Effect of exercise therapy and self-management support on multimorbidity: Secondary analysis of the MOBILIZE trial

Background: Multimorbidity is linked to systemic low-grade inflammation, poor glycaemic control, dyslipidaemia, and hypertension, yet evidence on effective interventions is limited. We evaluated the impact of a 12-week personalised exercise therapy and self-management support programme, in addition to usual care, on these outcomes in individuals with multimorbidity. Methods: This was a pre-planned secondary analysis of the MOBILIZE multicentre randomised controlled trial (NCT04645732). Participants (n = 228) had at least two of the following conditions: knee/hip osteoarthritis, chronic obstructive pulmonary disease, heart disease, hypertension, type 2 diabetes, or depression. The intervention included 24 supervised 60-minute group-based exercise sessions and 24 self-management sessions over 12 weeks. Outcomes were assessed at baseline and 4 months, including interleukin-1 receptor antagonist (IL-1ra), high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), glycated Hemoglobin (HbA1c), fasting glucose, insulin, High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), triglycerides, and blood pressure. Results: Compared to usual care, the intervention group shows a statistically significant reduction in systolic blood pressure (mean difference: −4.7 mmHg, 95% CI: −8.8 to −0.6). No significant between-group differences are observed for other biomarkers, although favouring the intervention. Sensitivity analyses—excluding participants with low adherence, those receiving supervised exercise in the control group, or undergoing surgery—support the primary findings. Conclusions: A 12-week personalised exercise and self-management programme reduces systolic blood pressure in people with multimorbidity. These findings support incorporating exercise therapy into multimorbidity care guidelines as a non-pharmacological adjunct.