Plow M A, Moore S, Husni M Elaine, Kirwan J P
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Obes Rev. 2014 Dec;15(12):945-56. doi: 10.1111/obr.12223. Epub 2014 Sep 30.
Obesity is a common comorbidity in adults with mobility-impairing neurological and musculoskeletal conditions, such as stroke and arthritis. The interaction between mobility impairments and environmental factors often compromises motivation and ability to engage in healthy behaviours. Such difficulties to engage in healthy behaviours can result in energy imbalance, weight gain and a cycle of functional declines; i.e. obesity can exacerbate mobility impairments and symptoms and increase the likelihood of other comorbid conditions, all of which make it more difficult to engage in healthy behaviours. To help disrupt this cycle, there is a need to identify strategies to optimize energy balance. Thus, this review summarizes clinical trials of nutrition and weight loss interventions in adults with mobility-impairing conditions. Although adults with osteoarthritis were represented in large rigorous clinical trials, adults with neurological conditions were typically represented in studies characterized by a small number of participants, a short-term follow-up and high attrition rates. Studies varied greatly in outcome measures, description and implementation of the interventions, and the strategies used to promote behaviour change. Nutrition and weight loss research in adults with mobility-impairing conditions is still in its formative stages, and there is a substantial need to conduct randomized controlled trials.
肥胖是患有导致行动不便的神经和肌肉骨骼疾病（如中风和关节炎）的成年人中常见的合并症。行动障碍与环境因素之间的相互作用往往会削弱人们参与健康行为的动力和能力。参与健康行为的这些困难可能导致能量失衡、体重增加以及功能衰退的恶性循环；也就是说，肥胖会加剧行动障碍和症状，并增加其他合并症的发生可能性，所有这些都会使参与健康行为变得更加困难。为了帮助打破这个循环，有必要确定优化能量平衡的策略。因此，本综述总结了针对患有行动障碍疾病的成年人进行营养和减肥干预的临床试验。尽管骨关节炎患者参与了大型严格的临床试验，但患有神经疾病的成年人通常参与的是参与者数量少、短期随访且损耗率高的研究。这些研究在结果测量、干预措施的描述和实施以及用于促进行为改变的策略方面差异很大。针对患有行动障碍疾病的成年人的营养和减肥研究仍处于形成阶段，非常需要进行随机对照试验。
