Tailored Exercise and Self-Management Programs Improve Quality of Life for Those with Multiple chronic Conditions
A new study published in Nature Medicine reveals that a combined approach of personalized exercise therapy and self-management support can safely and substantially improve the quality of life for adults managing multiple chronic health conditions.
More than one-third of adults worldwide currently live with multimorbidity – the presence of at least two long-term health conditions – a figure projected to surge by 84% by 2050. This growing health challenge disproportionately affects socially disadvantaged populations, exacerbating existing health inequalities. Individuals with multimorbidity frequently enough experience diminished physical and mental well-being, a heightened risk of premature mortality, and increased strain on healthcare systems.
The Need for a New Approach to Multimorbidity
Current healthcare models frequently address each condition in isolation, leading to fragmented and often inefficient care. Experts increasingly advocate for person-centered care, emphasizing the importance of empowering patients to actively manage their health.Both self-management support and exercise therapy have emerged as promising strategies, with exercise demonstrating proven benefits for conditions like depression, diabetes, and heart disease – illnesses that frequently co-occur. Though, until now, robust evidence confirming their effectiveness in real-world settings has been limited.
Did you know?-Multimorbidity is more common in older adults, but it’s also on the rise in younger populations.Factors like lifestyle, genetics, and socioeconomic status contribute to its development. Addressing this requires a shift toward holistic care.
The MOBILIZE Trial: A Randomized Controlled Study
Researchers conducted a multicenter randomized controlled trial (RCT),part of a five-year project called MOBILIZE,to investigate the impact of a combined intervention. The study, conducted in Denmark, involved 228 adults with multimorbidity – specifically, at least two of the following conditions: knee or hip osteoarthritis, chronic obstructive pulmonary disease, heart disease, hypertension, type 2 diabetes, and depression.
Participants were randomly assigned to either an intervention group or a control group receiving standard medical care.The intervention group participated in a 12-week program consisting of 24 supervised sessions, each combining 30 minutes of self-management support with 60 minutes of personalized exercise. Exercise intensity was tailored to each participant’s perceived exertion level, delivered by trained physiotherapists. Outcomes were assessed at baseline and at 4, 6, and 12 months using validated questionnaires and physical performance tests.
Significant Improvements in Quality of Life Reported
After 12 months, the study revealed a statistically significant advancement in health-related quality of life (HRQoL) among participants in the intervention group compared to those receiving usual care. The intervention group’s hrqol score improved by 0.050 points, while the control group experienced a slight decline of 0.014 points.Notably, 55% of participants in the support group achieved a patient-acceptable symptom state, compared to 40% in the control group.
Beyond overall quality of life, participants in the intervention group also demonstrated statistically significant improvements in physical function – as measured by the 30-second chair-stand test and the 6-minute walk test – as well as improvements in self-rated health, disability, illness burden, and depression. However, these secondary outcome improvements were not statistically significant when compared directly to the usual care group.
Pro tip:-When starting an exercise program, begin slowly and gradually increase intensity. Listen to your body and consult with a healthcare professional. Consistency is key to achieving lasting benefits for your health and well-being.
interestingly, the researchers found that the between-group difference in HRQoL was not statistically significant when analyzing onyl participants who fully adhered to the program, suggesting that consistent engagement is crucial for maximizing benefits.
Safety and Limitations
Crucially, the intervention proved safe, with no significant differences in serious or non-serious adverse events between the two groups. this indicates that the program is well-tolerated by individuals with multiple chronic conditions.
While the findings are promising, researchers acknowledge certain limitations. The study’s design did not allow for blinding of participants, possibly introducing bias. The intensive 24-session intervention may also present a treatment burden for some individuals. Furthermore, the specific definition of multimorbidity used in the study may limit the generalizability of the results. The researchers also noted that the increased attention from healthcare professionals in the intervention group could have contributed to the observed effects.
Looking Ahead: The Future of Multimorbidity Management
Despite these limitations, this trial provides compelling evidence supporting the safety and potential value of personalized self-management and exercise programs in enhancing the quality of life for individuals living with multimorbidity. However, the observed improvement of 0.064 points in HRQoL, while statistically significant, fell short of the 0.074-point threshold considered a “minimum significant difference” in some patient populations, raising questions about its clinical relevance.
“Further large-scale trials are needed to confirm these findings and clarify their long-term clinical importance,” researchers concluded. These future studies will be critical to determine whether this combined approach can become a standard component of care for the growing number of individuals navigating the complexities of multiple chronic conditions.
Journal reference:
Exercise therapy and self-management support for individuals with multimorbidity: a randomized and controlled trial. Skou, S.T., Nyberg, M., Dideriksen, M., Rasmussen, H., Overgaard, J.A., Bodilsen, C., Soja, A.M.B., Attarzadeh, A.P., Bieder, M.J., Dridi, N.P., Heltberg, A., Gæde, P.H.,Reventlow,J.L., Arnfred, S., Bodtger, U., Brønd, J.C., Thygesen, L.C., Møller, S.P., Jäger, M.,Bricca,A. Nature Medicine (2025). DOI: 10.1038/s41591-025-03779-4, https://www.nature.com/articles/s41591-025-03779-4
