School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
Research Institute at St Joseph's Healthcare, Hamilton, ON, Canada.
PLoS One. 2024 May 10;19(5):e0297675. doi: 10.1371/journal.pone.0297675. eCollection 2024.
Physical activity (PA) declines with age despite the knowledge that physical inactivity is a leading cause of disease, death, and disability worldwide. To better tailor PA interventions to older adults, researchers are turning to the collaborative principles of co-design. The purpose of this systematic review was to compare the effectiveness of co-designed PA interventions and standard care for increasing PA and other health outcomes (i.e., physical function, quality of life, mental health, functional independence, attendance and attrition rates) in older adults.
A search was conducted in MEDLINE, AgeLine, CINAHL, Embase, and SPORTDiscus. Records were screened by independent pairs of reviewers. Primary research studies conducted among community-dwelling older adults (age 60+) comparing co-designed PA interventions to standard care were considered for inclusion. Controls included wait-list control, usual care, sham interventions, PA interventions without the use of co-design, and no intervention. A random effects meta-analysis was conducted, and the standardized mean difference (SMD) was used to report effect estimates. Quality of evidence was rated using GRADE.
Of 16,191 studies screened, eight (N = 16,733) were included in this review. Most studies reported results favouring the effect of co-design on physical activity; however, only two studies (N = 433) could be pooled for meta-analysis resulting in a SMD of 0.28, (95% CI = -0.13 to 0.69; p = 0.19; I2 = 56%) immediately post-intervention. The GRADE quality of evidence was very low. The quantitative analysis of three studies reported improved physical function.
This review did not demonstrate that co-designed PA interventions are more effective than standard care for increasing PA in older adults; however, evidence was limited and of very low quality. Further well-designed trials are warranted to better understand the impacts of co-designed PA interventions and how to best implement them into practice.
PROSPERO registration number: CRD42022314217.
尽管人们知道身体活动不足是全球疾病、死亡和残疾的主要原因，但随着年龄的增长，身体活动量还是会下降。为了更好地为老年人量身定制身体活动干预措施，研究人员开始采用共同设计的协作原则。本系统评价的目的是比较共同设计的身体活动干预措施与标准护理在增加身体活动和其他健康结果（即身体功能、生活质量、心理健康、功能独立性、出席率和脱落率）方面对老年人的有效性。
在 MEDLINE、AgeLine、CINAHL、Embase 和 SPORTDiscus 中进行了检索。记录由独立的双人审查员进行筛选。考虑纳入的研究是在社区居住的老年人（年龄≥60 岁）中进行的，将共同设计的身体活动干预措施与标准护理进行比较。对照组包括等待名单对照、常规护理、假干预、未使用共同设计的身体活动干预以及无干预。进行了随机效应荟萃分析，并使用标准化均数差（SMD）报告效应估计值。使用 GRADE 评估证据质量。
在筛选出的 16191 项研究中，有 8 项（N=16733）纳入了本综述。大多数研究报告的结果都支持共同设计对身体活动的影响；然而，只有两项研究（N=433）可以进行荟萃分析，结果得出 SMD 为 0.28（95%CI=-0.13 至 0.69；p=0.19；I2=56%），即在干预后即刻。GRADE 证据质量为极低。三项研究的定量分析报告了身体功能的改善。
本综述并未表明共同设计的身体活动干预措施比标准护理更能有效增加老年人的身体活动量；然而，证据有限且质量极低。需要进一步进行精心设计的试验，以更好地了解共同设计的身体活动干预措施的影响以及如何将其最佳地应用于实践。
PROSPERO 注册号：CRD42022314217。
