Bieler T, Siersma V, Magnusson S P, Kjaer M, Christensen H E, Beyer N
Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Musculoskeletal Rehabilitation Research Unit, Department of Physical & Occupational Therapy Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.
Scand J Med Sci Sports. 2017 Aug;27(8):873-886. doi: 10.1111/sms.12694. Epub 2016 Apr 30.
This observer-blinded, randomized controlled trial compared the short- and long-term effects of 4 months of supervised strength training (ST) in a local fitness center, supervised Nordic Walking (NW) in a local park, and unsupervised home-based exercise (HBE, control) on functional performance in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self-efficacy, and health-related quality of life) were measured at baseline and at 2, 4, and 12 months. Based on intention-to-treat-analyses improvements [mean (95% CI)] after intervention in number of chair stands were equal in all three groups at 4 months [ST: 0.9 (0.2-1.6), NW: 1.9 (0.8-3.0), HBE: 1.1 (0.1-2.0)] but greater in the NW group [1.4 (0.02-2.8)] than in the ST group at 12 months. Generally, improvements in functional performance were greater (P < 0.001-P < 0.03) after NW compared with HBE and ST at all follow-up time points. Furthermore, NW was superior (P < 0.01) to HBE for improving vigorous physical activity and to both ST and HBE for improving (P < 0.01) mental health. These data suggest that NW is the recommended exercise modality compared with ST and HBE.
这项观察者盲法随机对照试验比较了在当地健身中心进行4个月有监督力量训练（ST）、在当地公园进行有监督北欧式健走（NW）以及无监督家庭锻炼（HBE，对照组）对152名60岁及以上非等待髋关节置换的髋骨关节炎（OA）患者功能表现的短期和长期影响。在基线以及第2、4和12个月时测量功能表现[即30秒坐立试验（主要结局）、定时爬楼梯和6分钟步行试验]以及自我报告结局（即身体功能、疼痛、身体活动水平、自我效能和健康相关生活质量）。基于意向性分析，干预后4个月时，三组的坐立次数改善情况[均值（95%置信区间）]相等[ST组：0.9（0.2 - 1.6），NW组：1.9（0.8 - 3.0），HBE组：1.1（0.1 - 2.0）]，但在12个月时，NW组[1.4（0.02 - 2.8）]的改善情况大于ST组。总体而言，在所有随访时间点，与HBE和ST相比，NW后功能表现的改善更大（P < 0.001 - P < 0.03）。此外，NW在改善剧烈身体活动方面优于HBE（P < 0.01），在改善心理健康方面优于ST和HBE（P < 0.01）。这些数据表明，与ST和HBE相比，NW是推荐的运动方式。
