Effect of exercise therapy and self-management support on multimorbidity: Secondary analysis of the MOBILIZE trial

BACKGROUND: Multimorbidity is linked to systemic low-grade inflammation, poor glycaemic control, dyslipidaemia, and hypertension, yet evidence on effective interventions is limited. We evaluated the impact of a 12-week personalised exercise therapy and self-management support programme, in addition to usual care, on these outcomes in individuals with multimorbidity.

METHODS: This was a pre-planned secondary analysis of the MOBILIZE multicentre randomised controlled trial (NCT04645732). Participants (n = 228) had at least two of the following conditions: knee/hip osteoarthritis, chronic obstructive pulmonary disease, heart disease, hypertension, type 2 diabetes, or depression. The intervention included 24 supervised 60-minute group-based exercise sessions and 24 self-management sessions over 12 weeks. Outcomes were assessed at baseline and 4 months, including interleukin-1 receptor antagonist (IL-1ra), high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), glycated Hemoglobin (HbA1c), fasting glucose, insulin, High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), triglycerides, and blood pressure.

RESULTS: Compared to usual care, the intervention group shows a statistically significant reduction in systolic blood pressure (mean difference: -4.7 mmHg, 95% CI: -8.8 to -0.6). No significant between-group differences are observed for other biomarkers, although favouring the intervention. Sensitivity analyses-excluding participants with low adherence, those receiving supervised exercise in the control group, or undergoing surgery-support the primary findings.

CONCLUSIONS: A 12-week personalised exercise and self-management programme reduces systolic blood pressure in people with multimorbidity. These findings support incorporating exercise therapy into multimorbidity care guidelines as a non-pharmacological adjunct.