Effects of Exercise in Adults with Physical and Cognitive Disabilities - A Meta-Analysis

The purposes of the study were (1) to identify the effects of exercise interventions on health outcomes in adults with disabilities; (2) to investigate the dose-response relationship between exercise interventions and health outcomes in adults with disabilities; and (3) to examine the safety of exercise interventions for adults with disabilities. A comprehensive literature search was implemented to retrieve published articles on randomized controlled trials related to exercise interventions and health outcomes in adults with disabilities. Meta-analyses were then conducted to identify the effects of exercise on the health across the seven major health categories reported in the Physical Activity Guidelines for Americans: cardiorespiratory health, musculoskeletal health, healthy weight, metabolic health, mental health, functional health, and general health. Eight specific disability groups were targeted: Alzheimer’s disease, cerebral palsy, intellectual disability, mental illness, multiple sclerosis, Parkinson’s disease, spinal cord injury, and stroke. Ninety-five randomized controlled trials were included in the meta-analyses. There was evidence that exercise training can elicit small to medium effects in cardiorespiratory, musculoskeletal, mental, functional, and general health in adults with disabilities. However, most health improvements were diminished after the intervention ended. In addition, with proper screening and supervision, adults with disabilities can exercise safely without increasing the risk for serious adverse events. Therefore, adults with disabilities are strongly advised to participate in exercise on a regular basis for several health benefits. Results also suggested that the frequency of exercise was the most significant moderator for aerobic exercise. Studies with better methodological quality were more likely to report smaller effect sizes for strength exercise. There is a pressing need for future research to target several understudied health outcomes. In particular, the most needed health outcomes include metabolic health, health weight, lipoprotein, flexibility, bone mineral density, sleep quality, upper limbs motor function, fatigue, and pain. Similarly, there is a need for dose-response studies between specific exercise exposures and health outcomes in people with various disabilities. Finally, further research is warranted to investigate effective strategies for better maintenance of a physically active lifestyle in individuals with disabilities after an intervention has ended.