Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands.
Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands.
BMJ Open. 2022 May 31;12(5):e058056. doi: 10.1136/bmjopen-2021-058056.
OBJECTIVES: To present an overview of effectiveness and training characteristics of physical training on aerobic fitness, compared with alternative or no training, in adults aged over 65 years with various health statuses, providing a basis for guidelines for aerobic training of vulnerable older adults that can be used in geriatric rehabilitation. DESIGN: An umbrella review of systematic reviews that included both randomised controlled trials and other types of trials. DATA SOURCES: MEDLINE, Embase, CINAHL and the Cochrane Library were searched on 9 September 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included systematic reviews reporting on physical training interventions that are expected to improve aerobic fitness, presenting results for adults aged 65 years and older, describing at least one of the FITT-characteristics: Frequency, Intensity, Time or Type of exercise, and measuring aerobic fitness at least before and after the intervention. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted the data and assessed the risk of bias. A narrative synthesis was performed. RESULTS: We included 51 papers on 49 reviews. Positive effect of training on aerobic fitness was reported by 33 reviews, 11 reviews remained inconclusive and 5 reviews reported no effect. Training characteristics varied largely. Frequency: 1-35 sessions/week, Intensity: light-vigorous, Time: <10-120 min/session and Types of exercise: many. The methodological quality was most often low. Subgroup analyses revealed positive effects for all health conditions except for trauma patients. Exercise characteristics from current existing guidelines are widely applicable. For vulnerable older adults, lower intensities and lower frequencies were beneficial. Some health conditions require specific adjustments. Information on adverse events was often lacking, but their occurrence seemed rare. CONCLUSION: Physical fitness training can be effective for vulnerable older adults. Exercise characteristics from current existing guidelines are widely applicable, although lower frequencies and intensities are also beneficial. For some conditions, adjustments are advised. PROSPERO REGISTRATION NUMBER: CRD42020140575.
目的：呈现 65 岁以上不同健康状况的成年人进行有氧健身的体能训练的有效性和训练特征的概述，与替代或不训练进行比较，为脆弱老年人的有氧训练指南提供依据，这些指南可用于老年康复。
设计：对包括随机对照试验和其他类型试验的系统评价进行伞式评价。
数据来源：2019 年 9 月 9 日在 MEDLINE、Embase、CINAHL 和 Cochrane 图书馆进行检索。
入选研究的资格标准：我们纳入了报告体能训练干预措施的系统评价，这些干预措施有望提高有氧健身水平，结果针对 65 岁及以上的成年人，至少描述了 FITT 特征中的一项：频率、强度、时间或运动类型，并在干预前后至少测量一次有氧健身。
数据提取和综合：两名独立评审员提取数据并评估偏倚风险。进行了叙述性综合。
结果：我们纳入了 51 篇论文，涉及 49 篇综述。33 篇综述报告了训练对有氧健身的积极影响，11 篇综述结果不确定，5 篇综述报告无效果。训练特征差异很大。频率：1-35 次/周，强度：轻到剧烈，时间：<10-120 分钟/次，运动类型：多种。方法学质量通常较低。亚组分析显示，除创伤患者外，所有健康状况均有积极影响。现行指南中的运动特征具有广泛的适用性。对于脆弱的老年人，较低的强度和较低的频率是有益的。某些健康状况需要特定的调整。关于不良事件的信息通常缺乏，但似乎很少发生。
结论：体能训练对脆弱的老年人可能有效。现行指南中的运动特征具有广泛的适用性，尽管较低的频率和强度也有益。对于某些情况，建议进行调整。
前瞻性注册号：CRD42020140575。
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