EXERCISE INTERVENTIONS ON THE ACUTE MEDICAL WARD: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

INTRODUCTION & AIMS An acute hospital stay is associated with high proportions of sedentary time, and bed rest, with low physical activity participation for the stay duration. Exercise prescription on the acute inpatient medical ward can prevent decline, or at least maintain, physical outcomes in the adult population. The purpose of this systematic review with meta-analyses was to evaluate the effectiveness of exercise intervention on the acute inpatient medical ward on physical outcomes of muscle strength, aerobic capacity and balance in adults, compared with usual care. METHODS Medline, CINAHL and EMBASE were searched from inception to 20th April 2023. Randomised controlled trials in English, which reported muscle strength, aerobic capacity or balance outcomes for adults who received an exercise intervention on an acute medical ward were included. Studies were excluded if they did not have a control group receiving usual care. Study quality was assessed using the PEDro and TESTEX scales. The GRADE rating assessed quality of evidence to evaluate certainty of effect. Where studies with continuous data used different measures of assessment, and reported post-test outcomes, standardised mean differences with a random effects model was used. For studies with continuous data that used different measures of assessment, and reported change from baseline scores, a weighted mean difference with a random effects model was used. Significance was set at p<0.05. RESULTS Twelve studies were included, with 1,273 unique participants, which compared exercise intervention with usual care. Low quality evidence demonstrated a significant difference between groups for aerobic capacity (p=0.02) and maximum isometric strength (p=0.001). A meta-analysis of balance outcomes could not be performed. CONCLUSION Exercise prescribed during an acute medical ward stay may improve participants’ aerobic capacity and maximum isometric strength.