Chase Jo-Ana D
Sinclair School of Nursing, University of Missouri, Columbia.
Gerontologist. 2015 Aug;55(4):706-18. doi: 10.1093/geront/gnu090. Epub 2014 Oct 7.
To determine the overall effectiveness of interventions designed to increase physical activity (PA) behavior among community-dwelling older adults.
Comprehensive literature searching identified eligible PA intervention studies among community-dwelling adults aged 65 and older, or sample mean age of 70. Diverse study characteristics were extracted and outcome data were duplicate coded. Overall mean effect sizes (ESs) were synthesized using a random-effects model. Heterogeneity of effects was analyzed using Q and I(2) statistics. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression for dichotomous and continuous moderators, respectively.
ESs were calculated from 13,829 primary study subjects. The overall mean ES for two-group posttest comparisons was 0.18 (95% CI 0.10-0.26, p < .001). This represents a difference of 620 steps/day or 73 min of PA/week between treatment and control groups. Significant moderators included the use of theory, how interventions were delivered, and cognitive plus behavioral-type intervention components. Non-significant moderators include the type of interventionist, delivery setting, and various measures of intervention dose.
PA interventions significantly improved PA behavior among community-dwelling older adults. Effective PA interventions may be efficiently delivered using already available resources and personnel. Future PA intervention research should be theoretically based, incorporate more diverse subjects, and compare intervention delivery methods.
确定旨在增加社区居住老年人身体活动(PA)行为的干预措施的总体效果。
通过全面的文献检索,确定了65岁及以上社区居住成年人或平均年龄为70岁的样本中的合格PA干预研究。提取了不同的研究特征,并对结果数据进行了重复编码。使用随机效应模型综合总体平均效应量(ESs)。使用Q和I(2)统计分析效应的异质性。分别使用方差分析和回归的元分析类似物对二分法和连续调节因素进行调节因素分析。
从13,829名主要研究对象中计算出ESs。两组后测比较的总体平均ES为0.18(95%CI 0.10 - 0.26,p <.001)。这代表治疗组和对照组之间每天步数相差620步或每周PA相差73分钟。显著的调节因素包括理论的使用、干预措施的实施方式以及认知加行为类型的干预成分。不显著的调节因素包括干预者类型、实施环境和各种干预剂量测量。
PA干预显著改善了社区居住老年人的PA行为。可以利用现有资源和人员有效地实施有效的PA干预措施。未来的PA干预研究应以理论为基础,纳入更多样化的研究对象,并比较干预实施方法。