Kanach Frances A, Pastva Amy M, Hall Katherine S, Pavon Juliessa M, Morey Miriam C
J Aging Phys Act. 2018 Apr 1;26(2):284-303. doi: 10.1123/japa.2016-0372. Epub 2018 Mar 30.
This review examined effects of structured exercise (aerobic walking, with or without complementary modes of exercise) on cardiorespiratory measures, mobility, functional status, healthcare utilization, and quality of life in older adults (≥60 years) hospitalized for acute medical illness. Inclusion required exercise protocol, at least one patient-level or utilization outcome, and at least one physical assessment point during hospitalization or within 1 month of intervention. MEDLINE, Embase, and CINAHL databases were searched for studies published from 2000 to March 2015. Qualitative synthesis of 12 articles, reporting on 11 randomized controlled trials (RCTs) and quasi-experimental trials described a heterogeneous set of exercise programs and reported mixed results across outcome categories. Methodological quality was independently assessed by two reviewers using the Cochrane Collaboration Risk of Bias tool. Larger, well-designed RCTs are needed, incorporating measurement of premorbid function, randomization with intention-to-treat analysis, examination of a targeted intervention with predefined intensity, and reported adherence and attrition.
本综述探讨了结构化运动（有氧步行，有或没有辅助运动方式）对因急性内科疾病住院的老年人（≥60岁）心肺功能指标、活动能力、功能状态、医疗保健利用及生活质量的影响。纳入标准要求有运动方案、至少一项患者层面或利用结局指标，以及住院期间或干预后1个月内至少一个身体评估点。检索MEDLINE、Embase和CINAHL数据库，查找2000年至2015年3月发表的研究。对12篇文章进行定性综合分析，这些文章报告了11项随机对照试验（RCT）和半实验性试验，描述了一组异质性的运动方案，并报告了各结局类别结果不一。两名评价者使用Cochrane协作网偏倚风险工具独立评估方法学质量。需要开展更大规模、设计良好的RCT，纳入病前功能测量、意向性分析随机分组、对具有预定义强度的靶向干预进行检验，以及报告依从性和失访情况。
