Sherrington Catherine, Tiedemann Anne, Fairhall Nicola, Close Jacqueline C T, Lord Stephen R
Musculoskeletal Division, The George Institute for Global Health, The University of Sydney, Australia.
N S W Public Health Bull. 2011 Jun;22(3-4):78-83. doi: 10.1071/NB10056.
This systematic review update includes 54 randomised controlled trials and confirms that exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Meta-regression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effect on reducing falls. We therefore recommend that exercise for falls prevention should provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis. Additionally, we recommend that: falls prevention exercise should target both the general community and those at high risk for falls; exercise may be undertaken in a group or home-based setting; strength and walking training may be included in addition to balance training but high risk individuals should not be prescribed brisk walking programs; and other health-related risk factors should also be addressed.
本系统评价更新纳入了54项随机对照试验,并证实运动作为单一干预措施可预防跌倒(合并率比为0.84,95%置信区间为0.77 - 0.91)。Meta回归分析显示,包含平衡训练、运动剂量较高且不包括步行训练的项目对减少跌倒的效果最为显著。因此,我们建议预防跌倒的运动应给平衡能力带来中度或高度挑战,并且应持续每周至少进行2小时。此外,我们建议:预防跌倒的运动应针对普通人群和跌倒高危人群;运动可在团体环境或居家环境中进行;除平衡训练外,可纳入力量训练和步行训练,但不应为高危个体开具快走项目;还应关注其他与健康相关的风险因素。