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Effects of home-based exercise programs on mobility, muscle strength, balance, and gait in community-dwelling older adults: a systematic review and meta-analysis
Costa SN, Ferreira LHB, Bento PCB
Journal of Aging and Physical Activity 2023 Jan;31(4):693-704
systematic review

OBJECTIVE: Individual unsupervised home-based exercise programs can enhance muscle strength, physical function, gait, and balance in older adults. However, the effectiveness of such programs may be limited by the lack of supervision. This study aims to verify the effectiveness of individual unsupervised home-based programs, compare the effects of individual unsupervised home based to supervised programs, and verify the influence of supervision over individual unsupervised home-based programs on the physical function of older adults. METHODS: A systematic literature search was performed in four electronic databases, and the trials involved randomized controlled comparing the home-based programs to supervised, control groups, or home-based plus supervised evaluating the muscle strength, physical function, gait, and balance in older adults. RESULTS: Eleven studiesmet the inclusion criteria. The meta-analysis revealed no differences between home-based program versus supervised program in gait, mobility, and balance, revealing a trend of significance to supervised program on strength (standardized mean difference (SMD) 0.27, p = 0.05). The analysis revealed effects in mobility (SMD 0.40, p = 0.003), balance (SMD 0.58, p = 0.0002), and muscle strength (SMD 0.36, p = 0.02) favoring home-based program versus control group. Significant effects between home-based program versus home based plus supervised program were observed in balance (SMD 0.74, p = 0.002) and muscle strength (SMD 0.58, p = 0.01) in favor of home-based plus supervised program. CONCLUSION: Home-based programs effectively improve older adults' physical function compared with control groups. However, supervised programs were more effective for muscle strength.

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