Review Article

Chair-Based Exercises for Frail Older People: A Systematic Review

Table 1

Characteristics of the selected studies.

Author Study typeSample sizeSetting FocusInterventionAdherenceOutcome measures Main/significant findings

Baum et al. (2003) [10]Prospective, randomised, controlled, semicrossover trial20Nursing home/assisted living scheme (USA)Upper/lower limb strength and flexibility related to functionSeated ROM and progressive resistance, 1 hour three times per week; 6 monthsMean attendance/adherence 80%Timed Up and Go
Berg Balance Scale
Physical Performance Test (PPT)
Mini Mental State Examination (MMSE)
Positive intervention effect for all outcomes as below:
TUG—18 seconds faster, effect size = 0.54
Berg Balance—4.8 better, effect size = 0.32
PPT—1.3 better, effect size = 0.40
MMSE—3.1 better, effect size = 0.54
NB: Effect sizes are the difference between intervention and control in standard deviation units

Hruda et al. (2003) [11]Randomised controlled trial25Long-term care facility (Canada)Lower limb strength related to functionProgressive lower body resistance exercises; ≤1 hour three times per week; 10 weeksMean attendance/adherence 71%Eight foot up and go
30 second chair stand
6 meter walk
30 second chair stand
Eccentric/concentric average power
Significant improvement in eight foot up and go speed ( )
Significant improvement in 30 second chair stand ( )
Negative correlation between eight foot up and go and concentric power ( )

Van de Winckel et al. (2004) [12]Randomised controlled trial25Dementia registered Residential home (Belgium)Mood and cognition in presence of dementia Music supported chair movement exercise (30 minutes daily) for 3 months (resistance not included)Mean attendance/adherencenot reportedMini-Mental State Examination
Beoordelingsschaal voor Oudere Patienten (BOP)
Improvement in MMSE in exercise group before and after intervention (mean 12.87 versus 15.53, effect size = 0.5, )
No significant differences in behaviour (no items in the BOP scale identified significant improvement in exercise group)

Thomas and Hageman (2003) [13]Before and after test28Day centre (USA)Lower limb strength and function in presence of dementiaModerate intensity progressive resistance training of hip extensors, flexors, and dorsiflexors with Theraband for up to 3 days per week for six weeksMean attendance/adherence 63%Bilateral muscle testing
Walking speed
Sit-stand x5
Standing balance
Timed Up and Go (TUG)
Body Mass Index
Mini-Mental State Examination
Gait Assessment Rating Scale
Of participants who exercise at least twice a week the following was noted:
22% improvement in sit-stand time
14% improvement in TUG
10.1% improvement in average grip strength
15.6% in average quadriceps strength
9.9% in usual gait time
5.4% in fast gait time

Nicholson et al. (1997) [14]Quasi experimental, nonrandomised control group before and after test71Multidisciplinary team geriatric hospital (South Africa) After-hip-fracture rehabilitation Seated “High paced” “choreographed” “complex movements.” 60% max heart rate for
20 minutes
Mean attendance/adherence 92%Falls Efficacy Scale
Habitual Physical Activity Questionnaire
Beck Depression Inventory (BDI)
Mini Mental State Examination
Increased levels of grip, mood and confidence before and after in both exercise and control group. Between group (control and exercise) differences nonsignificant:
Grip Strength,
FES Confidence,
FES Fear,
BDI,
Improved systolic blood pressure and heart rate ( ) over exercise and recovery period

Witham et al. (2005) [15]Randomised single blind controlled trial82Community (UK)Exercise capacity, function, and health status in presence of chronic heart failure 3 month supervised resistance exercise classes (unclear type of resistance) twice per week followed by home exercises with the aid of video/audio cassette (no face to face). Control was standard careMean attendance/adherence 83%Six-minute walk
Accelerometry
Guyatt (chronic heart failure questionnaire)
Hospital Anxiety and Depression Scale
Philadelphia Geriatric Morale Scale
Nonsignificant improvement in mental health (HADS, )
Nonsignificant improvement in walking distance (6-minute walk, )