Impact of exercise intervention-based changes on physical function biomarkers in older adults after hospital discharge: A systematic review with meta-analysis of randomized clinical trials.

This systematic review with meta-analysis aimed to compare the changes caused by exercise intervention with those provoked by usual care on physical function biomarkers in older adults immediately after hospital discharge. Two independent authors performed a systematic search (PubMed, Scopus, Web of Science, and SciELO) of studies published from database inception until August 2021. Randomized clinical trials investigating the effects of an exercise intervention compared to usual care were included. The Cochrane Collaboration assessment tool was used to analyze the risk of bias. The comparisons included handgrip strength, the short physical performance battery scale, six-minute walking test, and 10-m gait speed. Overall, the exercise intervention led to significantly greater changes compared to usual care in physical function biomarkers [standard mean difference = 0.89, 95% CI = 0.39, 1.42; P = 0.001]. However, considering the very few studies investigating each variable separately, our sub-analysis did not reveal a significant effect of the exercise intervention on handgrip strength, the short physical performance battery, six minutes walking test, and 10-m gait speed. This systematic review with meta-analysis of randomized clinical trials suggests that exercise intervention induce greater physical function biomarker alterations in older adults after hospitalization than usual care including physical activity guidance. Future trials comparing the effects of these intervention groups on physical function biomarkers in this population are needed to confirm our results. Potential mechanism involved in mitigating impairments in physiological resilience and declines in physical function biomarkers induced by exercise interventions in older adults after hospital discharge. [Display omitted] • Acute hospitalization causes an impact dramatic and permanent on physical function biomarkers during hospital-based care. • Vulnerability conferred by hospitalization in older adults leads to impairment in these biomarkers also after discharge. • Exercise intervention is better than usual care to improve physical function biomarkers in older adults after discharge. • Exercise intervention might help older adults recover from adverse effects caused by hospitalization also after discharge. [ABSTRACT FROM AUTHOR]