Supplementary Material for: Feasibility and Effectiveness of Intervention Programmes Integrating Functional Exercise into Daily Life of Older Adults: A Systematic Review

<p><b><i>Background:</i></b> Traditionally, exercise programmes for
improving functional performance and reducing falls are organised as
structured sessions. An alternative approach of integrating functional
exercises into everyday tasks has emerged in recent years. <b><i>Objectives:</i></b>
Summarising the current evidence for the feasibility and effectiveness
of interventions integrating functional exercise into daily life. <b><i>Methods:</i></b>
A systematic literature search was conducted including articles based
on the following criteria: (1) individuals ≥60 years; (2) intervention
studies of randomised controlled trials (RCTs) and non-randomised
studies (NRS); (3) using a lifestyle-integrated approach; (4) using
functional exercises to improve strength, balance, or physical
functioning; and (5) reporting outcomes on feasibility and/or
effectiveness. Methodological quality of RCTs was evaluated using the
PEDro scale. <b><i>Results:</i></b> Of 4,415 articles identified from 6
databases, 14 (6 RCTs) met the inclusion criteria. RCT quality was
moderate to good. Intervention concepts included (1) the
Lifestyle-integrated Functional Exercise (LiFE) programme integrating
exercises into everyday activities and (2) combined programmes using
integrated and structured training. Three RCTs evaluated LiFE in
community dwellers and reported significantly improved balance,
strength, and functional performance compared with controls receiving
either no intervention, or low-intensity exercise, or structured
exercise. Two of these RCTs reported a significant reduction in fall
rate compared with controls receiving either no intervention or
low-intensity exercise. Three RCTs compared combined programmes with
usual care in institutionalised settings and reported improvements for
some (balance, functional performance), but not all (strength, falls)
outcomes. NRS showed behavioural change related to LiFE and feasibility
in more impaired populations. One NRS comparing a combined home-based
programme to a gym-based programme reported greater sustainability of
effects in the combined programme. <b><i>Conclusions:</i></b> This
review provides evidence for the effectiveness of integrated training
for improving motor performances in older adults. Single studies suggest
advantages of integrated compared with structured training. Combined
programmes are positively evaluated in institutionalised settings, while
little evidence exists in other populations. In summary, the approach
of integrating functional exercise into daily life represents a
promising alternative or complement to structured exercise programmes.
However, more RCTs are needed to evaluate this concept in different
target populations and the potential for inducing behavioural change.</p>