Abstract
Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.
Highlights
Medical Aid-in-Dying (MAID), called death with dignity (Andersen, 2020), physician-assisted suicide or assisted suicide (Mishara & Weisstub, 2015), are all terms that refer to when a medical doctor gives a terminally ill patient the information or means needed to end their own life (Death with Dignity, n. d.)
Many supporters of MAID argue that it is a safe practice that allows for patients to determine their own quality of life and choose whether or not they want to continue to live in that condition (Dugdale, Lerner, & Callahan, 2019)
Euthanasia is different than MAID, as MAID laws do not allow a physician to administer the drug to the patient; the patient must be able to self-administer the drug (Hedberg & New, 2017)
Summary
Death with dignity allows for people who have a terminal illness and are at the end of their life to end their physical and mental suffering in a medically safe way Many supporters of MAID argue that it is a safe practice that allows for patients to determine their own quality of life and choose whether or not they want to continue to live in that condition (Dugdale, Lerner, & Callahan, 2019) Some opponents equate it with suicide or homicide, while others believe the desire for death with dignity stems from a lack of financial resources, health insurance or access to palliative care (Hedberg & New, 2017). Doctors are not required to prescribe a life-ending-drug; they have the right to refuse (Hedberg & New, 2017)
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