A Systematic Review of the Effects of Therapeutic Exercise With Psychological Interventions on Disability and Personal Outcomes in Older Adults
Open accessAbstract
Objective: To evaluate the effects of therapeutic exercise and psychological interventions on disability and personal outcomes in older adults. Data Sources: Articles published from January 2013 to February 2025 are available in PubMed, Embase, ProQuest Health & Medical and Psychology, PsycINFO, and PsycArticles. Study Selection: Inclusion criteria were as follows: (1) intervention included therapeutic exercise combined or integrated with a psychological intervention; (2) randomized controlled trial; (3) sample mean age ≥60 years; (4) primary or secondary outcome(s) of disability. Two authors independently screened trials (n=7391) for inclusion; a third author verified results and resolved discrepancies. Data Extraction: Data were extracted by a primary reviewer and verified by a second reviewer. The risk of bias assessment was performed using the risk of bias in randomized controlled trials. Data Synthesis: Thirty-eight trials (n=18,550 participants) were included. Therapeutic exercise included: exercise programs (34%), physical activity counseling and monitoring (37%), rehabilitation (18%), or other (eg, Tai Chi; 13%). Psychological interventions were primarily motivational interviewing (53%) or cognitive-behavioral therapy/strategies (39%). Significant improvement in body functions and structures (n=14, 37%), activity (n=6, 16%), participation (n=20, 53%), and personal factors (n=11, 29%) was observed. Conclusions: Therapeutic exercise with psychological interventions have a positive effect on disability and personal outcomes, especially in participation. Heterogeneity in the study design, intervention, and population challenged data synthesis. Nonetheless, the current review identified gaps within the literature and directions for future research. Testing the additive effect of these interventions compared to active comparators is a priority for future investigations.
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Research examining the effectiveness of psychological and non-pharmacological interventions remains limited, as no clear emphasis on such approaches was apparent in the findings.
“Also, research examining the effectiveness of psychological and non-pharmacological interventions remains limited, as no clear emphasis on such approaches was apparent in the findings [97,98].”
From Toward Holistic Aging in Lebanon: A Mapping of Gerontology and Geriatrics Research Trends, Gaps, and Future Directions (2026) · cites this paper as [97]
The Discussion (Future directions; page unavailable) calls for more trials comparing combined exercise-and-psychological interventions with either intervention alone, supporting a limited need for further effectiveness research. But the broad claim that research lacks a clear emphasis on psychological and non-pharmacological approaches is not supported: the Abstract (Data Synthesis; page unavailable) reports 38 trials focused on those approaches and significant improvements in several outcomes. (LLM, conf=0.84)
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- Authors
- Rose, G. A., Bruni, P. T., Wingood, M., Kallmi, S., Finer, E., & Bamonti, P. M.
- Affiliations
- VA Boston Healthcare System (US)
- Hofstra University (US)
- Harvard University (US)
- Corresponding author
- Rose, Grace A.
- Venue
- Archives of Rehabilitation Research and Clinical Translation
- Publisher
- Elsevier BV
- Published
- 2025-06
- Volume
- 7
- Issue
- 2
- Pages
- 100447
- ISSN
- 2590-1095 (ISSN-L)
- PMC
- PMC12265917
- OpenAlex
- W4408597496
- Cited by
- 0
- References
- 65
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Archives of Rehabilitation Research and Clinical Translation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- VA Rehabilitation Research & Development Service
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- exercise therapy, psychological intervention, older adults, disability, participation, activity, physiological function, motivational interviewing, cognitive behavioral therapy, Tai Chi, physical activity counseling, rehabilitation
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