Effectiveness of exercise therapy: A best-evidence summary of systematic reviews

Authors: Smidt N , de Vet HC , Bouter LM , Dekker J , Arendzen JH , de Bie R , Bierma-Zeinstra S , Helders PJ , Keus SH , Kwakkel G , Lenssen T , Oostendorp RA , Ostelo R , Reijman M , Terwee CB , Theunissen C , Thomas S , van Baar ME , van 't Hul A , van Peppen RP , Verhagen A , van der Windt DA , Exercise Therapy Group
Source: Aust J Physiother. 2005;51(2):71-85
DOI: 10.1016/S0004-9514(05)70036-2 Publication date: 2005 E-Publication date: March 21, 2011 Availability: full text Copyright: © 2005 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
Language: English Countries: Not specified Location: Not specified Correspondence address: N. Smidt : Institute for Research in Extramural Medicine, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. n.smidt@vumc.nl


Article abstract

The purpose of this project was to summarise the available evidence on the effectiveness of exercise therapy for patients with disorders of the musculoskeletal, nervous, respiratory, and cardiovascular systems. Systematic reviews were identified by means of a comprehensive search strategy in 11 bibliographic databases (08/2002), in combination with reference tracking. Reviews that included (i) at least one randomised controlled trial investigating the effectiveness of exercise therapy, (ii) clinically relevant outcome measures, and (iii) full text written in English, German or Dutch, were selected by two reviewers. Thirteen independent and blinded reviewers participated in the selection, quality assessment and data-extraction of the systematic reviews. Conclusions about the effectiveness of exercise therapy were based on the results presented in reasonable or good quality systematic reviews (quality score > or = 60 out of 100 points). A total of 104 systematic reviews were selected, 45 of which were of reasonable or good quality. Exercise therapy is effective for patients with knee osteoarthritis, sub-acute (6 to 12 weeks) and chronic (> or = 12 weeks) low back pain, cystic fibrosis, chronic obstructive pulmonary disease, and intermittent claudication. Furthermore, there are indications that exercise therapy is effective for patients with ankylosing spondylitis, hip osteoarthritis, Parkinson's disease, and for patients who have suffered a stroke. There is insufficient evidence to support or refute the effectiveness of exercise therapy for patients with neck pain, shoulder pain, repetitive strain injury, rheumatoid arthritis, asthma, and bronchiectasis. Exercise therapy is not effective for patients with acute low back pain. It is concluded that exercise therapy is effective for a wide range of chronic disorders.

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