Summary of the Effects of Exercise Therapy in Non-Communicable Diseases: Clinically Relevant Evidence from Meta-Analyses of Randomized Controlled Trials

There is strong evidence that exercise therapy leads to better measured and self-reported physical fitness and function in patients with chronic diseases, along with improvements in body composition. The evidence for other health benefits has not been summarized as systematically across different chronic diseases. Given the volume of research that has appeared in the past decade, this review of meta-analyses of randomized controlled trials (RCTs) in patients with specific chronic diseases summarizes the evidence regarding exercise therapy for various outcomes to help practitioners in prescribing exercise therapy for their patients. Meta-analyses published before Jan 1, 2021, based on at least four RCTs, and investigating the effect of exercise therapy on the same outcome among patients with a specific chronic disease were screened. These meta-analyses show that, in addition to improvements in fitness and function, various cardio-metabolic risk factor levels are improved in most of the common cardio-metabolic diseases, pain is reduced in musculoskeletal diseases, mood (depression and anxiety) and health-related quality of life are improved in various disease categories, and disease-specific indicators of disease progression are improved for conditions such as type 2 diabetes, hypertension, coronary heart disease, heart failure, claudication, chronic obstructive pulmonary disease, rheumatoid arthritis, fibromyalgia, depression, anxiety, and schizophrenia. Physicians should consider prescribing exercise to their patients with chronic disease conditions to improve their physical fitness, mood, and health-related quality of life and to slow down the progression of disease. This improves a patients possibility to enjoy an active and independent life. Key pointsO_LIThis study summarizes the data from meta-analyses of randomized controlled trials (RCTs) on the effects of exercise therapy in patients and discusses the clinical relevance of the findings. C_LIO_LIThe findings include the following: various cardio-metabolic risk factor levels are improved in most of the common cardio-metabolic diseases, pain is reduced in musculoskeletal diseases, mood (depression and anxiety) and health-related quality of life are improved in various disease categories, and disease-specific indicators of disease progression are improved in conditions such as type 2 diabetes, hypertension, coronary heart disease, heart failure, claudication, chronic obstructive pulmonary disease, fibromyalgia, depression, anxiety, and schizophrenia. C_LIO_LIRCTs usually test the same exercise program for all trial participants. To tailor the exercise therapy intervention in real life, individually based factors, such as disease status, fitness level, personal exercising interests and possibilities, and the infrastructure making different exercise therapy modalities possible in the patients everyday environment should all be considered. C_LI