Wright Patterson Medical Center, USAF, Wright State University Boonshoft School of Medicine, Dayton, USA.
Wright State University Boonshoft School of Medicine, Dayton, USA.
BMC Geriatr. 2021 Nov 1;21(1):616. doi: 10.1186/s12877-021-02572-5.
Currently, the evidence for exercise in maintaining health, well-being, and physical functioning is overwhelming. Despite these benefits, more than 50% of the population fails to meet the recommended exercise requirements for age and health status. In our study, we sought to provide a method to increase exercise adherence that was both effective and time-efficient for physicians and their patients.
The primary objective of this research study was to evaluate the effectiveness of a graded exercise protocol and biweekly monitoring on increasing the duration of aerobic exercise to 150 min per week in a population of elderly individuals with chronic disease. Secondarily, we evaluated for improvement in resting heart rate, blood pressure, body mass index (BMI), and cardiorespiratory fitness. The overall study design was a randomized, prospective cohort study with assessor blinding. Forty-five patients aged ≥60 years with multiple comorbidities were recruited from the Internal Medicine Clinic at Wright-Patterson AFB. Participants were randomized into a treatment or control arm and observed over a period of 34 weeks. Those in the treatment arm were given a graded walking protocol and received biweekly phone calls to evaluate compliance. Those in the control arm did not receive an intervention or biweekly monitoring. Measurements of heart rate, blood pressure, and BMI were taken quarterly in both groups. At the beginning and conclusion of the study, each participant completed a modified Balke treadmill test and Physical Activity Scale for the Elderly (PASE). Continuous variables were evaluated with the independent samples t-test, whereas categorical variables were evaluated with the chi-squared test.
A greater percentage of the treatment group achieved the primary outcome (41.6% vs. 0%; p = 0.003). Those in the treatment group also had favorable improvements in heart rate response (- 2.4 beats/min vs. + 5.3 beats/min; p = 0.038) and PASE (+ 66 vs.-20; p < 0.001). No significant differences were observed between groups for mean change in heart rate, blood pressure, or BMI.
Guided, independent exercise and surveillance can be an effective tool in primary care practice to help patients reach the recommended levels of exercise for both age and health status.
目前，运动对维持健康、幸福感和身体机能的证据是压倒性的。尽管有这些好处，但超过 50%的人口未能达到年龄和健康状况所建议的运动要求。在我们的研究中，我们试图提供一种方法来增加运动的坚持性，这种方法对医生及其患者既有效又省时。
本研究的主要目的是评估分级运动方案和双周监测对增加患有慢性疾病的老年人群有氧运动时间至 150 分钟/周的有效性。其次，我们评估静息心率、血压、体重指数（BMI）和心肺适应性的改善情况。总体研究设计是一项随机、前瞻性队列研究，评估人员设盲。从莱特-帕特森空军基地的内科诊所招募了 45 名年龄≥60 岁且合并多种疾病的患者。参与者被随机分为治疗组或对照组，并观察 34 周。治疗组给予分级步行方案，并每两周进行一次电话评估以评估依从性。对照组未接受干预或双周监测。两组均每季度测量心率、血压和 BMI。在研究开始和结束时，每位参与者都完成了改良的巴尔克跑步机测试和老年人体力活动量表（PASE）。连续变量采用独立样本 t 检验进行评估，分类变量采用卡方检验进行评估。
治疗组达到主要结局的比例更高（41.6%比 0%；p=0.003）。治疗组的心率反应（-2.4 次/分比+5.3 次/分；p=0.038）和 PASE（+66 比-20；p<0.001）也有明显改善。两组间的心率、血压或 BMI 的平均变化无显著差异。
在初级保健实践中，指导独立运动和监测可以是一种有效的工具，帮助患者达到年龄和健康状况所建议的运动水平。
