Exercise: necessary but not sufficient for improving function and preventing disability?

PURPOSE OF REVIEW: Several recent clinical trials and systematic reviews have examined functional outcomes of exercise programs in two populations: older adults and adults with knee arthritis. We synthesize recent clinical trials and systematic reviews to examine whether the links between exercise and functional outcomes are better understood than they were a decade ago. RECENT FINDINGS: Systematic reviews and current clinical trials reveal a modest beneficial effect of progressive resistance training (strengthening programs) and aerobic programs on strength, pain, and function in both populations. Few randomized controlled trials have investigated disability-level outcomes, and of those that do examine disability outcomes, the majority of studies have not shown a beneficial effect. SUMMARY: Current and recent evidence shows little to no impact of exercise on the prevention of disability. Exercise programs may need to be changed if the desire is to prevent or minimize disability. Alternatively, different strategies need to be developed to address disability more directly.