Xiangya School of Nursing, Central South University, China; College of Nursing and Health Sciences, Flinders University, Australia.
Xiangya School of Nursing, Central South University, China.
Arch Gerontol Geriatr. 2024 Sep;124:105470. doi: 10.1016/j.archger.2024.105470. Epub 2024 May 3.
Maintaining physical function is critical for older adults to achieve healthy aging. The Otago exercise program (OEP) has been widely used to prevent falls for older adults. However, the effects of OEP on physical function remain controversial and the possible effects modifiers have not been assessed.
To evaluate the effects of OEP on physical function in older adults and to explore potential moderators underlying the effects of OEP.
We searched five electronic databases and relevant systematic reviews to identify studies. We included randomized controlled trials (RCTs) evaluating the effects of OEP as a single intervention on physical function among older adults aged 65 and over. Meta-analysis was performed using the random-effects model. Standardized mean differences (SMD) for physical function changes, pertinent to balance, strength, and mobility, were outcome measures. Subgroup analyses on exercise protocol and participants' characteristics were performed.
Thirteen RCTs consisting of 2402 participants were included in this systematic review and meta-analysis. Results indicated a significant effect of OEP on balance (SMD = 0.59, 95 % CI: 0.22∼0.96), lower body strength (SMD = 0.93, 95 % CI: 0.31∼1.55), and mobility (SMD = -0.59, 95 % CI: -0.95∼-0.22) against control groups. No significant OEP effects were found on upper body strength (MD = 1.48, 95 % CI: -0.58∼3.55). Subgroup analysis revealed that the video-supported delivery mode was more effective for improving balance (P = 0.04) and mobility (P = 0.02) than the face-to-face mode. Session durations over 30 min was more effective on lower body strength (P < 0.001) and mobility (P < 0.001) than those 1-30 min. Program period of 13-26 weeks was more effective on mobility (P = 0.02) than those of 4-12 weeks. However, the effects of OEP on physical function were not associated with age groups, and baseline falling risks.
The OEP could improve physical function including balance, lower body strength, and mobility in older adults. Implementing the OEP in video-supported, more than 30 min per session and 4-12 weeks may be the most appropriate and effective exercise protocol for improving physical function among older adults. More RCTs with rigorous design and larger scale are needed to further assess the effectiveness of diverse OEP protocols and quantify the dose-effect relationship.
保持身体机能对于老年人实现健康老龄化至关重要。奥塔哥运动项目（OEP）已被广泛用于预防老年人跌倒。然而，OEP 对身体机能的影响仍存在争议，且可能的影响调节剂尚未得到评估。
评估 OEP 对老年人身体机能的影响，并探讨 OEP 影响的潜在调节因素。
我们检索了五个电子数据库和相关系统综述，以确定研究。我们纳入了评估 OEP 作为单一干预措施对 65 岁及以上老年人身体机能影响的随机对照试验（RCT）。使用随机效应模型进行荟萃分析。与平衡、力量和移动性相关的身体功能变化的标准化均数差（SMD）是观察结果。对运动方案和参与者特征进行了亚组分析。
本系统评价和荟萃分析共纳入 13 项 RCT，包含 2402 名参与者。结果表明，OEP 对平衡（SMD=0.59，95%CI：0.22∼0.96）、下肢力量（SMD=0.93，95%CI：0.31∼1.55）和移动性（SMD=-0.59，95%CI：0.95∼-0.22）具有显著效果，而对上肢力量（MD=1.48，95%CI：-0.58∼3.55）则无显著效果。亚组分析显示，视频支持的交付模式在改善平衡（P=0.04）和移动性（P=0.02）方面比面对面模式更有效。疗程超过 30 分钟比 1-30 分钟更有效提高下肢力量（P＜0.001）和移动性（P＜0.001）。13-26 周的项目周期比 4-12 周更有效提高移动性（P=0.02）。然而，OEP 对身体机能的影响与年龄组和基线跌倒风险无关。
OEP 可以改善老年人的身体机能，包括平衡、下肢力量和移动性。在老年人中实施 OEP 的视频支持、每次 30 分钟以上和 4-12 周可能是改善身体机能最适当和最有效的运动方案。需要更多设计严谨、规模更大的 RCT 来进一步评估不同 OEP 方案的有效性，并量化剂量-效应关系。
