The Effectiveness of Exercise Interventions for the Management of Frailty: A Systematic Review

Table 4

Description of studies that included hospitalized older adults.

N (%F); Mean age	Inclusion criteria	Intervention characteristics	Outcome measures^e	Quality	Reference
76 (72); 85	>70, acutely ill patients, acutely bedridden or with reduced mobility^c	Multicomponent training (intensive physiotherapy), 48 weeks, 5/week, 30 min/session	Body composition (weight, body mass index, fat mass, and arm and calf circumference); nutrition (energy and protein intake, haematological indicators); muscle function (grip strength); ADL disability (Katz ADL)	2	[85]
68 (100); 83	>75, admitted to a geriatric ward of primary-care health center hospital for an acute illness, difficulties in mobility and balance, and symptoms such as dizziness, reported falls, or difficulty to walk independently^c	Multicomponent training (resistance, functional exercises, relaxation), 10 weeks, 2/week, 90 min/session, 2 × 8–10 rep	Depression (Zung self-rating depression scale; muscle function (lower isometric strength); walking speed (10 meters test); balance (BBS); ADL disability (Joensuu classification); falls (incident rate); utilization of resources (health care, social welfare, and falls cost)	3	[57–59, 96]
57 (100); 82	>75, older adults admitted to a hospital due to a fall or with a history of injurious fall that required medical treatment^d	Functional multicomponent training (resistance, balance), 12 weeks, 3/week, 70–90% of maximum workload	Depression (Geriatric Depression Scale); psychosocial state (emotional status); muscle function (lower and upper strength); PA (Questionnaire); walking speed (15 meters test); chair rises (3 times); TUG; stair climb (13 steps); balance (stance, functional reach); test batteries (POMA); ADL disability (Barthel Index and the Lawton Index of IADL); falls (incident rate, fear of falling, walking steadiness, emotional instability, and behavioral changes following a fall)	5	[76]
243 (53); 79	frail (Winograd’s frailty scale), >65^a	Home-based resistance training, 10 weeks, 3/week, 3 × 8 rep at 60–80% 1RM	Psychosocial state (degree of fatigue); muscle function (KE strength); walking speed (4 meters test); TUG; balance (BBS); ADL disability (Barthel Index and Adelaide Activities Profile); QOL (SF-36); falls (incident rate, time to first fall, and fear of falling)	5	[92]
71 (0); 78	>65, hypogonadal recuperative care patients, recent functional decline^c	Progressive resistance training, 12 weeks, 3/week, 3 × 8 rep at 20% and 80% 1RM	Body composition (muscle mass); muscle function (lower and upper strength); test batteries (aggregate functional performance test)	5	[73]
29 (17); 79	>65, recent illness-induced functional decline^c	Progressive resistance training, 12 weeks, 3 × 8 rep at 20% and 80% 1RM	Body composition (weight, muscle mass, and fat mass); nutrition (energy intake); muscle function (lower and upper strength); test batteries (aggregate functional performance test)	5	[72]

^aValidated operational definition of frailty.
^cAt least one frailty indicator in the inclusion criteria.
^dNo frailty indicators on the inclusion criteria.
^eSignificant between-group differences are shown in bold.
1RM: one repetition maximum; ADL: activities of daily living; BBS: Berg balance scale; IADL: instrumental activities of daily living; KE: knee extension; PA: physical activity; POMA: Tinetti performance-oriented mobility assessment; QOL: quality of life; rep: repetitions; SF-36: medical outcomes survey short-form 36; TUG: timed up-and-go test.