Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Stress. 2020 Sep;23(5):519-528. doi: 10.1080/10253890.2020.1784136. Epub 2020 Jul 3.
Allostatic load (AL) is the manifestation of cumulative responses to chronic stress exposure. Numerous studies have shown the importance of AL in understanding disease risks. Yet little is known about existing interventions that target AL specifically. We aimed to address this gap by identifying interventions targeting AL and determining the success of these interventions in improving biological functioning. We searched five electronic databases using variations of two concepts: AL and programs or interventions. We included original research reports that focused on AL as an outcome. We excluded work that focused on a single indicator, not written in English or did not implement an intervention. The Template for Intervention Description and Replication checklist guided our intervention critique and synthesis. Six articles were included, with sample size across the interventions ranging between 2 and 733. Despite inconsistencies in the selection of AL indicators and scoring of AL, all four body systems were represented in all the studies. Four interventions showed significant improvement in Al (as indicated by a decrease in AL score) as early as 7weeks. More interventions targeting Al are needed. The reduction in AL scores among four of the six interventions suggests that Al could be a biological outcome measure that is sensitive to change in response to interventions. This has significant clinical and research implications. Future studies are needed to examine whether AL serves as a mediator in the effects of the intervention on improving clinical manifestations of diseases.
身体压力负荷(AL)是对慢性压力暴露的累积反应的表现。许多研究表明,AL 在理解疾病风险方面非常重要。然而,人们对专门针对 AL 的现有干预措施知之甚少。我们旨在通过确定针对 AL 的干预措施并确定这些干预措施在改善生物功能方面的成功来解决这一差距。我们使用两个概念的变体(AL 和计划或干预措施)搜索了五个电子数据库。我们纳入了专注于 AL 作为结果的原始研究报告。我们排除了仅关注单一指标、未用英文撰写或未实施干预的工作。干预描述和复制模板清单指导了我们的干预措施批评和综合。纳入了六篇文章,干预措施的样本量范围在 2 到 733 之间。尽管在选择 AL 指标和 AL 评分方面存在不一致,但所有四项身体系统都在所有研究中得到了代表。四项干预措施在 7 周内就显示出 AL 的显著改善(表现为 AL 评分降低)。需要更多针对 AL 的干预措施。六项干预措施中的四项中 AL 评分的降低表明,AL 可能是一种对干预措施的变化敏感的生物结果测量。这具有重要的临床和研究意义。需要进一步研究,以检验 AL 是否作为干预措施对改善疾病临床表现的影响的中介。