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Group exercise can improve participants' mobility in an outpatient rehabilitation setting: a randomized controlled trial [with consumer summary]
Sherrington C, Pamphlett PI, Jacka JA, Olivetti LM, Nugent JA, Hall JM, Dorsch S, Kwan MM-S, Lord SR
Clinical Rehabilitation 2008 Jun;22(6):493-502
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To establish the effects of group exercise on mobility and strength. DESIGN: Randomized controlled trial. SETTING: Two public hospital outpatient rehabilitation services. PARTICIPANTS: One hundred and seventy-three people (mean age 74.9 years, SD 10.8) with impaired mobility were randomized and 159 people (92%) completed the trial. INTERVENTIONS: Five-week, twice-weekly 'circuit-style' group exercise programme run by a physiotherapist (n = 85) and a no-intervention waiting list control group (n = 88). MAIN OUTCOME MEASURES: Three aspects of mobility: balance while standing and stepping (Step Test, semi-tandem and tandem stance times); sit-to-stand ability (rate and minimum height) and gait (6-metre and 6-minute walk tests). Lower limb muscle strength (knee flexion and extension). RESULTS: At retest, exercise participants had improved significantly more than their control counterparts on measures of balance while stepping, sit to stand and gait. Exercise participants averaged 1.6 more steps on the 15-second Step Test (95% confidence interval (CI) 0.5 to 2.8, p = 0.005), walked an average of 0.12 m/s faster (95% CI 0.05 to 0.2, p = 0.002) and took 2.5 fewer steps in 6 metres (95% CI -4.2 to -0.8, p = 0.004). Exercise participants also averaged 0.04 more sit-to-stands/second (95% CI 0.003 to 0.08, p = 0.037) and walked an average of 30.9 metres further in 6 minutes (95% CI 9.4 to 52.4, p = 0.005). There were no clinically important or statistically significant between-group differences at retest for the measures of strength (knee extension and flexion), balance while standing or minimal sit-to-stand height. CONCLUSION: This short-duration circuit class programme improved mobility, but not strength.

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