Exercise benefits people with chronic disease, but does the type matter?

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Nov 11 2026

Does the type of exercise matter when managing chronic disease? An analysis of 48 studies examined how different workouts affect health indicators and whether benefits vary across medical conditions and geographic regions.

The impact of physical activity on chronic diseases: a meta-analysis. Image Credit: onebit / Shutterstock

In a recent study published in the journal Scientific Reports, researchers evaluated the effects of physical activity on chronic disease-related health indicators in people with, or at risk of, chronic disease and compared outcomes across exercise modalities, disease types, and geographic regions.

Scientists from Wuhan Sports University, Guangxi Agricultural Vocational and Technical University, Guangxi University, and the Wuhan Botanical Garden of the Chinese Academy of Sciences in China conducted the research.

Background

Cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases are among the leading causes of death globally.

Changing lifestyles and increasing sedentary behavior have contributed to rising rates of chronic disease, even among young adults. Physical activity has many benefits, such as improving cardiovascular fitness and mental well-being.

Questions remain about which exercise types are most effective for particular health indicators and patient groups. The effectiveness of exercise interventions may also vary across geographical and sociocultural settings, but evidence for regional differences remains uncertain.

More evidence is needed to develop standardized, evidence-based exercise recommendations that account for disease type and population characteristics.

About the study

The researchers systematically reviewed and analyzed published studies to identify and synthesize evidence according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD420261357663). PubMed, Google Scholar, Web of Science, and Embase were searched for studies published through December 2023; the final database search was conducted on February 20, 2024.

The review excluded research published from 2024 onward. Controlled intervention studies published in English and Chinese that evaluated physical activity or exercise in relation to chronic diseases and reported sufficient data to estimate an effect size were included. Reviews, protocols, commentaries, single-arm studies, and studies with insufficient outcome data were excluded.

Two researchers independently screened the records and full-text articles, resolving disagreements through discussion or consultation with a third researcher. Study characteristics and outcome data were extracted using a standardized form, and a third researcher verified the information. The researchers assessed methodological quality using the Cochrane Risk of Bias 2.0 tool.

The researchers compared health measurements between exercise and control groups using a standardized statistical approach. They used random-effects models to account for variation between studies.

The authors assessed how widely the findings varied across studies. Subgroup analyses were performed for exercise modality, health indicators, geographic region, and disease type.  

Study results

The search identified 2,867 records; 2,100 remained after duplicate removal. Screening yielded 48 studies and 93 separate estimates of exercise effects.

Results varied considerably between studies. Across all outcomes, physical activity showed an overall statistically significant benefit, but this pooled estimate was difficult to interpret because some health indicators improved when values decreased, while others improved when values increased. Results for individual indicators were more informative.

Aerobic exercise was the only modality with a significant pooled effect in the primary analysis. Results for resistance exercise and combined aerobic and resistance exercise were less certain, with confidence intervals that included no effect.

Differences between modalities were also nonsignificant; no exercise type was shown to be superior. The evidence was uneven, with 70 effect sizes for aerobic exercise, seven for resistance training, and 16 for combined training.

Physical activity significantly improved systolic blood pressure, diastolic blood pressure, heart rate, and maximal oxygen uptake (VO₂max), an indicator of cardiorespiratory fitness.

No significant effects were observed for body mass index (BMI), physical health scores, or mental health scores. Total cholesterol appeared to increase, but this finding came from just one effect size and cannot establish a general adverse effect of exercise.

Physical activity produced significant improvements in the measured health indicators among people with hypertension and diabetes. The pooled effect among people with cardiovascular disease was not statistically significant, but that subgroup contained only six effect sizes.

Differences across disease categories were significant overall, but the estimates did not establish whether people with hypertension benefited more than those with diabetes.

Evidence of benefit was strongest in Asia, North America, and Europe, while estimates for Oceania, Africa, and South America were inconclusive. The study could not establish differences in effectiveness between regions, and few effect sizes were available from the latter three regions.

Sensitivity analyses supported the overall finding. When the direction of improvement was made consistent across health indicators, the pooled result still favored physical activity.

A model accounting for multiple outcomes from the same studies also retained a significant overall effect, but findings for individual exercise modalities and regions were no longer statistically significant. Removing each effect size in turn did not materially change the overall result.

Conclusions

The meta-analysis supports physical activity as a beneficial approach to managing several chronic disease-related health indicators, particularly blood pressure, heart rate, and cardiorespiratory fitness.

Benefits were evident among people with hypertension and diabetes, while significant effects on cardiovascular disease, BMI, and mental health were not established in this analysis. Aerobic exercise showed the clearest benefit in the primary analysis, but no modality proved superior. Because heterogeneity was substantial, the findings require cautious interpretation. 

Further limitations included the restricted language search, uneven geographic representation, and the failure to retrieve 517 of 587 reports sought for full-text assessment, which may have excluded eligible studies.

Larger, standardized studies across diverse populations and regions are needed to clarify optimal exercise type, frequency, intensity, and duration, and to improve the applicability of future recommendations for chronic disease prevention and management.