Taking a seat for better health? The benefits of modifying exercise for people with health conditions

The Bottom Line

  • Globally, it’s estimated that between 110 million and 190 million adults face substantial functional limitations, some of which are caused by an existing health condition or aging.    
  • Exercising within the limits of one’s health condition is still recommended by international psychical activity guidelines. Seated exercises are one type of modification that can be made to overcome barriers.  
  • Seated exercise programs may improve cognition in older adults with a health condition or impairment, as well as balance and mobility in individuals living with a stroke. 
  • Consider trying a seated exercise program, but first consult your health care provider about the benefits and risks, and guidance on how to choose the best program for your individual needs. 

Physical activity, an issue so important that each year the world dedicates an entire day to encouraging people to get up and get moving. But just because April 6th is officially World Physical Activity Day, it doesn’t mean we should forget about being physically active the other 364 days of the year. In fact, for the sake of our own physical, mental, and cognitive health, we need to be active every day (1-6).

Globally, it’s estimated that between 110 million and 190 million adults face substantial functional limitations due to aging, health conditions, and other factors (7). Despite this, getting and staying physically active needs to be a priority. This notion is supported by international guidelines, which recommend that people with a health condition continue to be as physically active as their circumstance allows (8-10). One approach to help keep people with functional limitations active is seated exercise (8). But does it lead to health benefits for older adults?

What the research tells us

systematic review looked at the impact of seated exercise programs on impairment (e.g., cognition) and activity (e.g., mobility) in older adults with a health condition or impairment (e.g., frailty, recent discharge from the hospital, and recent hip surgery). Exercise programs were generally supervised, group-based, and varied in terms of program structure, composition, and setting. Examples of exercise types within these programs include progressive and non-progressive resistance/strength training, tai chi, and dance therapy.

The review found that seated exercise programs may improve cognition in older adults with a health condition or impairment, compared to receiving usual care or engaging in social activities. However, similar benefits were not seen for mobility or balance. In terms of safety, seated exercise programs seem to be classified as generally safe, although in some instances muscle soreness, joint pain, and back pain were reported (8).

Not represented in the review above are individuals living with a stroke. A more recent review suggests that seated exercise may help improve balance and mobility in this population compared to control groups such as standard therapy or sham sitting (11).

Although more research is needed on seated exercise, it may be a good alternative for older adults with functional limitations (8).

Health conditions—be it those that leave you short of breath, impair vision, or decrease balance—can make it harder to engage in physical activity. But exercises can be modified to help overcome some barriers. Consider a seated exercise program, but first speak with your healthcare provider about the benefits and risks, ideal program components and delivery formats for your specific circumstance, and precautions you can take to engage in exercise more safely.

Get the latest content first. Sign up for free weekly email alerts.
Author Details


  1. Tulloch A, Bombell H, Dean C, et al. Yoga-based exercise improves health-related quality of life and mental well-being in older people: A systematic review of randomised controlled trials. Age Ageing. 2018; 47:537-44. 
  2. Murtagh EM, Michols L, Mohammed MA, et al. The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomized control trials. Prev Med. 2015; 72:34-43. doi: 10.1016/j.ypnmed.2014.12.041. 
  3. Kassavou A, Turner A, French DP. Do interventions to promote walking in groups increase physical activity? A meta-analysis. Int J Behav Nutr Phys Act. 2013; 10:18-30. doi: 10.1186/1479-5868-10-18. 
  4. O’Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015; 96:724-734. doi: 10.1016/j.apmr.2014.12.003. 
  5. Northey JM, Cherbuin N, Pumpa KL, et al. Exercise interventions for cognitive function in adults older than 50: A systematic review with meta-analysis. Br J Sports Med. 2018; 52(3):154-160. doi: 10.1136/bjsports-2016-096587.  
  6. Gordon BR, McDowell CP, Hallgren M, et al. Association of efficacy of resistance exercise training with depressive symptoms. JAMA Psychiatry. 2018; 75(6):566-576. doi: 10.1001/jamapsychiatry.2018.0572. 
  7. World Health Organization. Disability and health. [Internet] 2018. [cited Sept 2020]. Available from https://www.who.int/news-room/fact-sheets/detail/disability-and-health  
  8. Sexton BP, Taylor, NF. To sit or not to sit? A systematic review and meta-analysis of seated exercise for older adults. Australas J Ageing. 2019; 38:15-27. doi: 10.1111/ajag.12603.
  9. Sims J, Hill K, Hunt S, et al. National physical activity recommendations for older Australians: Discussion document. Canberra: Australian Government Department of Health and Ageing; 2006.
  10. Nelson M, Rejeski W, Blair S, et al. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007; 116:1094-1105. 
  11. Mackie P,  Eng JJ. The influence of seated exercises on balance, mobility, and cardiometabolic health outcomes in individuals living with a stroke: A systematic review and meta-analysis. Clin Rehabil. 2023 ; 37(7):927-941. doi: 10.1177/02692155221150002.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.