Beauchamp Marla K, Lee Annemarie, Ward Rachel F, Harrison Samantha L, Bain Paul A, Goldstein Roger S, Brooks Dina, Bean Jonathan F, Jette Alan M
School of Rehabilitation Science and Department of Medicine, McMaster University, IAHS Room 428, 1400 Main Street West, Hamilton, Ontario L8S 1C7, Canada.
West Park Healthcare Centre, Toronto, Ontario, Canada.
Phys Ther. 2017 Oct 1;97(10):964-974. doi: 10.1093/ptj/pzx082.
The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence base for interventions to improve participation remains inconclusive. In particular, whether exercise interventions improve participation in life roles is unclear.
The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles in older adults residing in the community.
The PubMed, Embase, CINAHL, Cochrane, and PEDro databases were searched from inception through March 2015.
Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults who were 60 years of age or older were included in this review.
Teams of 2 investigators independently extracted data on participation. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The protocol was registered with Prospero (CRD42014014880).
Eighteen randomized controlled trials with a total of 2,315 participants met the inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. A meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD = 0.03; 95% CI = -0.10 to 0.16). Subgroup analysis showed that exercise interventions lasting 12 months or more had a small positive effect on participation (SMD = 0.15; 95% CI = 0.02 to 0.28).
Limitations included variability in definitions and measures of participation.
In general, exercise interventions do not improve participation in life roles in older adults. The results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted.
世界卫生组织认为参与有意义的生活角色是健康的关键组成部分。然而，改善参与度的干预措施的证据基础仍不明确。特别是，运动干预是否能提高对生活角色的参与尚不清楚。
本综述的目的是评估体育锻炼干预对社区中老年人参与生活角色的影响。
检索了PubMed、Embase、CINAHL、Cochrane和PEDro数据库，检索时间从建库至2015年3月。
本综述纳入了比较运动干预与常规护理对60岁及以上成年人参与生活角色影响的随机对照试验。
由2名研究人员组成的团队独立提取关于参与度的数据。使用Cochrane工具评估偏倚风险来评价方法学质量。该方案已在国际系统评价注册平台（Prospero，注册号CRD42014014880）登记。
18项随机对照试验，共2315名参与者符合纳入标准。使用随机效应模型计算标准化均数差（SMD）及95%置信区间（CI）。对16项研究的荟萃分析表明，运动干预对参与度没有总体影响（SMD = 0.03；95% CI = -0.10至0.16）。亚组分析表明，持续12个月或更长时间的运动干预对参与度有小的积极影响（SMD = 0.15；95% CI = 0.02至0.28）。
局限性包括参与度定义和测量方法的变异性。
总体而言，运动干预并不能提高老年人对生活角色的参与度。这些结果不支持这样一种隐含假设，即与功能/活动改善相关的基于运动的干预也会导致参与度提高。有必要对超越运动范畴的复杂干预措施进行研究，以解决老年人参与生活角色的问题。
