Santanasto Adam J, Glynn Nancy W, Lovato Laura C, Blair Steven N, Fielding Roger A, Gill Thomas M, Guralnik Jack M, Hsu Fang-Chi, King Abby C, Strotmeyer Elsa S, Manini Todd M, Marsh Anthony P, McDermott Mary M, Goodpaster Bret H, Pahor Marco, Newman Anne B
Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
J Am Geriatr Soc. 2017 Jul;65(7):1427-1433. doi: 10.1111/jgs.14804. Epub 2017 Feb 21.
Physical activity (PA) reduces the rate of mobility disability, compared with health education (HE), in at risk older adults. It is important to understand aspects of performance contributing to this benefit.
To evaluate intervention effects on tertiary physical performance outcomes.
The Lifestyle Interventions and Independence for Elders (LIFE) was a multi-centered, single-blind randomized trial of older adults.
Eight field centers throughout the United States.
1635 adults aged 78.9 ± 5.2 years, 67.2% women at risk for mobility disability (Short Physical Performance Battery [SPPB] <10).
Moderate PA including walking, resistance and balance training compared with HE consisting of topics relevant to older adults.
Grip strength, SPPB score and its components (balance, 4 m gait speed, and chair-stands), as well as 400 m walking speed.
Total SPPB score was higher in PA versus HE across all follow-up times (overall P = .04) as was the chair-stand component (overall P < .001). No intervention effects were observed for balance (overall P = .12), 4 m gait speed (overall P = .78), or grip strength (overall P = .62). However, 400 m walking speed was faster in PA versus HE group (overall P =<.001). In separate models, 29% of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score, while 39% was explained by change in the chair stand component.
Lower extremity performance (SPPB) was significantly higher in the PA compared with HE group. Changes in chair-stand score explained a considerable portion of the effect of PA on the reduction of major mobility disability-consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability.
与健康教育（HE）相比，身体活动（PA）可降低高危老年人的行动能力残疾率。了解促成这一益处的表现方面很重要。
评估对三级身体表现结果的干预效果。
老年人生活方式干预与独立性（LIFE）是一项针对老年人的多中心、单盲随机试验。
美国各地的八个现场中心。
1635名年龄在78.9±5.2岁的成年人，67.2%为有行动能力残疾风险的女性（简易身体表现量表[SPPB]<10）。
与包含与老年人相关主题的健康教育相比，进行包括步行、阻力和平衡训练在内的适度身体活动。
在所有随访时间内，身体活动组的总SPPB得分均高于健康教育组（总体P = 0.04），椅子站立部分也是如此（总体P < 0.001）。在平衡（总体P = 0.12）、4米步速（总体P = 0.78）或握力（总体P = 0.62）方面未观察到干预效果。然而，身体活动组的400米步行速度比健康教育组更快（总体P = <0.001）。在单独的模型中，身体活动组与健康教育组相比，主要行动能力残疾率降低的29%可由SPPB得分的变化来解释，而39%可由椅子站立部分的变化来解释。
与健康教育组相比，身体活动组的下肢表现（SPPB）显著更高。椅子站立得分的变化解释了身体活动对降低主要行动能力残疾影响的相当一部分——这与保持肌肉力量/功率可能对预防主要行动能力残疾很重要的观点一致。
