Mathieu Maltais, PhD, Gérontopôle de Toulouse, Institut du Vieillissement, Bâtiment B, 37 Allée Jules Guesde, 31000, Toulouse France, +33 6 74 70 63 71, E-mail :
J Nutr Health Aging. 2019;23(6):586-594. doi: 10.1007/s12603-019-1199-5.
To gather available evidence about overtime changes on physical performance in institutionalized elderly.
DESIGN, SETTING AND PARTICIPANTS: An electronic search was performed on PubMed database on May 2018. We selected articles reporting the evolution of physical performance in older adults living in care institutions. We looked for data from observational longitudinal studies; data from clinical trials were extracted only for subjects who did not receive exercise intervention. All types of performance-based tests, for upper- and/or lower-body, were scrutinized.
Seventeen studies were reviewed; mean age varied from 78.3 to 88 years old. Fourteen studies were randomized controlled trials (RCTs), other three studies were non-randomized trials and a longitudinal observational study. Different tests assessing physical performance were examined: upper limb strength and lower limb strength, static balance, dynamic balance and mobility showed a tendency to decline over time. On average hand grip strength decreased by 2.2% per month, chair stand test by 3.5%, Berg balance scale by 2%, timed up-and-go test by 2.8%, gait speed by 2.1% and short physical performance battery by 2.8%. A minority of studies have shown an improvement in lower limb muscle strength, endurance and gait speed: in these studies, participants did not attend any kind of physical training but took part to social activities or cognitive interventions.
This review shows how physical performance decreases over time in nursing home residents and quantifies their decline. However, in active controls, there was an improvement in some physical performance measures, which indicates that intervention other than exercise might prevent some loss in physical performance.
收集有关机构老年人身体机能随时间变化的现有证据。
设计、设置和参与者：2018 年 5 月在 PubMed 数据库中进行了电子检索。我们选择了报告生活在护理机构中的老年人身体机能演变的文章。我们寻找了来自观察性纵向研究的数据；仅从未接受运动干预的受试者中提取临床试验数据。检查了所有类型的以上肢和/或下肢为基础的表现测试。
共审查了 17 项研究；平均年龄从 78.3 岁到 88 岁不等。14 项研究为随机对照试验（RCT），另外 3 项研究为非随机试验和一项纵向观察研究。检查了不同的身体机能测试：上肢力量和下肢力量、静态平衡、动态平衡和移动能力随着时间的推移呈现下降趋势。平均而言，手握力每月下降 2.2%，坐站测试下降 3.5%，伯格平衡量表下降 2%，起身行走测试下降 2.8%，步行速度下降 2.1%，短体适能电池测试下降 2.8%。少数研究表明下肢肌肉力量、耐力和步行速度有所提高：在这些研究中，参与者没有参加任何形式的体能训练，而是参加了社交活动或认知干预。
本综述显示了养老院居民的身体机能随时间的推移如何下降，并量化了他们的下降程度。然而，在积极对照中，一些身体机能指标有所改善，这表明除了运动之外的干预措施可能防止身体机能的某些损失。
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