Physical Education and Sports School, Soochow University, Suzhou, PR China.
School of Public Health, Suzhou Medical College of Soochow University, Suzhou, PR China.
Medicine (Baltimore). 2023 Mar 17;102(11):e33300. doi: 10.1097/MD.0000000000033300.
BACKGROUND: Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders' needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH. METHODS: A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers. RESULTS: Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = -0.84; 95% CI = -1.17, -0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = -6.39; 95% CI = -8.07, -4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001). CONCLUSIONS: Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders' postural control ability, especially during the COVID-19 pandemic.
背景：体位控制能力丧失和相关损伤是养老院（NH）中老年人特别关注的问题。奥塔哥运动计划（OEP）是一种多模式运动训练计划，最初是作为一种针对社区居住老年人的个体化家庭运动而设计的，但它的运动特征和运动强度是否符合 NH 老年人的需求仍需要澄清。本研究旨在确定 OEP 对提高 NH 老年人的体位控制能力的影响。
方法：两名评审员对英语数据库（Cochrane 图书馆、PubMed、EMBASE、CINAHL 和 Web of Science）和中文数据库（中国知网、万方和重庆 VIP）进行了系统的文献检索，检索时间截至 2022 年 4 月 15 日，检索内容为随机对照试验（RCT）和非随机对照试验（non-RCT）。使用 Review Manager 5.3 软件进行荟萃分析。连续数据表示为均数差（MD），置信区间（95%CI）。二分类数据表示为风险比（RR），95%CI。根据 Cochrane 干预系统评价手册和非随机干预研究的偏倚风险评估对 3 名评审员对研究方法学质量进行评估。
结果：本综述纳入了 9 项研究，共 546 名参与者。269 名参与者接受了 OEP，277 名参与者仅接受了常规运动训练。与常规运动训练组相比，OEP 组的 NH 老年人跌倒风险显著降低（MD=-0.84；95%CI=-1.17，-0.51；P<.00001），体位平衡（MD=5.55；95%CI=3.60，7.50；P<.00001）、短距离功能性移动（MD=-6.39；95%CI=-8.07，-4.70；P<.00001）、下肢肌肉力量（MD=4.32；95%CI=3.71，4.93；P<.00001）和健康状况（RR=0.35；95%CI=0.18，0.66；P=.001）均有显著改善。
结论：目前的证据表明，OEP 在 NH 中是实用且可行的。护理人员可以获得足够的支持，以维持和提高这些老年人的体位控制能力，尤其是在 COVID-19 大流行期间。
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