Liu Chiung-Ju, Chang Wen-Pin, Shin Yun Chan, Hu Yi-Ling, Morgan-Daniel Jane
Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, P.O. Box 100164, Gainesville, FL, 32610-0164, USA.
Department of Occupational Therapy, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, TX, USA.
Eur Rev Aging Phys Act. 2024 Dec 21;21(1):32. doi: 10.1186/s11556-024-00366-3.
Age-related decline in physical and cognitive capacity increases older adults' risk of disability, long-term care placement, and mortality rate. Functional training, which uses activities of daily living or simulated movements to complete activities as the intervention medium, could be more effective than rote exercise, which uses repetitive movements without added purpose, in preventing late-life disability in older people. With a growing number of studies in this area, systematically studying the effect of functional training is needed. The purpose of this systematic review was to examine the effects of functional training on the outcomes of activities of daily living, physical functioning, and cognitive function in community-dwelling older adults.
Literature published between January 2010 and April 2024 in 10 electronic databases were searched and screened. This timeframe was established to include studies published within the last 15 years. Each identified article was screened and reviewed by two authors independently. The methodological quality of the included studies was evaluated using the PEDro Scale. Key findings were synthesized according to participants' characteristics and intervention types.
The review included 32 studies. In the general community-dwelling older adult population (20 studies), studies that applied functional training as a single-component approach showed a positive effect on activities of daily living. However, the training effect on balance and mobility was not superior to that of other exercise programs. Moreover, the effect was mixed when functional training was combined with other intervention components. In older adults with mild cognitive impairment (5 studies), Simulated Functional Tasks Exercise, a single-component training, consistently demonstrated positive effects on the activities of daily living and cognitive functions. In older adults with dementia (4 studies) or frailty (3 studies), the effect was mixed across the single- and multi-component approaches.
Functional training alone is effective in preventing late-life disability in general community-dwelling older adults. When training activities challenge both motor and cognitive abilities, the effect seems to improve the performance of activities of daily living and cognitive functions in older adults with mild cognitive impairment. Additional studies of functional training in older adults with cognitive impairment or frailty are recommended.
与年龄相关的身体和认知能力下降会增加老年人残疾、长期护理安置和死亡率的风险。功能训练以日常生活活动或模拟动作作为干预媒介来完成活动，在预防老年人晚年残疾方面可能比单纯的重复运动训练更有效，后者只是进行无附加目的的重复动作。随着该领域研究的不断增加，有必要系统地研究功能训练的效果。本系统评价的目的是检验功能训练对社区居住老年人日常生活活动、身体功能和认知功能结局的影响。
检索并筛选了2010年1月至2024年4月期间在10个电子数据库中发表的文献。确定这个时间范围是为了纳入过去15年内发表的研究。每篇被识别的文章由两位作者独立筛选和评审。使用PEDro量表评估纳入研究的方法学质量。根据参与者的特征和干预类型对主要研究结果进行综合分析。
该综述纳入了32项研究。在一般社区居住的老年人群体中（20项研究），将功能训练作为单一成分方法应用的研究对日常生活活动显示出积极效果。然而，对平衡和活动能力的训练效果并不优于其他运动项目。此外，当功能训练与其他干预成分结合时，效果不一。在轻度认知障碍的老年人中（5项研究），模拟功能任务训练，一种单一成分训练，始终对日常生活活动和认知功能显示出积极效果。在患有痴呆症的老年人中（4项研究）或虚弱的老年人中（3项研究），单一成分和多成分方法的效果不一。
单独的功能训练在预防一般社区居住老年人晚年残疾方面是有效的。当训练活动同时挑战运动和认知能力时，似乎可以改善轻度认知障碍老年人的日常生活活动表现和认知功能。建议对认知障碍或虚弱的老年人进行更多关于功能训练的研究。
