Zeng Ziwei, Ho Cheuk-Yin, Sit Cindy Hui-Ping, Wong Stephen Heung-Sang, Liao Jing, Yang Yijian
Department of Sports Science and Physical Education, The Chinese University of Hong Kong, New Territories, Hong Kong.
Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou.
Arch Phys Med Rehabil. 2025 May;106(5):781-800. doi: 10.1016/j.apmr.2024.12.002. Epub 2024 Dec 12.
To review and synthesize the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with mild cognitive impairment (MCI).
This review was registered with PROSPERO (CRD42023453320) and adhered to the PRISMA guidelines. The PubMed, Embase, APA PsycInfo, Cochrane Library, Web of Science, CINAHL, and SPORTDiscus were searched from inception until September 2024.
Randomized controlled trials (RCTs) examining the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with MCI.
Data extraction included author names, publication years, participant characteristics, intervention details, outcomes, key results, and attrition rates. Data accuracy was verified by 2 reviewers, with discrepancies resolved through consultation with a third reviewer.
Thirty-two RCTs met the criteria for qualitative systematic review, with 22 RCTs included in the pairwise meta-analysis and network meta-analysis. Aerobic exercise (AE) (SMD 1.07 [95% CI, 0.62-1.52]), multicomponent exercise (SMD 0.46 [95% CI, 0.18-0.74]), and simultaneous cognitive-motor training (SMD 0.56 [95% CI, 0.23-0.89]) significantly improved gait speed during single task (P<.05). AE was the most effective intervention for single-task walking performance (99.3%), whereas Exergaming was the most effective for timed Up and Go performance (100.0%) according to the surface under the cumulative ranking. Paddling exercise (SMD 0.42 [95% CI, 0.16-0.68]) effectively increased handgrip strength (P<.05). However, network meta-analyses revealed no intervention demonstrating significant effects on postural control performance (Berg Balance Scale and Functional Reach Test scores). The effect of exercise on falls remained inconclusive because of the limited number of studies.
AE, multicomponent exercise, and combined cognitive-motor training significantly enhance gait speed and functional performance in older adults with MCI. However, the effect of exercise on fall risk remains unclear. These findings underscore the potential of tailored exercise interventions to improve physical function in this vulnerable population.
回顾并综合分析运动干预对轻度认知障碍（MCI）老年人的活动能力、姿势控制和跌倒情况的有效性。
本综述已在国际前瞻性系统评价注册库（PROSPERO，注册号CRD42023453320）登记，并遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。检索了PubMed、Embase、美国心理学会心理学文摘数据库（APA PsycInfo）、考克兰图书馆、科学引文索引数据库（Web of Science）、护理学与健康领域数据库（CINAHL）和体育科学数据库（SPORTDiscus），检索时间从建库至2024年9月。
考察运动干预对MCI老年人的活动能力、姿势控制和跌倒情况有效性的随机对照试验（RCT）。
数据提取内容包括作者姓名、发表年份、参与者特征表、干预细节、结局指标、关键结果和失访率。由两名审阅者核实数据准确性，如有分歧则通过与第三名审阅者协商解决。
32项RCT符合定性系统评价标准，其中22项RCT纳入成对Meta分析和网状Meta分析。有氧运动（AE）（标准化均数差[SMD]为1.07[95%置信区间（CI），0.62 - 1.52]）、多成分运动（SMD为0.46[95%CI，0.18 - 0.74]）和认知 - 运动同步训练（SMD为0.56[95%CI，0.23 - 0.89]）在单任务期间显著提高了步速（P <.05）。根据累积排序曲线下面积，AE是对单任务步行表现最有效的干预措施（99.3%），而电子游戏运动对定时起立行走测试表现最有效（100.0%）。划桨运动（SMD为0.42[95%CI，0.16 - 0.68]）有效增加了握力（P <.05）。然而，网状Meta分析显示，没有干预措施对姿势控制表现（伯格平衡量表和功能性前伸测试得分）有显著影响。由于研究数量有限，运动对跌倒的影响仍无定论。
有氧运动、多成分运动和认知 - 运动联合训练可显著提高MCI老年人的步速和功能表现。然而，运动对跌倒风险的影响仍不清楚度。这些发现强调了定制运动干预措施对改善这一脆弱人群身体功能的潜力。
