Adverse events of exercise therapy in randomised controlled trials

a systematic review and meta-analysis

Andre Niemeijer, Hans Lund, Signe Nilssen Stafne, Thomas Ipsen, Cathrine Luhaäär Goldschmidt, Claus Thomas Jørgensen, Carsten B Juhl

Research output: Contribution to journalReviewResearchpeer-review

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 numberCRD42014014819.

Original languageEnglish
JournalBritish Journal of Sports Medicine
ISSN0306-3674
DOIs
Publication statusE-pub ahead of print - 28. Sep 2019

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Meta-Analysis
Randomized Controlled Trials
Numbers Needed To Treat
Databases
Exercise
Control Groups

Cite this

Niemeijer, Andre ; Lund, Hans ; Stafne, Signe Nilssen ; Ipsen, Thomas ; Goldschmidt, Cathrine Luhaäär ; Jørgensen, Claus Thomas ; Juhl, Carsten B. / Adverse events of exercise therapy in randomised controlled trials : a systematic review and meta-analysis. In: British Journal of Sports Medicine. 2019.
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title = "Adverse events of exercise therapy in randomised controlled trials: a systematic review and meta-analysis",
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 numberCRD42014014819.",
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Adverse events of exercise therapy in randomised controlled trials : a systematic review and meta-analysis. / Niemeijer, Andre; Lund, Hans; Stafne, Signe Nilssen; Ipsen, Thomas; Goldschmidt, Cathrine Luhaäär; Jørgensen, Claus Thomas; Juhl, Carsten B.

In: British Journal of Sports Medicine, 28.09.2019.

Research output: Contribution to journalReviewResearchpeer-review

TY - JOUR

T1 - Adverse events of exercise therapy in randomised controlled trials

T2 - a systematic review and meta-analysis

AU - Niemeijer, Andre

AU - Lund, Hans

AU - Stafne, Signe Nilssen

AU - Ipsen, Thomas

AU - Goldschmidt, Cathrine Luhaäär

AU - Jørgensen, Claus Thomas

AU - Juhl, Carsten B

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/9/28

Y1 - 2019/9/28

N2 - 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 numberCRD42014014819.

AB - 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 numberCRD42014014819.

U2 - 10.1136/bjsports-2018-100461

DO - 10.1136/bjsports-2018-100461

M3 - Review

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

ER -