Home-based upper limb exercise shows no benefit over lower limb exercise for shoulder function in older adults

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PloS one Published June 7, 2026 Medically reviewed June 7, 2026 Study authors: Bates Amanda, Sherrington Cathie, Furber Susan, Gilchrist Heidi, van den Dolder Paul, Ginn Karen, Ba… PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Note that home-based upper limb exercise did not improve function versus lower limb exercise in older adults.

This randomized controlled trial evaluated the effectiveness of a home-based exercise program targeting upper limb strength, mobility, and function in community-dwelling people aged 65 years and older. The comparator was a home-based exercise program targeting lower limb balance and strength. A total of 617 participants were included in the analysis, with 462 providing data for the primary outcome assessment.

The primary outcome measured upper limb function using the self-report Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. At 12 months, no clinically important or statistically significant between-group difference was detected. The mean difference (MD) was 0.99 with a 95% CI of -0.82 to 2.79 and a p value of 0.283. Secondary outcomes included shoulder strength, range of motion, quality of life, and physical activity. No significant between-group differences were found for these measures.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported in the study. The authors noted that more research is needed to determine the optimal exercise protocols for prevention of shoulder dysfunction. Funding sources and conflicts of interest were not reported.

In practice, people aged 65+ can successfully learn and adhere to a home-based exercise program for the upper limb with instruction provided in a group setting. However, this program did not improve upper limb strength, mobility, and function compared to the lower limb exercise intervention.

Study Details

Study typeRct

Sample sizen = 617

EvidenceLevel 2

Follow-up780.0 mo

PublishedJan 2026

PMID42234658

View Original Abstract ↓

BACKGROUND: Upper limb dysfunction, including shoulder pain, is a major health issue for older people. Exercise is commonly used to treat shoulder disorders. This study aimed to determine the effect of a home-based upper limb exercise program on upper limb function compared to a lower limb exercise program, among community-dwelling people aged 65 years + . METHODS: A randomized controlled trial was conducted. One group received a home-based exercise program targeting upper limb (UL) strength, mobility and function. The other group received a home-based exercise program targeting lower limb (LL) balance and strength. Both exercise programs were taught at three group-based sessions in weeks 1, 4 and 12 post-randomization. Participants were requested to complete exercises three times per week for 12 months. The primary outcome was UL function, measured with the self-report Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcomes included shoulder strength and range of motion (ROM), quality of life (QOL) and physical activity. RESULTS: 617 participants were randomly assigned to UL (n = 307) or LL (n = 310) groups. Mean age was 73 years, (SD 6.0) and 64% were female. No clinically important or statistically significant between-group difference was detected in UL function (measured by the DASH) at 12 months (mean difference (MD) = 0.99, 95% CI -0.82 to 2.79, p = 0.283, n = 462). There were no significant between-group differences in shoulder ROM, most measures of strength, physical activity (device-measured and self-report), QOL and UL function at three and six months. Participants performed the exercises twice per week, averaging 104 exercise sessions (SD 69, median 117, range 0-371) over the 12-month intervention period. CONCLUSION: People aged 65 + can successfully learn and adhere to a home-based exercise program for the UL with instruction provided in a group setting, however this program did not improve UL strength, mobility and function. Considering the increased rates of shoulder dysfunction in older age, more research is needed to determine the optimal exercise protocols for prevention of shoulder dysfunction.