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基于电子健康促进系统的智能个性化运动处方改善中老年社区居民健康结局的研究:预-后测试研究。

Intelligent Personalized Exercise Prescription Based on an eHealth Promotion System to Improve Health Outcomes of Middle-Aged and Older Adult Community Dwellers: Pretest-Posttest Study.

机构信息

School of Nursing, Bengbu Medical College, Bengbu, China.

Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Intelligent Machines, Hefei Institutes of Physical Sciences, Chinese Academy of Sciences, Hefei, China.

出版信息

J Med Internet Res. 2021 May 24;23(5):e28221. doi: 10.2196/28221.

Abstract

BACKGROUND

A scientific, personalized, and quantitative exercise prescription that has the potential to be an important therapeutic agent for all ages in the prevention of chronic disease is highly recommended. However, it is often poorly implemented, as clinicians lack the necessary knowledge and skills while participants have low adherence due to design defects (eg, prescriptions fail to take individual willingness, the appeal of exercise, and complex physical conditions into account). Intelligent personalized prescription is thus worth exploring.

OBJECTIVE

The aim of this study was to investigate whether a year-long cloud platform-based and intelligent personalized exercise prescription intervention could improve Chinese middle-aged and older adult community dwellers' health outcomes.

METHODS

A total of 177 participants (aged 52-85 years; mean 67.93, SD 7.05) were recruited from 2 Chinese community health service centers in Anhui Province, China. The exercise intervention was delivered over 12 months with a single-group pretest-posttest design. After being assessed in terms of physical activity, health-related lifestyle, history of chronic diseases and drug use, family history of disease and cardiovascular function, body composition, bone mineral density, and physical fitness through an eHealth promotion system, participants with relative contraindications for exercise were personally prescribed the health care exercise mode by an intelligent system, while those without relative contraindication and who had a regular exercise habit were prescribed the scientific fitness mode. Paired t tests were used for the analysis.

RESULTS

A total of 97 participants were classified into the health care mode, and the remaining 80 participants were assigned to the scientific fitness mode. Significant changes in heart rate (mean difference [MD] 2.97; 95% CI 1.1-4.84; P=.002), subendocardial viability ratio (MD -0.13; CI: -1.19 to -0.63; P<.001), weight (MD 0.99; CI 0.29-1.69; P=.006), BMI (MD 0.38; CI 0.11-0.64; P=.006), body fat rate (MD 0.88; CI 0.24-1.51; P=.007), fat mass (MD 0.92; CI 0.33-1.53; P=.003), and brachial-ankle pulse wave velocity (MD: -0.72; CI -1.17 to -0.27; P=.002) were observed among participants with the health care mode exercise prescriptions at the 12-month postintervention versus the baseline assessment, while no changes in systolic blood pressure, diastolic blood pressure, muscle mass, bone mineral density, t value, z value, balance, or ability were discerned. The results showed a functional decline in the physical fitness of both groups, including in handgrip strength (healthcare mode: MD 4.41; scientific fitness mode: MD 3.11), vital capacity (healthcare mode: MD 261.99; scientific fitness mode: MD 250.78), and agility (healthcare mode MD=-0.35; scientific fitness mode: MD=-0.39) with all P values <.001, except handgrip strength in the scientific fitness mode (P=.002). There were no significant differences in other parameters among participants with scientific fitness mode exercise prescriptions.

CONCLUSIONS

The observations suggest that our exercise prescription intervention program might promote certain health outcomes in Chinese middle-aged and older adult community dwellers, yet we are unable to recommend such a program given the existing limitations. Future randomized controlled trials with diverse samples are warranted to confirm our findings.

摘要

背景

科学、个性化和定量的运动处方有可能成为预防慢性病的重要治疗手段,适用于所有年龄段的人群。然而,由于临床医生缺乏必要的知识和技能,同时由于设计缺陷(例如,处方未能考虑个人意愿、运动的吸引力和复杂的身体状况),参与者的依从性较低,因此该处方往往无法得到很好的实施。因此,智能个性化处方值得探索。

目的

本研究旨在探讨基于云平台的智能个性化运动处方干预是否能改善中国中老年社区居民的健康状况。

方法

共招募了来自中国安徽省的 2 个社区卫生服务中心的 177 名参与者(年龄 52-85 岁,平均年龄 67.93,标准差 7.05)。采用单组前后测设计,对参与者进行为期 12 个月的运动干预。通过电子健康促进系统评估他们的身体活动、健康相关生活方式、慢性病和药物使用史、家族病史和心血管功能、身体成分、骨密度和体能,为有相对运动禁忌证的参与者制定智能系统的保健运动模式,而没有相对禁忌证且有规律运动习惯的参与者则制定科学健身模式。采用配对 t 检验进行分析。

结果

共有 97 名参与者被分类为保健模式,其余 80 名参与者被分配到科学健身模式。在心率(平均差异 [MD] 2.97;95%置信区间 1.1-4.84;P=.002)、心内膜下活力比(MD -0.13;置信区间 -1.19 至 -0.63;P<.001)、体重(MD 0.99;置信区间 0.29-1.69;P=.006)、BMI(MD 0.38;置信区间 0.11-0.64;P=.006)、体脂率(MD 0.88;置信区间 0.24-1.51;P=.007)、脂肪量(MD 0.92;置信区间 0.33-1.53;P=.003)和臂踝脉搏波速度(MD:-0.72;置信区间 -1.17 至 -0.27;P=.002)方面,有保健运动处方的参与者在干预后 12 个月与基线评估相比有显著变化,而收缩压、舒张压、肌肉量、骨密度、t 值、z 值、平衡或能力方面没有变化。结果显示,两组的体能都出现了功能性下降,包括握力(保健模式:MD 4.41;科学健身模式:MD 3.11)、肺活量(保健模式:MD 261.99;科学健身模式:MD 250.78)和敏捷性(保健模式 MD=-0.35;科学健身模式 MD=-0.39),所有 P 值均<.001,除了科学健身模式的握力(P=.002)。在科学健身模式中,其他参数没有显著差异。

结论

研究结果表明,我们的运动处方干预方案可能会促进中国中老年社区居民的某些健康结果,但鉴于现有的局限性,我们无法推荐这样的方案。未来需要进行有不同样本的随机对照试验来证实我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0719/8185615/bb3c388fa344/jmir_v23i5e28221_fig1.jpg

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