In-hospital exercise interventions improve inpatients’ frailty and demonstrate promising implementation outcomes: A systematic review and meta-analysis

IF 15.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI:10.1016/j.arr.2025.102934

Madeline E. Shivgulam , Haoxuan Liu , Zainab Zafar , Muhammad Cheema , Shirko Ahmadi , Olga Theou , Myles W. O’Brien

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引用次数: 0

Abstract

Background

Frail, hospitalized patients are at a greater risk of further health issues. Frailty levels can worsen during hospitalization, with exercise being one of the best strategies to manage frailty. However, there is a lack of synthesized evidence to indicate whether exercise interventions are effective at managing frailty in this unique setting.

Objective

This systematic review and meta-analysis determined if exercise interventions either preserve or improve frailty levels among inpatients.

Methods

Sources were searched in May 2024 (updated August 2025) and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. Studies were included if they conducted an exercise intervention in middle-to-older adult (≥45-years) inpatients and assessed frailty as an outcome using any validated frailty assessment tool. The between-group effect size of change in frailty (Intervention vs. Control) was calculated as the standardized mean difference (SMD) using a random effects model.

Results

Five studies including n = 810 intervention (age: 82.9 [range: 79–87.6] years; 45 ± 1 % reported females) and 900 control (age: 82.0 [range: 76.0–87.1] years; 44 ± 1 % reported females) participants were included. Improvements in patients’ frailty were observed in n = 3/5 studies. The meta-analysis exhibited a favorable effect on frailty between the intervention and control groups (SMD: 0.716, 95 %CI: 0.119–1.312) with significant heterogeneity between studies (I²=92 %, p < 0.001). No differences were observed between interventions using distinct exercise types or frailty assessment tools (both, p > 0.196).

Conclusion

Despite limited available evidence, results indicate exercise training interventions may be effective in improving frailty. This supports the inclusion of exercise interventions beyond usual hospital care to improve frailty.

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住院运动干预改善住院病人虚弱和展示有希望的实施结果：系统回顾和荟萃分析。

背景：体弱的住院患者出现进一步健康问题的风险更大。在住院期间，虚弱程度可能会恶化，锻炼是控制虚弱的最佳策略之一。然而，缺乏综合证据表明，在这种独特的环境下，运动干预是否能有效地控制虚弱。目的：本系统综述和荟萃分析确定运动干预是否能保持或改善住院患者的虚弱水平。方法：检索于2024年5月（更新于2025年8月）的文献，包括Scopus、EMBASE、MEDLINE、CINAHL和Academic Search Premier。纳入对中老年住院患者（≥45岁）进行运动干预的研究，并使用任何经过验证的衰弱评估工具评估衰弱作为结果。采用随机效应模型计算虚弱变化（干预组与对照组）的组间效应量为标准化平均差（SMD）。结果：共纳入5项研究，其中干预组810例（年龄：82.3±3.5[范围：79-87.6]岁，女性45±1%），对照组900例（年龄：81.6±4.1[范围：76.0-87.1]岁，女性44±1%）。在n=3/5的研究中观察到患者虚弱的改善。meta分析显示，干预组和对照组对虚弱有良好的影响（SMD: 0.716, 95%CI: 0.119 ~ 1.312），研究间存在显著的异质性（I2=92%, p0.196）。结论：尽管现有证据有限，但结果表明运动训练干预可能有效改善虚弱。这支持在常规医院护理之外纳入运动干预以改善虚弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.