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健康指导对 60 岁及以上人群身体活动参与的影响如何?一项随机对照试验的系统评价。

What is the effect of health coaching on physical activity participation in people aged 60 years and over? A systematic review of randomised controlled trials.

机构信息

The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.

Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia.

出版信息

Br J Sports Med. 2017 Oct;51(19):1425-1432. doi: 10.1136/bjsports-2016-096943. Epub 2017 Mar 20.

Abstract

BACKGROUND

Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people.

METHODS

MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses.

RESULTS

27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies; SMD = 0.27; 95% CI 0.18 to 0.37; p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies; SMD = 0.10; 95% CI -0.03 to 0.23; p=0.13), quality of life (eight studies; SMD = 0.07; 95% CI -0.06 to 0.20; p<0.05) or mood (five studies; SMD = 0.02; 95% CI -0.12 to 0.16; p=0.83).

CONCLUSIONS

Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes.

摘要

背景

体力活动减少在老年人中很常见,但增加体力活动可以预防慢性病,最大限度地提高老年人的独立性,对他们有益。健康教练是一种行为改变干预措施,已被证明可以增加临床人群的体力活动。本系统评价和荟萃分析调查了健康教练对老年人体力活动、移动能力、生活质量和情绪的影响。

方法

使用 MEDLINE、EMBASE、CENTRAL、PsycINFO、PEDro、SPORTDiscus、LILACS 和 CINAHL 数据库,以确定评估健康教练对 60 岁以上人群体力活动(主要结果)影响的随机对照试验。次要结果是移动能力、生活质量和情绪。我们从随机效应荟萃分析中计算了标准化均数差(SMD,Hedges'g)及其 95%置信区间。

结果

纳入了 27 项符合条件的试验。健康教练对体力活动有较小但具有统计学意义的影响(27 项研究;SMD=0.27;95%CI 0.18 至 0.37;p<0.001)。健康教练对移动能力(8 项研究;SMD=0.10;95%CI-0.03 至 0.23;p=0.13)、生活质量(8 项研究;SMD=0.07;95%CI-0.06 至 0.20;p<0.05)或情绪(5 项研究;SMD=0.02;95%CI-0.12 至 0.16;p=0.83)没有影响。

结论

健康教练显著增加了 60 岁以上人群的体力活动。健康教练对生活质量、移动能力和情绪没有影响,因此可能需要采取不同的方法来影响这些结果。

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