Work

Effects of exercise therapy on balance, functional performance, and fall-related outcomes in community-dwelling older adults with chronic conditions: a systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: Community residents with chronic diseases face a higher risk of falls, functional decline, and loss of independence, constituting a significant public health burden. Exercise therapy is widely recommended; however, its efficacy in improving balance, functional performance, and fall-related outcomes remains controversial. Objective: To systematically evaluate and quantify the effects of exercise therapy on balance, functional performance, and fall-related outcomes in community-dwelling older adults with chronic conditions. Methods: This study conducted a systematic review and meta-analysis of randomized controlled trials. PubMed, Cochrane Library, Embase, CINAHL, and Web of Science databases were searched, and studies published up to 8 March 2026 were included. Participants were community-dwelling adults with chronic diseases who received exercise therapy. A random-effects model was used to calculate the pooled effect size. Outcome measures included balance, functional performance, and fall-related indicators. Subgroup analyses were conducted according to chronic condition categories and exercise modalities to explore potential sources of heterogeneity. Results: A total of 14 randomized controlled trials involving 857 participants were included in the meta-analysis. Exercise therapy significantly improved multiple objective indicators of balance and functional performance in community-dwelling older adults with chronic conditions. Significant improvements were observed in the One-Leg Stance (OLS) (WMD = 5.45, 95% CI: 1.45 to 9.44), In addition, exercise therapy significantly reduced Timed Up and Go (TUG) (WMD = -0.76, 95% CI: -1.50 to -0.02), indicating improved functional mobility and dynamic balance. Subgroup analyses suggested that improvements in TUG performance varied according to chronic condition categories and exercise modalities, with greater benefits observed among participants with musculoskeletal-related chronic conditions and those receiving balance training. Conclusions: Exercise therapy may improve selected measures of balance and functional mobility in community-dwelling older adults with chronic conditions, although the certainty and clinical importance of these effects remain uncertain. Effects on falls and fear of falling were not established in this review. Further high-quality studies are needed to determine the optimal exercise characteristics for specific chronic condition populations. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, CRD420261390054.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1918701

Authors: Xiaofeng Cheng, Jinsong Luo, Beihai Ge, Deng Wang, Renming Liu, Xianhui Liao