Cochrane Newsletter

Two reviews are discussed in the current Cochrane Newsletter (issue 56, November 20-22). The first review examines the effectiveness of exercise training in older people with frailty and the second review examines the effectiveness of exercise therapy in people with cystic fibrosis.

The first review looked at the effectiveness of exercise training in older people (65+) with frailty (https://doi.org/10.1002/14651858.CD010494.pub2). Frailty affects approximately 20% of all older people. Frailty syndrome increases the risk of adverse health events and is a predictor of falls, dependency, reduced mobility and death. The authors, led by Daniel Treacy, tested the effectiveness of mobility training on outcome measures of mobility and functional capacity. Mobility training was compared with interventions that did not actively aim to improve mobility. A total of 12 studies with 1317 participants were included. At the end of the intervention, there were significant improvements in mobility (Short Physical Performance Battery [0 to 12 points]: 1 point, 95% CI: 0.51 to 1.51) and functional capacity (Barthel Index [0 to 100 points]: 8.58 points, 95% CI: 3.00 to 14.30). The mobility benefit was maintained at six months. In addition, adverse health events were less frequent (RR = 0.74, 95% CI: 0.63 to 0.88). The authors cite the short follow-up of the included studies as a major limitation.

The second review examined the effectiveness of exercise therapy in people with cystic fibrosis (CF) (https://doi.org/10.1002/14651858.CD013285.pub2). Approximately 8000 people in Germany are affected by cystic fibrosis. The life expectancy of a newborn with CF is 45 to 50 years. In patients with CF, the mucus in the bronchial tubes is significantly more viscous than in healthy people. This leads to chronic cough, bronchiectasis, frequent recurrent lung infections and severe pneumonia. Typically, exercise therapy is used to clear the lungs of mucus. This review examined whether exercise therapy leads to better respiratory function than conventional breathing exercises. The authors, led by Katie Heinz, were able to include 4 trials with 86 participants. A meta-analysis was not performed because of the heterogeneity of the interventions. None of the trials showed differences between the groups compared.