Quick Stephen, Cleary Stacey, Shields Nora
Department of Physiotherapy, Northern Health, Bundoora.
† Department of Physiotherapy, Podiatry & Prosthetics and Orthotics, La Trobe University, Melbourne, Vict., Australia.
Physiother Can. 2020 Winter;72(1):83-93. doi: 10.3138/ptc-2018-0067.
We systematically reviewed the effectiveness of interventions to increase physical activity in older adults (aged ≥ 60 y), admitted for inpatient rehabilitation, without increasing the amount of therapy. Five electronic databases were systematically searched to identify English-language articles reporting controlled trials of interventions to increase the physical activity (through participation or behavioural change) of older adults receiving inpatient rehabilitation. Trials were excluded if an intervention increased the intensity of usual care, either during the week or on the weekend. Two reviewers independently completed trial selection, quality assessment, and data extraction. Data were synthesized descriptively, and effect sizes with 95% CIs were calculated. Of the 316 articles identified, 3 were included. Two were activity-based, and 1 was a behavioural change intervention. Physical activity was significantly improved in the behavioural change intervention trial that occurred during therapy ( = 0.27; 95% CI: 0.02, 0.52) and non-therapy time ( = 0.43; 95% CI: 0.19, 0.68). Participants in all trials were sedentary for the vast majority of the day. Older adults in inpatient rehabilitation have a high level of inactivity. Evidence is lacking that interventions increase physical activity in older adults admitted to inpatient rehabilitation without increasing the amount of time in therapy. Evidence from one trial indicates that behaviour-based strategies are effective for increasing physical activity levels in the inpatient rehabilitation setting.
我们系统回顾了在不增加治疗量的情况下，增加住院康复老年患者（年龄≥60岁）身体活动的干预措施的有效性。系统检索了五个电子数据库，以识别报告干预措施对照试验的英文文章，这些干预措施旨在增加接受住院康复的老年患者的身体活动（通过参与或行为改变）。如果干预措施增加了平日或周末常规护理的强度，则排除该试验。两名评审员独立完成试验选择、质量评估和数据提取。对数据进行描述性综合分析，并计算95%置信区间的效应量。在识别出的316篇文章中，纳入了3篇。2篇基于活动，1篇是行为改变干预。在治疗期间进行的行为改变干预试验（效应量=0.27；95%置信区间：0.02，0.52）和非治疗时间（效应量=0.43；95%置信区间：0.19，0.68）中，身体活动得到显著改善。所有试验中的参与者一天中的大部分时间都久坐不动。住院康复的老年患者身体活动水平较低。缺乏证据表明，在不增加治疗时间的情况下，干预措施能增加住院康复老年患者的身体活动。一项试验的证据表明，基于行为的策略在住院康复环境中对提高身体活动水平有效。
