A 2020 meta-analysis of seven RCTs reported a moderate effect of ≥ 4 weeks resistance training on physical function (standardised mean difference (SMD) 0.67 (95% CI 0.25 – 1.08), I2= 71%, n=346) among adults (aged ≥18 years) who are overweight or obese . Subgroup analysis found resistance training to improve activities of daily living (SMD 0.59, 95% CI 0.04 -1.13, n=289, 6 studies) and gait speed (SMD 0.54, 95% CI 0.08-1.00, n=297, 7 studies). Physiotherapy Evidence Database (PEDro) quality scores of included studies, ranged from 4/10-8/10 and the median score was 4.5/10 .
Additionally, a 2021 network meta- analysis of
(SMD ) 0.51, (95% CI: 0.16–0.86 ), P= 0.92) when compared to usual care. The authors reported the quality of included studies to be medium-high .
Although data from one cross-sectional study  and one RCT (n=424)  suggest that obesity blunts the benefits of exercise on mobility in older adults, evidence from a large RCT of obese older adults (n=1613) found moderate intensity aerobic and resistance exercise reduced the risk of mobility disability. Exercise was effective and safe for participants across all ranges of BMI. .
Quality of evidence
- Consistent evidence that exercise improves mobility from meta-analyses and large scale RCTs.
Strength of recommendation
1A- Exercise is likely to improve mobility among most or all patients who are overweight or obese. Clear positive balance of benefit/risk.
Exercise interventions are likely to improve mobility including walking speed, walking ability, and the ability to do the activities of daily living. Exercise can be recommended to most people as safe and effective, unless they have absolute contraindication to exercise.
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