Gallardo-Gomez, Daniel , del Pozo-Cruz, Jesus , Pedder, Hugo , Alfonso-Rosa, Rosa M. , Alvarez-Barbosa, Francisco , Noetel, Michael , Jasper, Unyime , Chastin, Sebastien , RAMOS MUNELL, JAVIER, Cruz, Borja del Pozo
No
Br. J. Sports Med.
Review
Científica
11.6
4.691
01/10/2023
001042180900001
Objective To identify the optimal dose and type of physical activity to improve functional capacity and reduce adverse events in acutely hospitalised older adults. Design Systematic review and Bayesian model-based network meta-analysis. Data sources Four databases were searched from inception to 20 June 2022. Eligibility criteria for selecting studies Randomised controlled trials that assessed the effectiveness of a physical activity-based intervention on at least one functional outcome in people aged >= 50 years hospitalised due to an acute medical condition were included. Pooled effect estimates (ie, standardised mean differences for functional capacity and the ratio of means for adverse events) were calculated using random treatment effects network meta-analysis models. Results Nineteen studies (3842 participants) met the inclusion criteria. Approximately 100 Metabolic Equivalents of Task per day (METs-min/day) (similar to 40 min/ day of light effort or similar to 25 min/day of moderate effort activities) was the minimal dose to improve the functional capacity of acute hospitalised older adults (standardised mean difference (SMD)=0.28, 95% credible interval (CrI) 0.01 to 0.55). The optimal dose was estimated at 159 METs-min/ day (similar to 70 min/day of light effort or similar to 40 min/day of moderate effort activities; SMD=0.41, 95% CrI 0.08 to 0.72). Ambulation was deemed the most efficient intervention, and the optimal dose was reached at 143 METs-min/ day (similar to 50 min/day of slow-paced walking; SMD=0.76, 95% CrI 0.35 to 1.16), showing a high evidential power (87.68%). The minimal effective ambulation dose was estimated at 74 METs-min/ day (similar to 25 min/day of slow-paced walking; SMD=0.25, 95% CrI 0.01 to 0.41). Physical activity interventions resulted in a decrease in the rate of adverse events compared with usual care at discharge (ratio of means=0.96, 95% CrI 0.95 to 0.97; median time 7 days). Conclusions This meta-analysis yielded low to moderate evidence supporting the use of in-hospital supervised physical activity programmes in acutely hospitalised older adults. As little as similar to 25 min/day of slow-paced walking is sufficient to improve functional capacity and minimise adverse events in this population.
Physical activity; Meta-analysis; Old; Public health; Health promotion