TNO-VU University Medical Center, Amsterdam, The Netherlands.
Int J Behav Nutr Phys Act. 2011 Dec 28;8:142. doi: 10.1186/1479-5868-8-142.
The health benefits of regular physical activity and exercise have been widely acknowledged. Unfortunately, a decline in physical activity is observed in older adults. Knowledge of the determinants of physical activity (unstructured activity incorporated in daily life) and exercise (structured, planned and repetitive activities) is needed to effectively promote an active lifestyle. Our aim was to systematically review determinants of physical activity and exercise participation among healthy older adults, considering the methodological quality of the included studies.
Literature searches were conducted in PubMed/Medline and PsycINFO/OVID for peer reviewed manuscripts published in English from 1990 onwards. We included manuscripts that met the following criteria: 1) population: community dwelling healthy older adults, aged 55 and over; 2) reporting determinants of physical activity or exercise. The outcome measure was qualified as physical activity, exercise, or combination of the two, measured objectively or using self-report. The methodological quality of the selected studies was examined and a best evidence synthesis was applied to assess the association of the determinants with physical activity or exercise.
Thirty-four manuscripts reporting on 30 studies met the inclusion criteria, of which two were of high methodological quality. Physical activity was reported in four manuscripts, exercise was reported in sixteen and a combination of the two was reported in fourteen manuscripts. Three manuscripts used objective measures, twenty-two manuscripts used self-report measures and nine manuscripts combined a self-report measure with an objective measure. Due to lack of high quality studies and often only one manuscript reporting on a particular determinant, we concluded "insufficient evidence" for most associations between determinants and physical activity or exercise.
Because physical activity was reported in four manuscripts only, the determinants of physical activity particularly need further study. Recommendations for future research include the use of objective measures of physical activity or exercise as well as valid and reliable measures of determinants.
定期进行身体活动和锻炼对健康有益，这一点已得到广泛认可。然而，老年人的身体活动量呈下降趋势。为了有效地促进积极的生活方式，我们需要了解身体活动（日常生活中包含的非结构化活动）和锻炼（结构化、有计划和重复的活动）的决定因素。我们的目的是系统地回顾健康老年人身体活动和锻炼参与的决定因素，同时考虑纳入研究的方法学质量。
我们在 PubMed/Medline 和 PsycINFO/OVID 中进行了文献检索，以查找 1990 年以来以英文发表的同行评议文献。我们纳入了符合以下标准的文献：1）人群：居住在社区的健康老年人，年龄在 55 岁及以上；2）报告身体活动或锻炼的决定因素。结果测量标准为身体活动、锻炼或两者的组合，使用客观测量或自我报告进行测量。我们对选定研究的方法学质量进行了检查，并应用最佳证据综合评估了决定因素与身体活动或锻炼之间的关联。
符合纳入标准的文献有 34 篇，共涉及 30 项研究，其中 2 项研究具有较高的方法学质量。有 4 篇文献报告了身体活动，16 篇文献报告了锻炼，14 篇文献报告了两者的组合。有 3 篇文献使用了客观测量，22 篇文献使用了自我报告测量，9 篇文献将自我报告测量与客观测量相结合。由于缺乏高质量的研究，而且通常只有一篇文献报告了特定的决定因素，我们得出的结论是，大多数决定因素与身体活动或锻炼之间的关联“证据不足”。
由于仅有 4 篇文献报告了身体活动，因此身体活动的决定因素特别需要进一步研究。对未来研究的建议包括使用身体活动或锻炼的客观测量以及有效和可靠的决定因素测量。
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