Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
J Gerontol A Biol Sci Med Sci. 2018 Apr 17;73(5):688-694. doi: 10.1093/gerona/glx231.
Structured physical activity interventions delay the onset of disability for at-risk older adults. However, it is not known if at-risk older adults continue to participate in physical activity or maintain mobility benefits after cessation of structured intervention.
One thousand six hundred and thirty-five sedentary men and women aged 70-89 years with Short Physical Performance Battery (SPPB) scores of 9 or less and able to walk 400 m were randomized to a structured, moderate-intensity physical activity (PA) program consisting of center-based (twice/week) and home-based (three to four times per week) aerobic, resistance, and flexibility training or a health education (HE) program combined with upper extremity stretching.
Most of the participants (88% of HE and 87% of PA) returned for a follow-up visit (POST) 1 year after cessation of formal intervention. The HE group reported about 1-hour less activity per week than the PA group at end of intervention (LAST TRIAL; -68.9; 95% confidence interval [CI] = -86.5 to -51.3) but similar weekly activity at POST (-13.5; 95% CI = -29.5 to 2.47). SPPB did not differ between the two groups at LAST TRIAL (-0.06; 95% CI = -0.31 to 0.19) nor POST (-0.18; 95% CI = -0.45 to 0.088).
Although sedentary at-risk older adults increased their physical activity during a structured physical activity intervention, they did not continue at this level following the cessation of intervention. Future exercise interventions need to include novel methods to support older adults in continued physical activity following structured interventions.
有组织的体育活动干预可延迟高危老年人的残疾发生。然而,尚不清楚高危老年人在停止有组织的干预后是否继续参加体育活动或保持运动获益。
1635 名 70-89 岁、短体适能表现测试(SPPB)评分为 9 分或更低、能够行走 400 米的久坐男性和女性被随机分为结构化、中等强度的体育活动(PA)方案组或健康教育(HE)方案组。前者包括基于中心(每周两次)和家庭(每周三到四次)的有氧运动、抗阻运动和柔韧性训练,后者则是结合上肢拉伸的综合 HE 方案。
大多数参与者(HE 组的 88%,PA 组的 87%)在正式干预结束后 1 年时返回进行随访(POST)。与 PA 组相比,HE 组在干预结束时报告的每周活动量减少了约 1 小时(LAST TRIAL;-68.9;95%置信区间[CI] = -86.5 至 -51.3),但在 POST 时的每周活动量相似(-13.5;95% CI = -29.5 至 2.47)。两组在 LAST TRIAL 时 SPPB 评分无差异(-0.06;95% CI = -0.31 至 0.19),在 POST 时也无差异(-0.18;95% CI = -0.45 至 0.088)。
尽管久坐的高危老年人在结构化体育活动干预中增加了身体活动量,但在干预结束后并未继续保持这一水平。未来的运动干预需要包括新的方法,以支持老年人在结构化干预后继续进行身体活动。