title: Effectiveness of exercise therapy: a best-evidence summary of systematic reviews.
abstract: The purpose of this project was to summarise the available evidence on the effectiveness of exercise therapy for patients with disorders of the musculoskeletal, nervous, respiratory, and cardiovascular systems. Systematic reviews were identified by means of a comprehensive search strategy in 11 bibliographic databases (08/2002), in combination with reference tracking. Reviews that included (i) at least one randomised controlled trial investigating the effectiveness of exercise therapy, (ii) clinically relevant outcome measures, and (iii) full text written in English, German or Dutch, were selected by two reviewers. Thirteen independent and blinded reviewers participated in the selection, quality assessment and data-extraction of the systematic reviews. Conclusions about the effectiveness of exercise therapy were based on the results presented in reasonable or good quality systematic reviews (quality score > or = 60 out of 100 points). A total of 104 systematic reviews were selected, 45 of which were of reasonable or good quality. Exercise therapy is effective for patients with knee osteoarthritis, sub-acute (6 to 12 weeks) and chronic (> or = 12 weeks) low back pain, cystic fibrosis, chronic obstructive pulmonary disease, and intermittent claudication. Furthermore, there are indications that exercise therapy is effective for patients with ankylosing spondylitis, hip osteoarthritis, Parkinson's disease, and for patients who have suffered a stroke. There is insufficient evidence to support or refute the effectiveness of exercise therapy for patients with neck pain, shoulder pain, repetitive strain injury, rheumatoid arthritis, asthma, and bronchiectasis. Exercise therapy is not effective for patients with acute low back pain. It is concluded that exercise therapy is effective for a wide range of chronic disorders.
authors.affiliation: n.smidt@vumc.nl
authors.forename: Nynke
authors.initials: N
authors.lastname: Smidt
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
authors.forename: Johan H
authors.initials: JH
authors.lastname: Arendzen
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: Samyra H J
authors.initials: SH
authors.lastname: Keus
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.forename: Ton
authors.initials: T
authors.lastname: Lenssen
authors.forename: Rob A B
authors.initials: RA
authors.lastname: Oostendorp
authors.forename: Raymond W J G
authors.initials: RW
authors.lastname: Ostelo
authors.forename: Max
authors.initials: M
authors.lastname: Reijman
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Terwee
authors.forename: Carlo
authors.initials: C
authors.lastname: Theunissen
authors.forename: Siep
authors.initials: S
authors.lastname: Thomas
authors.forename: Margriet E
authors.initials: ME
authors.lastname: van Baar
authors.forename: Alex
authors.initials: A
authors.lastname: van 't Hul
authors.forename: Roland P S
authors.initials: RP
authors.lastname: van Peppen
authors.forename: Arianne
authors.initials: A
authors.lastname: Verhagen
authors.forename: Daniëlle A W M
authors.initials: DA
authors.lastname: van der Windt
mesh_terms: D002908:Chronic Disease / Q000534:rehabilitation*; D019317:Evidence-Based Medicine / Q000379:methods; D005081:Exercise Therapy; D006801:Humans; D016896:Treatment Outcome