Adverse events of exercise therapy in randomised controlled trials: a systematic review and meta-analysis, 2019, Niemeijer et al

Dolphin · Oct 5, 2019

https://bjsm.bmj.com/content/early/2019/09/27/bjsports-2018-100461.abstract

Review

Adverse events of exercise therapy in randomised controlled trials: a systematic review and meta-analysis

Andre Niemeijer1,

Hans Lund2,

Signe Nilssen Stafne3,4,

Thomas Ipsen1,

Cathrine Luhaäär Goldschmidt1,

Claus Thomas Jørgensen1,

Carsten B Juhl1,5

Author affiliations

hans.lund@hvl.no

Abstract
Objective To evaluate the relative risk (RR) of serious and non-serious adverse events in patients treated with exercise therapy compared with those in a non-exercising control group.

Design Systematic review and meta-analysis.

Data sources Primary studies were identified based on The Cochrane Database of Systematic Reviews investigating the effect of exercise therapy.

Eligibility criteria At least two of the authors independently evaluated all identified reviews and primary studies. Randomised controlled trials were included if they compared any exercise therapy intervention with a non-exercising control. Two authors independently extracted data. The RR of serious and non-serious adverse events was estimated separately.

Results 180 Cochrane reviews were included and from these, 773 primary studies were identified. Of these, 378 studies (n=38 368 participants) reported serious adverse events and 375 studies (n=38 517 participants) reported non-serious adverse events. We found no increase in risk of serious adverse events (RR=0.96 (95%CI 0.90 to 1.02, I2: 0.0%) due to exercise therapy. There was, however, an increase in non-serious adverse events (RR=1.19 (95%CI 1.09 to 1.30, I2: 0.0%). The number needed to treat for an additional harmful outcome for non-serious adverse events was 6 [95%CI 4 to 11).

Conclusion Participating in an exercise intervention increased the relative risk of non-serious adverse events, but not of serious adverse events. Exercise therapy may therefore be recommended as a relatively safe intervention.

PROSPERO registration number

CRD42014014819.

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http://dx.doi.org/10.1136/bjsports-2018-100461
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Dolphin · Oct 5, 2019

Many clinical guidelines recommend exercise therapy as a core element of treatment.14 15 In some cases, clinical guidelines recommend exercise, but advise patients to consider specific symptoms related to the disease, such as risk of hypoglycaemia in type 1 diabetes,16 or recommend avoidance of unsupervised exercise, due to the risk of performing the prescribed exercise incorrectly, and thereby increasing the risk of adverse events.17
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16 National Guideline C. Clinical practice guideline for diabetes mellitus type 1, 2012.
17 NNIfHaC. Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management, 2007. Available: https://www. nice. org. uk/ guidance/ cg53

alktipping · Oct 5, 2019

it says systematic reviews and meta analysis does anybody actually study each of these piss poor trials individually or do they take the lazy route of trusting the abstracts and cherry picked data lazy crap in and lazy crap out there is no sense of shame with this careless shoddy approach to data .

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