电子健康传递的运动方案对社区居住的 65 岁及以上老年人平衡能力的影响：随机对照试验的系统评价和荟萃分析。
Effect of eHealth-delivered exercise programmes on balance in people aged 65 years and over living in the community: a systematic review and meta-analysis of randomised controlled trials.
机构信息
School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
Neuroscience Research Australia, Randwick, New South Wales, Australia.
出版信息
BMJ Open. 2022 Jun 10;12(6):e051377. doi: 10.1136/bmjopen-2021-051377.
INTRODUCTION
Exercise that challenges balance is proven to prevent falls in community-dwelling older people, yet widespread implementation and uptake of effective programmes is low. This systematic review and meta-analysis synthesised the evidence and evaluated the effect of eHealth-delivered exercise programmes compared with control on balance in community-dwelling people aged ≥65 years.
METHODS
Nine databases including MEDLINE, CINAHL and Embase, were searched from inception to January 2022 to identify randomised controlled trials evaluating eHealth-delivered exercise programmes for community-dwelling people aged ≥65 years, published in English that included a balance outcome. Primary outcomes were static and dynamic balance. Secondary outcomes included fall risk and fear of falling. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses.
RESULTS
We identified 14 eligible studies that included 1180 participants. Methodological quality ranged from 3 to 8 (mean, 5). The pooled effect indicated that eHealth-delivered exercise programmes have a medium significant effect on static balance (11 studies; SMD=0.62, 95% CI 0.27 to 0.72) with very low-quality evidence. There was small statistically significant effect on dynamic balance (14 studies; SMD=0.42, 95% CI 0.11 to 0.73) with very low-quality evidence, and fall risk (5 studies; SMD=0.32, 95% CI 0.00 to 0.64) with moderate-quality evidence. No significant effect of eHealth programmes on fear of falling was found (four studies; SMD=0.10, 95% CI -0.05 to 0.24; high-quality evidence).
CONCLUSION
This review provides preliminary evidence that eHealth-delivered exercise programmes improved balance and reduced fall risk in people aged ≥65 years. There is still uncertainty regarding the effect of eHealth delivered exercise programmes on fear of falling.
PROSPERO REGISTRATION NUMBER
CRD42018115098.
介绍
已证实，挑战平衡的运动可预防社区居住的老年人跌倒，但广泛实施和采用有效的方案的情况很低。本系统评价和荟萃分析综合了证据，并评估了与对照组相比，电子健康提供的运动方案对年龄≥65 岁的社区居住者平衡的影响。
方法
从建库到 2022 年 1 月，我们在 9 个数据库（包括 MEDLINE、CINAHL 和 Embase）中进行了检索，以确定评估年龄≥65 岁的社区居住者的电子健康提供的运动方案的随机对照试验，这些试验发表于英文，包含平衡结果。主要结局是静态和动态平衡。次要结局包括跌倒风险和对跌倒的恐惧。我们从随机效应荟萃分析中计算了标准化均数差值（SMD，Hedges'g）及其 95%置信区间。
结果
我们确定了 14 项符合条件的研究，这些研究共纳入了 1180 名参与者。方法学质量从 3 分到 8 分（平均 5 分）不等。汇总效应表明，电子健康提供的运动方案对静态平衡有中等显著影响（11 项研究；SMD=0.62，95%CI 0.27 至 0.72），证据质量为极低。对动态平衡有小的统计学显著影响（14 项研究；SMD=0.42，95%CI 0.11 至 0.73），证据质量为极低，对跌倒风险有较小的统计学显著影响（5 项研究；SMD=0.32，95%CI 0.00 至 0.64），证据质量为中等。电子健康方案对跌倒恐惧没有显著影响（4 项研究；SMD=0.10，95%CI -0.05 至 0.24；高质量证据）。
结论
本综述提供了初步证据，表明电子健康提供的运动方案改善了年龄≥65 岁人群的平衡并降低了跌倒风险。关于电子健康提供的运动方案对跌倒恐惧的影响，仍存在不确定性。
PROSPERO 注册号：CRD42018115098。
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