Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy.
Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, and Fondazione Luigi Villa, Università degli Studi di Milano, Milan, Italy.
J Am Med Dir Assoc. 2023 Apr;24(4):489-496. doi: 10.1016/j.jamda.2023.01.023. Epub 2023 Mar 3.
There is uncertainty about effects of physical activity on physical performance, such as gait speed, among community-dwelling older adults according to their physical frailty status. We determined whether a long-term, moderate-intensity physical activity program was associated with different responses on gait speed over 4 m and 400 m based on physical frailty status.
Post hoc analysis from the Lifestyle Interventions and Independence for Elders (LIFE) (NCT01072500), a single-blind randomized clinical trial testing the effect of physical activity intervention compared with health education program.
We analyzed data on 1623 community-dwelling older adults (78.9 ± 5.2 years) at risk for mobility disability.
Physical frailty was assessed at baseline using the Study of Osteoporotic Fractures frailty index. Gait speed over 4 m and 400 m was measured at baseline, and 6, 12, and 24 months.
We estimated significantly better 400-m gait speed at 6, 12, and 24 months for nonfrail older adults in the physical activity group, but not for frail participants. Among frail participants, physical activity showed a potentially clinically meaningful benefit on 400-m gait speed at 6 months (0.055; 95% CI 0.016-0.094; P = .005), compared with the healthy educational intervention, only in those who, at baseline, were able to rise from a chair 5 times without using their arms.
A well-structured physical activity program produced a faster 400-m gait speed potentially able to prevent mobility disability among physically frail individuals with preserved muscle strength in lower limbs.
对于社区居住的老年人，根据其身体虚弱状况，身体活动对身体表现（如步速）的影响尚不确定。我们确定了一种长期的、中等强度的身体活动计划是否与基于身体虚弱状况的步速 4 米和 400 米的不同反应相关。
生活方式干预和老年人独立（LIFE）的事后分析（NCT01072500），这是一项单盲随机临床试验，测试身体活动干预与健康教育计划的效果。
我们分析了 1623 名有移动障碍风险的社区居住老年人（78.9 ± 5.2 岁）的数据。
基线时使用骨质疏松性骨折研究虚弱指数评估身体虚弱。在基线、6、12 和 24 个月时测量 4 米和 400 米的步速。
我们估计在身体活动组中，非虚弱的老年人在 6、12 和 24 个月时的 400 米步速显著提高，但虚弱的参与者则不然。在虚弱的参与者中，与健康的教育干预相比，身体活动在 6 个月时对 400 米步速显示出潜在的临床有意义的益处（0.055；95%CI 0.016-0.094；P=0.005），仅在那些基线时能够不使用手臂从椅子上站起来 5 次的参与者中。
一个结构良好的身体活动计划可以提高 400 米的步速，有可能预防下肢肌肉力量保存的身体虚弱者的移动障碍。
