Kleijnen Systematic Reviews Ltd., York, UK.
Nanyang Technological University, Singapore, Singapore.
BMC Public Health. 2020 Nov 16;20(1):1724. doi: 10.1186/s12889-020-09855-3.
BACKGROUND: Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. METHODS: Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. RESULTS: Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. CONCLUSION: There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. TRIAL REGISTRATION: Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.
背景:久坐的生活方式是导致非传染性疾病(如心血管疾病、癌症和糖尿病)的主要危险因素。据估计,每年约有 320 万人的死亡归因于体力活动水平不足。我们评估了 Cochrane 系统评价(CSR)中关于运动/体育活动对各种健康结果的有效性的现有证据。
方法:概述和荟萃分析。从 2000 年 1 月 1 日至 2019 年第 1 期,在 Cochrane 图书馆中进行了检索。未施加任何语言限制。仅包括随机对照试验(RCT)的 CSR。任何年龄和性别的健康个体、有疾病风险的个体和有医疗问题的个体都符合条件。我们评估了任何类型的运动或体育活动干预措施;与任何类型的对照措施;以及测量任何类型的与健康相关的结果措施。使用 AMSTAR-2 工具评估纳入研究的方法学质量。
结果:有 150 项 CSR 符合纳入标准。涉及 54 种不同的疾病。大多数 CSR 的方法学质量较高。有 130 项 CSR 采用了荟萃分析技术,而 20 项没有。研究的局限性是降低证据质量的最常见原因。基于 10 项 CSR 和 187 项 RCT(涉及 27671 名参与者),死亡率风险比(RR)降低了 13%(RR 0.87 [95%置信区间(CI)0.78 至 0.96];I=26.6%[预测区间(PI)0.70,1.07],中位效应大小(MES)为 0.93 [四分位距(IQR)0.81,1.00]。来自 15 项 CSR 和 408 项 RCT(涉及 32984 名参与者)的数据显示,生活质量(QOL)有微小改善,标准化均数差(SMD)为 0.18 [95% CI 0.08,0.28];I=74.3%;PI -0.18,0.53],MES=0.20 [IQR 0.07,0.39]。按疾病类型进行的亚组分析表明,在心理健康状况患者中,效应大小的幅度最大。
结论:有大量的 CSR 评估了体育活动/锻炼的有效性。证据表明,体育活动/锻炼可降低死亡率并提高生活质量,且几乎没有或没有安全问题。
试验注册:于 2019 年 1 月 10 日在 PROSPERO(CRD42019120295)注册。
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