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志愿者主导的身体活动干预措施对改善社区居住老年人健康结局的影响:系统综述。

Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: a systematic review.

机构信息

Academic Geriatric Medicine, University of Southampton, Southampton, UK.

NIHR ARC Wessex, University of Southampton, Southampton, UK.

出版信息

Aging Clin Exp Res. 2021 Apr;33(4):843-853. doi: 10.1007/s40520-020-01556-6. Epub 2020 Apr 30.

Abstract

BACKGROUND

Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. There is strong evidence to support the benefits of physical activity interventions on the health outcomes of older adults. Nonetheless, innovative approaches are needed to ensure that these interventions are practical and sustainable.

AIM

This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people.

METHODS

Five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years. Meta-analysis was not conducted due to included study heterogeneity.

RESULTS

Twelve papers describing eight studies (five papers reported different outcomes from the same study) were included in the review. All eight studies included strength and balance exercises and frequency of PA ranged from weekly to three times a week. Volunteer-led exercises led to improvements in functional status measured using the short physical performance battery, timed up and go test, Barthel Index, single leg stand, step touch test, chair stand test, and functional reach. Frailty status identified by grip strength measurement or the use of long-term care insurance improved with volunteer-led exercises. Interventions led to improvement in fear of falls and maintained or improved the quality of life. The impact on PA levels were mixed.

CONCLUSION

Limited evidence suggests that volunteer-led PA interventions that include resistance exercise training, can improve outcomes of community-dwelling older adults including functional status, frailty status, and reduction in fear of falls. More high-quality RCTs are needed to investigate the effects of volunteer-led PA interventions among older people.

摘要

背景

体力活动(PA)对于老年人保持功能独立性和健康衰老非常重要。有强有力的证据支持体力活动干预对老年人健康结果的益处。尽管如此,仍需要创新方法来确保这些干预措施切实可行且可持续。

目的

本系统综述探讨了志愿者主导的 PA 干预在改善社区居住的老年人健康结果方面的有效性。

方法

系统检索了五个数据库(MEDLINE、Embase、CINAHL、PEDro、Cochrane 图书馆),以寻找使用经过培训的志愿者为年龄≥65 岁的社区居住老年人提供 PA 干预的研究。由于纳入研究的异质性,未进行荟萃分析。

结果

综述纳入了 12 篇描述 8 项研究的论文(5 篇论文报告了来自同一研究的不同结果)。所有 8 项研究均包括力量和平衡练习,PA 频率从每周一次到每周三次不等。志愿者主导的运动导致使用短体适能电池、计时起立行走测试、巴氏指数、单腿站立、台阶触摸测试、椅子站立测试和功能伸展测试测量的功能状态得到改善。通过握力测量或使用长期护理保险识别的虚弱状态随着志愿者主导的运动而改善。干预措施导致跌倒恐惧减少,并维持或改善生活质量。PA 水平的影响存在差异。

结论

有限的证据表明,包括抗阻训练的志愿者主导的 PA 干预可以改善社区居住的老年人的结局,包括功能状态、虚弱状态和跌倒恐惧的减少。需要更多高质量的 RCT 来研究志愿者主导的 PA 干预对老年人的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c16f/8084781/ffc513b044ac/40520_2020_1556_Fig1_HTML.jpg

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