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Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews

Pieper, Dawid; Bajpai, Ram; Posadzki, Pawel; Makaruk, Hubert; Könsgen, Nadja; Neuhaus, Annika Lena; Semwal, Monika

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Authors

Dawid Pieper

Pawel Posadzki

Hubert Makaruk

Nadja Könsgen

Annika Lena Neuhaus

Monika Semwal



Abstract

BACKGROUND: Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. METHODS: Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. RESULTS: Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 =?26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES)?=?0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 =?74.3%; PI -0.18, 0.53], MES?=?0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. CONCLUSION: There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. TRIAL REGISTRATION: Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.

Journal Article Type Article
Acceptance Date Nov 8, 2020
Publication Date Nov 16, 2020
Publicly Available Date Mar 28, 2024
Journal BMC Public Health
Publisher Springer Verlag
Volume 20
Issue 1
Article Number ARTN 1724
DOI https://doi.org/10.1186/s12889-020-09855-3
Keywords Exercise, Health, Effectiveness, Mortality
Publisher URL https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09855-3#article-info
PMID 33198717