015

https://doi.org/10.1097/00005650-198903001-00015 DOI: https://doi.org/10.1097/00005650-198903001-00015

Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 2012; 10: 142-151. DOI: 10.1370/afm.1337

https://doi.org/10.1370/afm.1337 DOI: https://doi.org/10.1370/afm.1337

Harrison C, Britt H, Miller G, Henderson J. Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open 2014; 4: e004694. DOI: 10.1136/bmjopen-2013-004694

https://doi.org/10.1136/bmjopen-2013-004694 DOI: https://doi.org/10.1136/bmjopen-2013-004694

Banks AZ, Mentz R, Stebbins A, Mikus C, Schulte P, Fleg J, et al. Response to exercise training and outcomes in heart failure patients with diabetes mellitus: Insights from HF-action. J Am Coll Cardiol 2015; 65: A1034 DOI: 10.1016/j.cardfail.2015.12.007 DOI: https://doi.org/10.1016/S0735-1097(15)61034-8

https://doi.org/10.1016/j.cardfail.2015.12.007 DOI: https://doi.org/10.1016/j.cardfail.2015.12.007

Castro C, Gonzalez N, Oliveira M. Changing diabetic dialysis patients physical functioning with exercise training. Nephrol Dial Transplant 2015; 3: iii527-iii528.

https://doi.org/10.1093/ndt/gfv194.14 DOI: https://doi.org/10.1093/ndt/gfv194.14

Collins T, Lunos S. Home-based walking therapy improves walking ability and quality of life in persons with diabetes mellitus and peripheral arterial disease. Vasc Med 2010; 15: 155.

https://doi.org/10.1177/1358863X10362604 DOI: https://doi.org/10.1177/1358863X10362604

Collins T, Lunos S, Hodges J. Effects of a walking intervention on systemic inflammation in persons with diabetes mellitus and peripheral arterial disease. J Gen Internal Med 2011; 1: S174-S175.

Johnson ST, Mundt C, Boule N, Bell G, Vallance J, Taylor L, et al. Improved functional status following the aquatic physical exercise for arthritis and diabetes (APEXD) study. Can J Diabet 2014; 5: S63.

https://doi.org/10.1016/j.jcjd.2014.07.176 DOI: https://doi.org/10.1016/j.jcjd.2014.07.176

Kurian R, Gobejishvili L, Barve S, Mokshagundam SP. Effect of resistance training on cytokine responses in elderly subjects with peripheral neuropathy-effect of gender. Proceedings of the 70th Scientific Sessions of the American Diabetes Association. 2010 June 25-29; Orlando, USA.

Martin B, Hauer T, Austford LD, Arena R, Stone JA, Aggarwal S. Cardiac rehabilitation in subjects with peripheral arterial disease: a higher risk patient population who benefit from attendance. Can J Cardiol 2016; 134: A18122.

https://doi.org/10.1016/j.cjca.2016.07.160 DOI: https://doi.org/10.1016/j.cjca.2016.07.160

Mundra V, Henquinet S, Moudry G. Outcomes of cardiac rehabilitation in obese patients. Cardiol 2013; 2: 482.

Srinivasan S, Reagan LP, Hardin JW, Matthews M, Leaphart E, Grillo CA, et al. Adjunctive tai chi in geriatric depression with comorbid arthritis: a randomized, controlled trial. Am J Geriatr Psych 2014; 1: S135-S136. DOI: 10.1016/j.jagp.2013.12.158

https://doi.org/10.1016/j.jagp.2013.12.158 DOI: https://doi.org/10.1016/j.jagp.2013.12.158

Zwerink M, Van Der Meer S, Van Der Valk P, Van Der Palen J. Safety, feasibility and effectiveness of a community-based physiotherapy exercise program for patients with both copd and chronic heart failure a pilot study. Am J Respir Crit Care Med 2010; 181: A3452. DOI 10.1164/ajrccm-conference.2010.181.1.

https://doi.org/10.1164/ajrccm-conference.2010.181.1_MeetingAbstracts.A3452 DOI: https://doi.org/10.1164/ajrccm-conference.2010.181.1_MeetingAbstracts.A3452

Abd El-Kader MS, Al-Jiffri O, Ashmawy EM. Impact of weight loss on markers of systemic inflammation in obese Saudi children with asthma. Afr Health Sci 2013; 13: 682-688. DOI: 10.4314/ahs.v13i3.23

https://doi.org/10.4314/ahs.v13i3.23 DOI: https://doi.org/10.4314/ahs.v13i3.23

Ambrosy AP, Mulder H, Coles A, Krauss WE, Lam CSP, McCullough PA, et al. Renal function and exercise training in ambulatory heart failure patients with a reduced ejection fraction. Am J Cardiol 2018; 122: 999-1007. DOI: 10.1016/j.amjcard.2018.06.011

https://doi.org/10.1016/j.amjcard.2018.06.011 DOI: https://doi.org/10.1016/j.amjcard.2018.06.011

Beaudoin N, Bouvet GF, Coriati A, Rabasa-Lhoret R, Berthiaume Y. Combined exercise training improves glycemic control in adult with cystic fibrosis. Med Sci Sports Exerc 2017; 49: 231-237. DOI: 10.1249/MSS.0000000000001104

https://doi.org/10.1249/MSS.0000000000001104 DOI: https://doi.org/10.1249/MSS.0000000000001104

Bernocchi P, Vitacca M, La Rovere MT, Volterrani M, Galli T, Baratti D, et al. Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial. Age Ageing 2018; 47: 82-88. DOI: 10.1093/ageing/afx146

https://doi.org/10.1093/ageing/afx146 DOI: https://doi.org/10.1093/ageing/afx146

Byrkjeland R, Njerve IU, Anderssen S, Arnesen H, Seljeflot I, Solheim S. Effects of exercise training on HbA1c and VO2peak in patients with type 2 diabetes and coronary artery disease: a randomised clinical trial. Diab Vasc Dis Res 2015; 12: 325-333. DOI: 10.1177/1479164115590552

https://doi.org/10.1177/1479164115590552 DOI: https://doi.org/10.1177/1479164115590552

Jones WS, Clare R, Ellis SJ, Mills JS, Fischman DL, Kraus WE, et al. Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION). Am J Cardiol 2011; 108: 380-384. DOI: 10.1016/j.amjcard.2011.03.057

https://doi.org/10.1016/j.amjcard.2011.03.057 DOI: https://doi.org/10.1016/j.amjcard.2011.03.057

McNamara RJ, McKeough ZJ, McKenzie DK, Alison JA. Water-based exercise in COPD with physical comorbidities: a randomised controlled trial. Eur Respir J 2013; 41: 1284-1291. DOI: 10.1183/09031936.00034312

https://doi.org/10.1183/09031936.00034312 DOI: https://doi.org/10.1183/09031936.00034312

Mentz RJ, Schulte PJ, Fleg JL, Fiuzat M, Kraus WE, Pina IL, et al. Clinical characteristics, response to exercise training, and outcomes in patients with heart failure and chronic obstructive pulmonary disease: findings from Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing (HF-ACTION). Am Heart J 2013; 165: 193-199. DOI: 10.1016/j.ahj.2012.10.029

https://doi.org/10.1016/j.ahj.2012.10.029 DOI: https://doi.org/10.1016/j.ahj.2012.10.029

Servantes DM, Pelcerman A, Salvetti XM, Salles AF, de Albuquerque PF, de Salles FC, et al. Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes. Clin Rehabil 2012; 26: 45-57. DOI: 10.1177/0269215511403941

https://doi.org/10.1177/0269215511403941 DOI: https://doi.org/10.1177/0269215511403941

Sridhar B, Haleagrahara N, Bhat R, Kulur AB, Avabratha S, Adhikary P. Increase in the heart rate variability with deep breathing in diabetic patients after 12-month exercise training. Tohoku J Exp Med 2010; 220: 107-113. DOI: 10.1620/tjem.220.107

https://doi.org/10.1620/tjem.220.107 DOI: https://doi.org/10.1620/tjem.220.107

Abdelbasset WK, Alqahtani BA, Alrawaili SM, Ahmed AS, Elnegamy TE, Ibrahim AA, Soliman GS. Similar effects of low to moderate-intensity exercise program vs moderate-intensity continuous exercise program on depressive disorder in heart failure patients. Medicine 2019; 98: e16820. DOI: 10.1097/MD.0000000000016820

https://doi.org/10.1097/MD.0000000000016820 DOI: https://doi.org/10.1097/MD.0000000000016820

Chiang S-L, Shen C-L, Chen L-C, Lo Y-P, Lin C-H, Lin C-H. Effectiveness of a home-based telehealth exercise training program for patients with cardiometabolic multimorbidity. J Cardiovasc Nurs 2020; 35: 491-501. DOI: 10.1097/JCN.0000000000000693

https://doi.org/10.1097/JCN.0000000000000693 DOI: https://doi.org/10.1097/JCN.0000000000000693

Hsu Y-I, Chen Y-C, Lee C-L, Chang N-J. Effects of diet control and telemedicine-based resistance exercise intervention on patients with obesity and knee osteoarthritis: a randomised control trial. Int J Environ Res Public Health 2021; 18: 7744. DOI: 10.3390/ijerph18157744

https://doi.org/10.3390/ijerph18157744 DOI: https://doi.org/10.3390/ijerph18157744

Lo Y-P, Chiang S-L, Lin C-H, Liu H-C, Chiang L-C. Effects of individualised aerobic exercise training on physical activity and health-related physical fitness among middle-aged and older adults with multimorbidity: a randomised controlled trial. Int J Environ Res Public Health 2021; 18: 101. DOI: 10.3390/ijerph18010101

https://doi.org/10.3390/ijerph18010101 DOI: https://doi.org/10.3390/ijerph18010101

Al-Jiffri O, Al-Sharif FM, Abd El-Kader SM, Ashmawy EM. Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver. Afr Health Sci 2013; 13: 667-672. DOI: 10.4314/ahs.v13i3.21

https://doi.org/10.4314/ahs.v13i3.21 DOI: https://doi.org/10.4314/ahs.v13i3.21

Freitas PD, Ferreira PG, Silva AG, Stelmach R, Carvalho-Pinto RM, Fernandes FL, et al. The role of exercise in a weight-loss program on clinical control in obese adults with asthma. A randomized controlled trial. Am J Respir Crit Care Med 2017; 195: 32-42. DOI: 10.1164/rccm.201603-0446OC

https://doi.org/10.1164/rccm.201603-0446OC DOI: https://doi.org/10.1164/rccm.201603-0446OC

Freitas PD, Silva AG, Ferreira PG, Carvalho CRF, Da Silva A, Salge JM, et al. Exercise improves physical activity and comorbidities in obese adults with asthma. Med Sci Sports Exerc 2018; 50: 1367-1376. DOI: 10.1249/MSS.0000000000001574

https://doi.org/10.1249/MSS.0000000000001574 DOI: https://doi.org/10.1249/MSS.0000000000001574

Halvari H, Healey J, Olafsen AH, Byrkjeland R, Deci EL, Williams GC. Physical activity and motivational predictors of changes in health behavior and health among DM2 and CAD patients. Scand J Med Sci Sports 2017; 27: 1454-1469. DOI: 10.1111/sms.12757

https://doi.org/10.1111/sms.12757 DOI: https://doi.org/10.1111/sms.12757

Barnes M, Goldsworthy UR, Cary BA, Hill CJ. A diet and exercise program to improve clinical outcomes in patients with obstructive sleep apnea - a feasibility study. J Clin Sleep Med 2009; 5: 409-415.

https://doi.org/10.5664/jcsm.27594 DOI: https://doi.org/10.5664/jcsm.27594

Crisafulli E, Gorgone P, Vagaggini B, Pagani M, Rossi G, Costa F, et al. Efficacy of standard rehabilitation in COPD outpatients with comorbidities. Eur Respir J 2010; 36: 1042-1048. DOI: 10.1183/09031936.00203809

https://doi.org/10.1183/09031936.00203809 DOI: https://doi.org/10.1183/09031936.00203809

de Groot M, Doyle T, Kushnick M, Shubrook J, Merrill J, Rabideau E, et al. Can lifestyle interventions do more than reduce diabetes risk? Treating depression in adults with type 2 diabetes with exercise and cognitive behavioral therapy. Cur Diab Rep 2012; 12: 157-166. DOI: 10.1007/s11892-012-0261-z

https://doi.org/10.1007/s11892-012-0261-z DOI: https://doi.org/10.1007/s11892-012-0261-z

Hassan M, Mourad S, Abdel Wahab NH, Daabis R, Younis G. Effect of comorbidities on response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Egyp J Chest Dis Tuberc 2016; 65: 63-69. DOI: 10.1016/j.ejcdt.2015.11.006

https://doi.org/10.1016/j.ejcdt.2015.11.006 DOI: https://doi.org/10.1016/j.ejcdt.2015.11.006

Khadanga S, Savage PD, Ades PA. Insulin resistance and diabetes mellitus in contemporary cardiac rehabilitation. J Cardiopul Rehabil Prev 2016; 36: 331-338. DOI: 10.1097/HCR.0000000000000187

https://doi.org/10.1097/HCR.0000000000000187 DOI: https://doi.org/10.1097/HCR.0000000000000187

Listerman J, Bittner V, Sanderson BK, Brown TM. Cardiac rehabilitation outcomes: impact of comorbidities and age. J Cardiopul Rehabil Prev 2011; 31: 342-348. DOI: 10.1097/HCR.0b013e31822f189c

https://doi.org/10.1097/HCR.0b013e31822f189c DOI: https://doi.org/10.1097/HCR.0b013e31822f189c

Mesquita R, Vanfleteren LE, Franssen FM, Sarv J, Taib Z, Groenen MT, et al. Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes. Eur Respir J 2015; 46: 545-548. DOI: 10.1183/09031936.00026215

https://doi.org/10.1183/09031936.00026215 DOI: https://doi.org/10.1183/09031936.00026215

Naz I, Sahin H, Varol Y, Komurcuoglu B. The effect of comorbidity severity on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients. Chron Respir Dis 2019; 16: 1479972318809472. DOI: 10.1177/1479972318809472

https://doi.org/10.1177/1479972318809472 DOI: https://doi.org/10.1177/1479972318809472

Nonoyama ML, Marzolini S, Brooks D, Oh P. Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: a retrospective review. Can J Respir Ther 2016; 52: 43-49.

Soleimani A, Nejatian M, Hajizaynali MA, Abbasi SH, Alidoosti M, Sheikhfathollahi M, et al. Effect of gender and type 2 diabetes mellitus on heart rate recovery in patients with coronary artery disease after cardiac rehabilitation. Endokrynol Pol 2009; 60: 430-436.

Takaya Y, Kumasaka R, Arakawa T, Ohara T, Nakanishi M, Noguchi T, et al. Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction. Circ J 2014; 78: 377-384. DOI: 10.1253/circj.cj-13-0779

https://doi.org/10.1253/circj.CJ-13-0779 DOI: https://doi.org/10.1253/circj.CJ-13-0779

Tunsupon P, Lal A, Khamis MA, Mador MJ. Comorbidities in patients with chronic obstructive pulmonary disease and pulmonary rehabilitation outcomes. J Cardiopul Rehabil Prev 2017; 37: 283-289. DOI: 10.1097/HCR.0000000000000236

https://doi.org/10.1097/HCR.0000000000000236 DOI: https://doi.org/10.1097/HCR.0000000000000236

Tunsupon P, Mador MJ. The influence of body composition on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients. Lung 2017; 195: 729-738. DOI: 10.1007/s00408-017-0053-y

https://doi.org/10.1007/s00408-017-0053-y DOI: https://doi.org/10.1007/s00408-017-0053-y

Verges B, Patois-Verges B, Cohen M, Lucas B, Galland-Jos C, Casillas JM. Effects of cardiac rehabilitation on exercise capacity in type 2 diabetic patients with coronary artery disease. Diabet Med 2004; 21: 889-895. DOI: 10.1111/j.1464-5491.2004.01262.x

https://doi.org/10.1111/j.1464-5491.2004.01262.x DOI: https://doi.org/10.1111/j.1464-5491.2004.01262.x

Wang JS, Fu TC, Lien HY, Wang CH, Hsu CC, Wu WC, et al. Effect of aerobic interval training on erythrocyte rheological and hemodynamic functions in heart failure patients with anemia. Int J Cardiol 2013; 168: 1243-1250. DOI: 10.1016/j.ijcard.2012.11.053

https://doi.org/10.1016/j.ijcard.2012.11.053 DOI: https://doi.org/10.1016/j.ijcard.2012.11.053

Woodard CM, Berry MJ, Rejeski WJ, Ribisl PM, Miller HS. Exercise training in patients with cardiovascular disease and coexistent knee arthritis. J Cardiopul Rehabil 1994; 14: 255-261.

https://doi.org/10.1097/00008483-199407000-00008 DOI: https://doi.org/10.1097/00008483-199407000-00008

Butler SJ, Li LSK, Ellerton L, Gershon AS, Goldstein RS, Brooks D. Prevalence of comorbidities and impact on pulmonary rehabilitation outcomes. ERJ Open Res 2019; 5: 4. DOI: 10.1183/23120541.00264-2019

https://doi.org/10.1183/23120541.00264-2019 DOI: https://doi.org/10.1183/23120541.00264-2019

Maniar S, Sanderson BK, Bittner V. Comparison of baseline characteristics and outcomes in younger and older patients completing cardiac rehabilitation. J Cardiopul Rehabil Prev 2009; 29: 220-229. DOI: 10.1097/HCR.0b013e3181ac7870

https://doi.org/10.1097/HCR.0b013e3181ac7870 DOI: https://doi.org/10.1097/HCR.0b013e3181ac7870

Campbell KL, Foster-Schubert K, Xiao L, Cadmus Bertram LA, Duggan C, Irwin M, et al. Injuries in sedentary individuals enrolled in a 12 month, randomized, controlled, exercise trial. J Phys Act Health 2012; 9: 198-207. DOI: 10.1123/jpah.9.2.198

https://doi.org/10.1123/jpah.9.2.198 DOI: https://doi.org/10.1123/jpah.9.2.198

Little RM, Paterson DH, Humphreys DA, Stathokostas L. A 12-month incidence of exercise-related injuries in previously sedentary community-dwelling older adults following an exercise intervention. BMJ Open 2013; 3:6. DOI: 10.1136/bmjopen-2013-002831

https://doi.org/10.1136/bmjopen-2013-002831 DOI: https://doi.org/10.1136/bmjopen-2013-002831

Dekker J, Buurman BM, van der Leeden M. Exercise in people with comorbidity or multimorbidity. Health Psychol 2019; 38: 822-830. DOI: 10.1037/hea0000750

https://doi.org/10.1037/hea0000750 DOI: https://doi.org/10.1037/hea0000750

van der Leeden M, Stuiver MM, Huijsmans R, Geleijn E, de Rooij M, Dekker J. Structured clinical reasoning for exercise prescription in patients with comorbidity. Disabil Rehabil 2020; 42: 1474-1479. DOI: 10.1080/09638288.2018.1527953

https://doi.org/10.1080/09638288.2018.1527953 DOI: https://doi.org/10.1080/09638288.2018.1527953

Turner-Warwick MEH, Pentecost BL, Jones JH, Bannister SR, Chambers TL, Clayton RN, et al. Medical aspects of exercise. Benefits and risks. Summary of a report of the Royal College of Physicians. J R Coll Physicians Lond 1991; 25: 193-196.

Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 2006; 16: 3-63. DOI: 10.1111/sms.12581 DOI: https://doi.org/10.1111/j.1600-0838.2006.00520.x

https://doi.org/10.1111/sms.12581 DOI: https://doi.org/10.1111/sms.12581

Kujala UM. Evidence for exercise therapy in the treatment of chronic disease based on at least three randomized controlled trials - summary of published systematic reviews. Scand J Med Sci Sports 2004; 14: 339-345. DOI: 10.1111/j.1600-0838.2004.413.x

https://doi.org/10.1111/j.1600-0838.2004.413.x DOI: https://doi.org/10.1111/j.1600-0838.2004.413.x

Wu T, Gao X, Chen M, van Dam RM. Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev 2009; 10: 313-323. DOI: 10.1111/j.1467-789X.2008.00547.x

https://doi.org/10.1111/j.1467-789X.2008.00547.x DOI: https://doi.org/10.1111/j.1467-789X.2008.00547.x

Smith SM, Wallace E, Salisbury C, Sasseville M, Bayliss E, Fortin M. A core outcome set for multimorbidity research (COSmm). Ann Fam Med 2018; 16: 132-138. DOI: 10.1370/afm.2178

https://doi.org/10.1370/afm.2178 DOI: https://doi.org/10.1370/afm.2178

Carlesso LC, Skou ST, Tang LH, Simony C, Brooks D. Multimorbidity: making the case for an end to disease-specific rehabilitation. Physiother Can 2020; 72: 1-3. DOI: 10.3138/ptc-72-1-gee

https://doi.org/10.3138/ptc-72-1-gee DOI: https://doi.org/10.3138/ptc-72-1-gee

Leijten FRM, Hoedemakers M, Struckmann V, Kraus M, Cheraghi-Sohi S, Zemplenyi A, et al. Defining good health and care from the perspective of persons with multimorbidity: results from a qualitative study of focus groups in eight European countries. BMJ Open 2018; 8: e021072. DOI: 10.1136/bmjopen-2017-021072

https://doi.org/10.1136/bmjopen-2017-021072 DOI: https://doi.org/10.1136/bmjopen-2017-021072

Additional Files

Published

2023-03-06

How to Cite

Barker, K., Holland, A. E., Skinner, E. H., & Lee, A. L. (2023). Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review. Journal of Rehabilitation Medicine, 55, jrm00377. https://doi.org/10.2340/jrm.v55.2551

Issue

Section

Original Report

Categories