Ramírez-Vélez Robinson, García-Hermoso Antonio, Martínez-Velilla Nicolás, Zambom-Ferraresi Fabricio, L Sáez de Asteasu Mikel, Recarey Anel E, Izquierdo Mikel
Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain.
Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain.
J Clin Med. 2021 Jan 14;10(2):290. doi: 10.3390/jcm10020290.
The purpose of this systematic review and meta-analysis was to appraise the acute effects of exercise training on inflammatory parameters in hospitalized older adults. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, Medline and PubMed were searched for studies published until August 2020. The review included all randomized controlled trials (RCTs) that evaluated and compared the effect of exercise versus usual care on inflammatory parameters in acutely hospitalized older adults. Two reviewers independently assessed the studies. The quality of all the included studies was assessed using the DerSimonian-Laird random-effects inverse-variance model. Five studies (275 participants) met the inclusion criteria. The exercise interventions included resistance or multicomponent intervention programs. The results indicate that, compared with usual care, exercise interventions have a positive impact on overall inflammatory parameters, including C-reactive protein (CRP) and insulin-like growth factor-I (IGF-1) (Hedge's = -0.19, 95% confidence interval [CI] -0.33 to -0.04, = 0.011, = 0%). However, analyses of individual inflammatory parameters revealed a non-significant trend for reductions in CRP (Hedge's = -0.20, 95% CI -0.47 to 0.07, = 0.151, = 31.2%) and IGF-I (Hedge's = -0.34, 95% CI -0.79 to 0.11, = 0.138, = 0%). On the basis of this review, we conclude that exercise during acute hospitalization offers a mild improvement in the inflammatory profile over usual care in older patients. Nevertheless, due to limited number of RCTs, our findings must be interpreted with caution and confirmed in future studies.
本系统评价和荟萃分析的目的是评估运动训练对住院老年患者炎症参数的急性影响。我们按照系统评价和荟萃分析的首选报告项目指南进行了一项系统评价。在科学网、医学数据库和PubMed中检索截至2020年8月发表的研究。该评价纳入了所有评估并比较运动与常规护理对急性住院老年患者炎症参数影响的随机对照试验（RCT）。两名评价者独立评估这些研究。使用DerSimonian-Laird随机效应逆方差模型评估所有纳入研究的质量。五项研究（275名参与者）符合纳入标准。运动干预包括阻力训练或多组分干预方案。结果表明，与常规护理相比，运动干预对总体炎症参数有积极影响，包括C反应蛋白（CRP）和胰岛素样生长因子-I（IGF-1）（Hedge's = -0.19，95%置信区间[CI] -0.33至-0.04， = 0.011， = 0%）。然而，对个体炎症参数的分析显示，CRP（Hedge's = -0.20，95% CI -0.47至0.07， = 0.151， = 31.2%）和IGF-I（Hedge's = -0.34，95% CI -0.79至0.11， = 0.138， = 0%）降低的趋势不显著。基于本评价，我们得出结论，急性住院期间的运动与常规护理相比，能使老年患者的炎症指标略有改善。然而，由于RCT数量有限，我们的研究结果必须谨慎解读，并有待未来研究进一步证实。
