Table 1.
Summary table of study characteristics, intervention details, main findings and risk of methodological bias. Key: SD, Standard Deviation; ADL, Activities of Daily Living; NA, not available
| Study | Year | Country | Sample size |
Mean age (SD) |
Study participants | Baseline characteristics |
Intervention | Delivery | Treatment Frequency/ Duration |
Completion (Adherence) rate (%) |
Main Findings | Risk of bias |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chandler (16) | 1998 | USA | 100 | 78 (8) | Aged over 64 years and meeting an operationalised, non-validated definition of frailty - inability to descend the stairs without holding the bannister. Participants then further stratified on the basis of whether they were able to rise from a chair without using their arms | 50% male, 50% female 57% were unable to do stairs but able to do chair rise 43% were unable to do either stairs or chair rise | Lower body progressive resistance exercises | Home visits from physiotherapist for each session | 3 times per week for 10 weeks | 87 (NA) | Strength improved. Greater improvement in more frail group. | High |
| Gill (17) | 2002 | USA | 188 | 83 (5) | Aged 75 years and over and meeting an operationalised, non-validated definition of frailty - greater than 10 seconds to perform a rapid gait test or unable to stand from a seated position with arms folded. ‘Moderate’ frailty if one of two criteria present, ‘severe’ frailty if both criteria present | 20% male, 80% female 47% living alone Mean of 2.1 chronic conditions 62% moderate frailty, 38% severe frailty | Complex, individualized progamme of occupational intervention with progressive resistance, balance and range of motion exercises | Home visits from physiotherapist; average of 16 visits over the 6 month period | Once a day, 3 times per week for 6 months | 65 (78) | Improvement in ADL at 6 months. No improvement at 3 months. No improvement in most frail group | Low |
| Luukinen (18) | 2006 | Finland | 486 | 88 (3) | Aged 85 years and over with at least one risk factor for ADL disability or history of recurrent falls | 21% male, 79% female 31% had severe mobility restriction, 25% had slow walking speed, 20% had severe restriction in ADL score, 19% had poor self-related health Mean of 6.5 (SD 4) medications used | Complex individualised exercise and occupational intervention including a combination of; walking, group exercises, home-based resistance exercises and self care exercises | Unclear | Home-based resistance exercises 3 times a day for 18 months | 59 (NA) | Improvement in mobility score. No effect on ADL disability, hospitalisation or long-term care admission. | Low |
| McMurdo (19) | 1995 | UK | 86 | 82 | Aged 75 years and over, living in sheltered housing with limited mobility requiring the use of a walking aid and ADL dependence requiring home help at least once a week | 12% male, 88% female Median Barthel score 19 (range 14-20) | Whole body resistance exercises and range of motion exercises | Exercise cards with diagrams and written explanations. Physiotherapist visit every 3-4 weeks | Once a day for 6 months | 73 (NA) | Trend towards improved mobility. No effect on strength, physical condition. | Low |
| Rosie (20) | 2007 | New Zealand | 66 | 85 (4) | Aged 80 years and over, able to walk 4m with or without a mobility aid, sedentary and mobility-limited. Participants were considered to have a mobility limitation if they were limited ‘a lot’ in vigorous activity and in one or more activity on the Short-Form 36 Health Survey (SF-36) Physical Functioning Scale (PF-10) | 29% male, 71% female 59.1% limited ‘a lot’ in 5 or more domains of the PF-10 63.6% had no falls in the preceding 12 months | Repeat sit-to-stands using a GrandStand system | One home visit from study researcher followed by one weekly telephone call thereafter | Once a day for 6 weeks | 88 (66) | No effect on mobility, ADL or balance | Low |
| Vestergaard (21) | 2007 | Denmark | 61 | 81 (3) | Aged 75 years and over in receipt of home care who were housebound but able to get out of a chair and bed | Intervention group took mean of 19.3 seconds (SD 11.6) to complete 5 repetitions of a chair rise, control group took mean of 16.4 seconds (SD 5.3) | Flexibility and balance exercises, whole body resistance exercises and aerobic exercises | Exercise video & booklet. One home visit from exercise instructor followed by bi-weekly telephone calls thereafter | 3 times a week for 5 months | 83 (89) | Improvement in quality of life. No effect on strength, mobility, physical performance or balance | Moderate |