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适应身心练习对老年人身体功能、生活质量和幸福感的影响:系统评价和荟萃分析。

The effects of adapted mind-body exercises on physical function, quality of life and wellbeing for older people: a systematic review and meta-analysis.

机构信息

Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.

Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.

出版信息

J Nutr Health Aging. 2024 Apr;28(4):100186. doi: 10.1016/j.jnha.2024.100186. Epub 2024 Feb 14.

Abstract

BACKGROUND

Participating in physical activity programmes is one way to optimise wellbeing and quality of life in older adults. Mind-body exercises could provide greater benefits than other forms of traditional physical activity and can be easily adapted for older people who are starting to develop functional decline.

OBJECTIVES

To synthesise the literature looking at the effects of adapted mind-body interventions on older people.

DESIGN

A systematic review and meta-analysis was conducted on articles from Web of Science, MEDLINE, SPORTDiscus, AMED and CINAHL that were searched up to 13 September 2023. Studies were extracted and assessed by two authors and included if they were adapted mind-body quasi experimental trials (QET) or randomised controlled trials (RCT) evaluating physical function, quality of life or wellbeing in community dwelling older adults aged 60 years and over. The Cochrane Risk of Bias 2 scale was used for quality appraisal. Analysis of the results included calculating standardised effect sizes (Hedge's g) and a narrative synthesis of results not included in meta-analysis.

RESULTS

18 studies (8 quasi-experimental trial designs, n = 310; 10 randomised control trials, n = 1829) were included in the systematic review, with 14 studies (9 RCT, n = 1776, 5 QET, n = 100) retained for meta-analysis. For the RCT studies, some improvement was noted in mobility (ES 0.36: 95% CI: 0.01, 0.71), flexibility (ES 0.36: 0.01, 0.70), well-being (ES 0.54: 0.18, 0.91) and quality of life (ES 0.50: 0.21, 0.79). No positive effect was observed for leg power (ES 0.09: -0.33, 0.51), leg endurance (ES 0.16: -0.72, 1.03), back scratch test (ES 0.24: -0.10, 0.59), or balance, (ES 0.05: -0.06, 0.15). Heterogeneity varied from 0%-87% across the different outcomes. For the QET studies, gait velocity was shown to improve (ES 0.54: 0.18, 0.91), while fear of falling showed no significant improvements (ES 0.82: -0.06, 1.69). A meta-regression for quality of life in which the total physical activity of the intervention, in hours, was used as a covariate, showed ES = 1.1 for every 100 h of physical activity.

CONCLUSION

There is scope for adapted mind-body physical activity interventions to play a role in improving quality of life, wellbeing, and physical function in older adults. The provision of adapted interventions for older people might improve uptake of and engagement with physical activity interventions in older people with limited or reduced abilities.

摘要

背景

参与体育活动计划是优化老年人身心健康和生活质量的一种方式。身心锻炼可能比其他形式的传统体育活动带来更大的益处,并且可以轻松适应开始出现功能下降的老年人。

目的

综合研究身心适应干预对老年人影响的文献。

设计

对截至 2023 年 9 月 13 日在 Web of Science、MEDLINE、SPORTDiscus、AMED 和 CINAHL 上搜索的文章进行了系统评价和荟萃分析。研究由两位作者提取和评估,如果它们是适应身心的准实验试验(QET)或随机对照试验(RCT),评估 60 岁及以上社区居住的老年人的身体功能、生活质量或幸福感,则将其纳入研究。使用 Cochrane 偏倚风险 2 量表进行质量评估。结果分析包括计算标准化效应大小(Hedge's g)和对荟萃分析中未包括的结果进行叙述性综合。

结果

18 项研究(8 项准实验试验设计,n = 310;10 项随机对照试验,n = 1829)被纳入系统评价,其中 14 项研究(9 项 RCT,n = 1776,5 项 QET,n = 100)保留进行荟萃分析。对于 RCT 研究,在移动性(ES 0.36:95%CI:0.01,0.71)、灵活性(ES 0.36:0.01,0.70)、幸福感(ES 0.54:0.18,0.91)和生活质量(ES 0.50:0.21,0.79)方面观察到一些改善。腿部力量(ES 0.09:-0.33,0.51)、腿部耐力(ES 0.16:-0.72,1.03)、背部抓挠测试(ES 0.24:-0.10,0.59)或平衡(ES 0.05:-0.06,0.15)没有产生积极影响。不同结局的异质性从 0%到 87%不等。对于 QET 研究,显示步行速度有所提高(ES 0.54:0.18,0.91),而跌倒恐惧没有明显改善(ES 0.82:-0.06,1.69)。一项关于生活质量的荟萃回归分析中,将干预措施的总体力活动(以小时为单位)作为协变量,表明每 100 小时的体力活动 ES 为 1.1。

结论

身心适应体育活动干预在改善老年人生活质量、幸福感和身体功能方面具有一定的作用。为老年人提供适应性干预措施可能会提高身体活动干预措施在身体能力有限或下降的老年人中的参与度和接受度。

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