Stookey Alyssa D, Katzel Leslie I
Department of Veterans Affairs and Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center (GRECC), Baltimore, MD, USA.
Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Curr Geriatr Rep. 2020 Sep;9(3):163-175. doi: 10.1007/s13670-020-00326-6. Epub 2020 Aug 5.
Frailty is characterized by decreased physiological reserve and increased risk of falls, disability, hospitalization, and mortality. Frail older adults may benefit from exercise interventions targeting their multiple problems and functional deficits; however, most research focuses on center-based interventions, which may present accessibility challenges for frail older adults. Therefore, the purpose of this review is to summarize the most recently published home-based exercise interventions for frail older adults living at home.
Eight manuscripts met inclusion criteria. Research interventions consisted of a variety of modes (strength, strength/nutrition, strength/flexibility/balance/endurance), duration (12 weeks to 6 months), frequency (2-7 days/week), and delivery methods (volunteer-led, videos on a tablet, manuals/brochures). Investigators examined the effects of home-based exercise on a variety of outcomes to include feasibility, frailty status, physical performance, lean body mass, skeletal muscle mass, other physiological outcomes, mental health, nutritional status, and incidence of falls in frail.
This review demonstrates the feasibility and effectiveness of home-based exercise interventions to improve frailty, functional performance, nutritional status, and incidence of falls in frail older adults. However, the limited literature available provides conflicting reports regarding benefits for mental health outcomes and no evidence of a beneficial effect on skeletal muscle or lean mass. Future research is needed to shed light on the optimal components of home exercise programs most important for maximizing benefits for frail older adults, as well as the most effective delivery method.
衰弱的特征是生理储备下降，跌倒、残疾、住院和死亡风险增加。体弱的老年人可能会从针对其多种问题和功能缺陷的运动干预中受益；然而，大多数研究集中在基于中心的干预措施上，这可能给体弱的老年人带来可及性挑战。因此，本综述的目的是总结最近发表的针对居家体弱老年人的居家运动干预措施。
八篇手稿符合纳入标准。研究干预措施包括多种模式（力量训练、力量训练/营养、力量训练/灵活性/平衡/耐力训练）、持续时间（12周至6个月）、频率（每周2 - 7天）和实施方式（志愿者主导、平板电脑视频、手册/宣传册）。研究人员考察了居家运动对多种结果的影响，包括可行性、衰弱状态、身体机能、瘦体重、骨骼肌质量、其他生理结果、心理健康、营养状况以及体弱老年人的跌倒发生率。
本综述表明，居家运动干预措施对于改善体弱老年人的衰弱状况、功能表现、营养状况和跌倒发生率具有可行性和有效性。然而，现有有限的文献对于心理健康结果的益处提供了相互矛盾的报告，并且没有证据表明对骨骼肌或瘦体重有有益影响。需要进一步的研究来阐明居家运动计划的最佳组成部分，这些部分对于体弱老年人最大化获益最为重要，以及最有效的实施方式。
