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老年人运动训练身体功能反应的异质性。

Heterogeneity of physical function responses to exercise training in older adults.

作者信息

Chmelo Elizabeth A, Crotts Charlotte I, Newman Jill C, Brinkley Tina E, Lyles Mary F, Leng Xiaoyan, Marsh Anthony P, Nicklas Barbara J

机构信息

J. Paul Sticht Center on Aging and Rehabilitation, Wake Forest University, Winston-Salem, North Carolina; Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, North Carolina.

出版信息

J Am Geriatr Soc. 2015 Mar;63(3):462-9. doi: 10.1111/jgs.13322. Epub 2015 Mar 6.

Abstract

OBJECTIVES

To describe the interindividual variability in physical function responses to supervised resistance and aerobic exercise training interventions in older adults.

DESIGN

Data analysis of two randomized, controlled exercise trials.

SETTING

Community-based research centers.

PARTICIPANTS

Overweight and obese (body mass index (BMI)≥27.0 kg/m2) sedentary men and women aged 65 to 79 (N=95).

INTERVENTION

Five months of 4 d/wk of aerobic training (AT, n=40) or 3 d/wk of resistance training (RT, n=55).

MEASUREMENTS

Physical function assessments: global measure of lower extremity function (Short Physical Performance Battery (SPPB)), 400-m walk, peak aerobic capacity (VO2 peak), and knee extensor strength.

RESULTS

On average, both exercise interventions significantly improved physical function. For AT, there was a 7.9% increase in VO2 peak; individual absolute increases varied from 0.4 to 4.3 mL/kg per minute, and four participants (13%) showed no change or a decrease in VO2 peak. For RT, knee extensor strength improved an average of 8.1%; individual increases varied from 1.2 to 63.7 Nm, and 16 participants (30%) showed no change or a decrease in strength. Usual gait speed, 400-m walk time, chair rise time, and SPPB improved for the majority of AT participants and usual gait speed, chair rise time, and SPPB improved for the majority of RT participants, but there was wide variation in the magnitude of improvement. Only change in 400-m walk time with RT was related to exercise adherence (correlation coefficient=-0.31, P=.004).

CONCLUSION

Despite sufficient levels of adherence to both exercise interventions, some participants did not improve function, and the magnitude of improvement varied widely. Additional research is needed to identify factors that optimize responsiveness to exercise to maximize its functional benefits in older adults.

摘要

目的

描述老年人在接受有监督的抗阻和有氧运动训练干预后身体功能反应的个体间差异。

设计

两项随机对照运动试验的数据分析。

地点

社区研究中心。

参与者

65至79岁的超重和肥胖(体重指数(BMI)≥27.0kg/m²)久坐不动的男性和女性(N = 95)。

干预措施

为期五个月,每周进行4天的有氧训练(AT,n = 40)或每周进行3天的抗阻训练(RT,n = 55)。

测量指标

身体功能评估:下肢功能综合测量(简短体能状况量表(SPPB))、400米步行、最大有氧能力(VO₂峰值)和膝伸肌力量。

结果

平均而言,两种运动干预均显著改善了身体功能。对于有氧训练,VO₂峰值增加了7.9%;个体绝对增加量从每分钟0.4至4.3毫升/千克不等,4名参与者(13%)VO₂峰值未变化或下降。对于抗阻训练,膝伸肌力量平均提高了8.1%;个体增加量从1.2至63.7牛米不等,16名参与者(30%)力量未变化或下降。大多数有氧训练参与者的日常步速、400米步行时间、从椅子上起身的时间和SPPB得到改善,大多数抗阻训练参与者的日常步速、从椅子上起身的时间和SPPB得到改善,但改善幅度差异很大。只有抗阻训练中400米步行时间的变化与运动依从性相关(相关系数 = -0.31,P = 0.004)。

结论

尽管对两种运动干预的依从性都足够,但一些参与者的功能并未改善,且改善幅度差异很大。需要进一步研究以确定优化运动反应性的因素,从而在老年人中最大化运动的功能益处。

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