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是否有证据表明步行小组对健康有益?一项系统评价与荟萃分析。

Is there evidence that walking groups have health benefits? A systematic review and meta-analysis.

作者信息

Hanson Sarah, Jones Andy

机构信息

Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.

出版信息

Br J Sports Med. 2015 Jun;49(11):710-5. doi: 10.1136/bjsports-2014-094157. Epub 2015 Jan 19.

Abstract

OBJECTIVE

To assess the health benefits of outdoor walking groups.

DESIGN

Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end.

DATA SOURCES

Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013.

ELIGIBILITY CRITERIA

Adults, group walking outdoors with outcomes directly attributable to the walking intervention.

RESULTS

Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure -3.72 mm Hg (-5.28 to -2.17) and diastolic blood pressure -3.14 mm Hg (-4.15 to -2.13); resting heart rate -2.88 bpm (-4.13 to -1.64); body fat -1.31% (-2.10 to -0.52), body mass index -0.71 kg/m(2) (-1.19 to -0.23), total cholesterol -0.11 mmol/L (-0.22 to -0.01) and statistically significant mean increases in VO(2max) of 2.66 mL/kg/min (1.67-3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37-105.84). A standardised mean difference showed a reduction in depression scores with an effect size of -0.67 (-0.97 to -0.38). The evidence was less clear for other outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as high-density lipids. There were no notable adverse side effects reported in any of the studies.

CONCLUSIONS

Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.

摘要

目的

评估户外步行小组对健康的益处。

设计

对步行小组干预措施进行系统评价和荟萃分析,研究基线与干预结束时常用的生理、心理和幸福感指标的差异。

数据来源

截至2013年11月的七个电子数据库、临床试验注册库、灰色文献及英文参考文献列表。

纳入标准

成年人,在户外进行小组步行,其结果可直接归因于步行干预。

结果

共纳入42项研究,涉及1843名参与者。有证据表明步行小组对健康有广泛益处。荟萃分析显示,收缩压平均差值有统计学显著降低,为-3.72 mmHg(-5.28至-2.17),舒张压平均差值为-3.14 mmHg(-4.15至-2.13);静息心率降低-2.88 次/分钟(-4.13至-1.64);体脂降低-1.31%(-2.10至-0.52),体重指数降低-0.71 kg/m²(-1.19至-0.23),总胆固醇降低-0.11 mmol/L(-0.22至-0.01),且最大摄氧量有统计学显著的平均增加,为2.66 mL/kg/min(1.67至3.65),36项简短健康调查量表(生理功能)得分增加6.02(0.51至11.53),6分钟步行距离增加79.6 米(53.37至105.84)。标准化平均差值显示抑郁得分降低,效应量为-0.67(-0.97至-0.38)。对于其他指标,如腰围、空腹血糖、36项简短健康调查量表(心理健康)和血清脂质(如高密度脂蛋白),证据则不太明确。在任何研究中均未报告明显的不良副作用。

结论

步行小组有效且安全,依从性良好,对健康有广泛益处。它们可能是一种有前景的干预措施,可作为其他医疗保健的辅助手段或作为积极的健康促进活动。

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