In-hospital exercise interventions improve inpatients’ frailty and demonstrate promising implementation outcomes: A systematic review and meta-analysis
Bibliographic record
Abstract
Frail, hospitalized patients are at a greater risk of further health issues. Frailty levels can worsen during hospitalization, with exercise being one of the best strategies to manage frailty. However, there is a lack of synthesized evidence to indicate whether exercise interventions are effective at managing frailty in this unique setting. This systematic review and meta-analysis determined if exercise interventions either preserve or improve frailty levels among inpatients. Sources were searched in May 2024 (updated August 2025) and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. Studies were included if they conducted an exercise intervention in middle-to-older adult (≥45-years) inpatients and assessed frailty as an outcome using any validated frailty assessment tool. The between-group effect size of change in frailty (Intervention vs. Control) was calculated as the standardized mean difference (SMD) using a random effects model. Five studies including n=810 intervention (age: 82.3±3.5 [range: 79-87.6] years; 45±1% reported females) and 900 control (age: 81.6±4.1 [range: 76.0-87.1] years; 44±1% reported females) participants were included. Improvements in patients’ frailty were observed in n=3/5 studies. The meta-analysis exhibited a favorable effect on frailty between the intervention and control groups (SMD: 0.716, 95%CI: 0.119–1.312) with significant heterogeneity between studies ( I 2 =92%, p <0.001). No differences were observed between interventions using distinct exercise types or frailty assessment tools (both, p >0.196) . Despite limited available evidence, results indicate exercise training interventions may be effective in improving frailty. This supports the inclusion of exercise interventions beyond usual hospital care to improve frailty. • Exercise interventions are a viable and feasible strategy for managing frailty in hospitalized patients. • Aerobic or combined exercise programs are effective at improving frailty assessed via the frailty phenotype or frailty index. • High adherence & retention support intervention efficacy but improving recruitment and eligibility may enhance implementation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.015 | 0.004 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".