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Seated exercise may improve cognition in older adults with a health condition or impairment

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.

Review question

What is the effect of seated exercise on impairment, activity, and participation levels in older adults with a health condition or impairment?


Not being physically active can negatively impact the physical and cognitive health of older adults; while exercising daily, even for a minimal amount of time, can increase lifespan and lower the risk of death. Older adults with health conditions often face barriers to being physically active as a result of balance and mobility issues. Despite these barriers, older adults with health conditions still have much to gain from exercising as much as their limitations allow. Seated exercise programs are one strategy that can help those facing mobility and balance issues exercise. However, evidence on their effect has been mixed and requires further clarification.        

How the review was done

This is a systematic review and meta-analysis of 15 studies reporting on 14 randomized controlled trials. The studies were published between 1993 and 2016 and included a total of 921participants. Key features of the studies:

  • On average, participants were 81 years old. Most were frail, some had recently been discharged from the hospital, and a few had very recently undergone hip surgery.
  • residential care facility, day care centre, home, or hospital). Most programs were group-based and supervised.
  • Researchers mainly evaluated the following outcomes: impairment, balance, activity, and quality of life. Various measures of impairment were used—such as cognitive [e.g., cognition], physical [e.g., strength and range of motion when bending forward], and mental [e.g., depression]—and various measures of activity (e.g., mobility, physical function/performance).
  • Results were compared to people in control groups receiving usual care, engaging in social activities (e.g., recreational or reminiscence groups, social visits), or engaging in an alternate exercise.

What the researchers found

Overall, compared to usual care or social activities, seated exercise may improve cognition in older adults with a health condition or impairment, but not mobility or balance. There is a very small amount of evidence suggesting that seated exercise may improve strength, range of motion, depression, health-related quality of life, and performance in activities of daily living, but much more research is needed before definite recommendations can be made.


Seated exercise may hold some benefits, such as improved cognition, for older adults who are limited by a health condition or impairment. More research is needed to determine if benefits extend to physical outcomes such as mobility and balance.



Control group
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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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 (

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