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老年肌少症患者肌肉量、肌肉力量和身体机能的运动方案:一项系统评价与荟萃分析

Exercise Programs for Muscle Mass, Muscle Strength and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis.

作者信息

Bao Wangxiao, Sun Yun, Zhang Tianfang, Zou Liliang, Wu Xiaohong, Wang Daming, Chen Zuobing

机构信息

Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Aging Dis. 2020 Jul 23;11(4):863-873. doi: 10.14336/AD.2019.1012. eCollection 2020 Jul.

Abstract

Sarcopenia is an age-related condition that is characterized by progressive and generalized loss of muscle mass and function. Exercise treatment has been the most commonly used intervention among elderly populations. We performed a systematic review and meta-analysis to evaluate the available literature related to the effects of exercise interventions/programs on muscle mass, muscle strength and physical performance in older adults with sarcopenia. We searched PubMed, EMBASE, MEDLINE and the Web of Science for randomized controlled trials and controlled clinical trials exploring exercise in older adults with sarcopenia published through July 2019 without any language restrictions. Pooled analyses were conducted using Review Manager 5.3, with standardized mean differences (SMDs) and fixed-effect models. A total of 3898 titles and abstracts were initially identified, and 22 studies (1041 individuals, 80.75% females, mean age ranged from 60.51 to 85.90 years) were included in the meta-analysis. The exercise programs in the studies consisted of 30 to 80 min of training, with 1 to 5 training sessions weekly for 6 to 36 weeks. Muscle strength (grip strength [SMD 0.57, 95 % CI 0.42 to 0.73, P <0.00001] and timed five chair stands [SMD -0.56, 95 % CI -0.85 to -0.28, P < 0.0001]) and physical performance (gait speed [SMD 0.44, 95 % CI 0.26 to 0.61, P < 0.00001] and the timed up and go test [SMD -0.97, 95 % CI -1.22 to -0.72, P < 0.00001]) showed significant improvement following exercise treatment, while no differences in muscle mass (ASM [SMD 0.15, 95 % CI -0.05 to 0.36, P = 0.15] and ASM/height [SMD 0.21, 95 % CI -0.05 to 0.48, P = 0.12]) were detected. Exercise programs showed overall significant positive effects on muscle strength and physical performance but not on muscle mass in sarcopenic older adults.

摘要

肌肉减少症是一种与年龄相关的病症,其特征是肌肉质量和功能进行性、全身性丧失。运动疗法是老年人群中最常用的干预措施。我们进行了一项系统评价和荟萃分析,以评估现有文献中关于运动干预/方案对患有肌肉减少症的老年人的肌肉质量、肌肉力量和身体机能的影响。我们在PubMed、EMBASE、MEDLINE和科学网中检索了截至2019年7月发表的、探索患有肌肉减少症的老年人运动情况的随机对照试验和对照临床试验,无语言限制。使用Review Manager 5.3进行汇总分析,采用标准化均数差(SMD)和固定效应模型。最初共识别出3898个标题和摘要,22项研究(1041名个体,80.75%为女性,平均年龄在60.51至85.90岁之间)纳入荟萃分析。研究中的运动方案包括每次30至80分钟的训练,每周1至5次训练课,共6至36周。运动治疗后,肌肉力量(握力[SMD 0.57,95%CI 0.42至0.73,P<0.00001]和定时5次从椅子上站起[SMD -0.56,95%CI -0.85至-0.28,P<0.0001])和身体机能(步速[SMD 0.44,95%CI 0.26至0.61,P<0.00001]和定时起立行走测试[SMD -0.97,95%CI -1.22至-0.72,P<0.00001])有显著改善,而肌肉质量(四肢骨骼肌质量[SMD 0.15,95%CI -0.05至0.36,P = 0.15]和四肢骨骼肌质量/身高[SMD 0.21,95%CI -0.05至0.48,P = 0.12])无差异。运动方案对患有肌肉减少症的老年人的肌肉力量和身体机能总体显示出显著的积极影响,但对肌肉质量无影响。

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