Jianqing Wu, Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, P.R. China, Fax: 011-86-25-83780170, Telephone number: 011-86-25-68305103, Email address:
J Nutr Health Aging. 2023;27(11):1063-1075. doi: 10.1007/s12603-023-2031-9.
To confirm whether multicomponent exercise following vivifrail recommendations was an effective method for improving physical ability, cognitive function, gait, balance, and muscle strength in Chinese older adults.
This was a multicenter and randomized clinical trial conducted in Jiangsu, China, from April 2021 to April 2022. Intervention lasted for 12 weeks and 104 older adults with functional declines were enrolled. All participants were randomly assigned to a control (usual care plus health education) or exercise group (usual care plus health education plus exercise). Primary outcomes were the change score of Short Physical Performance Battery (SPPB) and activities of daily living (ADL). The secondary outcomes included instrumental activities of daily living, Tinetti scores, Frailty score, short-form Mini Nutritional Assessment, Mini-Mental State Examination, Geriatric Depression Scale-15, the 12-item Short Form Survey, 4-meter gait speed test, 6-min walking distance, grip strength, and body composition analysis.
Among the participants, the average age was 85 (82, 88) years. After 12 weeks of follow-up, the exercise group showed a significant improvement in SPPB, with a change of 2 points (95% confidence interval [0, 3.5], P<0.001) compared to control. In contrast, SPPB remained stable in the control group. Compared to the control group, ADL improved in the exercise group, as did instrumental activities of daily living, Tinetti, Frailty, Short Form Survey, 4-meter gait speed test, and 6-min walking distance. Although there was no significant difference between groups in body composition analysis after post-intervention, the exercise group still improved in soft lean mass (P=0.002), fat-free mass (P=0.002), skeletal muscle mass index (P<0.001), fat-free mass index (P=0.004), appendicular skeletal muscle mass (P<0.001), and leg muscle mass (P<0.001), while the control group had no significant increase. No difference was observed in adverse events during trial period.
The multicomponent exercise intervention following vivifrail recommendations is an effective method for older adults with functional decline and can reverse the functional decline and improve gait, balance, and muscle strength. Additionally, the 12-week multicomponent exercise method provides guidance for Chinese medical professionals working in the field of geriatrics and is a promising method to improve physical function in the general population.
确认遵循 vivifrail 建议的多成分运动是否是改善中国老年人身体能力、认知功能、步态、平衡和肌肉力量的有效方法。
这是一项在中国江苏省进行的多中心、随机临床试验，于 2021 年 4 月至 2022 年 4 月进行。干预持续 12 周，纳入 104 名功能下降的老年人。所有参与者均随机分配至对照组（常规护理加健康教育）或运动组（常规护理加健康教育加运动）。主要结局为短体功能力表（SPPB）和日常生活活动（ADL）的变化评分。次要结局包括工具性日常生活活动、Tinetti 评分、衰弱评分、简短营养评估量表、简易精神状态检查、老年抑郁量表-15、12 项简短健康状况调查、4 米步态速度测试、6 分钟步行距离、握力和身体成分分析。
在参与者中，平均年龄为 85（82，88）岁。经过 12 周的随访，运动组 SPPB 显著改善，与对照组相比，变化 2 分（95%置信区间[0，3.5]，P<0.001）。相比之下，对照组 SPPB 保持稳定。与对照组相比，运动组的 ADL 和工具性日常生活活动、Tinetti、衰弱、简短健康状况调查、4 米步态速度测试和 6 分钟步行距离均有所改善。虽然干预后两组间的身体成分分析无显著差异，但运动组的软组织瘦质量（P=0.002）、去脂体重（P=0.002）、骨骼肌质量指数（P<0.001）、去脂体重指数（P=0.004）、四肢骨骼肌质量（P<0.001）和腿部肌肉质量（P<0.001）仍有改善，而对照组则无明显增加。试验期间未观察到不良事件的差异。
遵循 vivifrail 建议的多成分运动干预是功能下降老年人的有效方法，可以逆转功能下降，改善步态、平衡和肌肉力量。此外，12 周的多成分运动方法为从事老年医学领域的中国医疗专业人员提供了指导，是改善普通人群身体功能的有前途的方法。
