Adliah Fadhia, Hall Abigail J, Goodwin Victoria, Lamb Sarah
Public Health and Sport Sciences, University of Exeter Faculty of Health and Life Sciences, Exeter, UK
Faculty of Nursing, Physiotherapy, Hasanuddin University, Makassar, Indonesia.
BMJ Open. 2025 Apr 30;15(4):e092775. doi: 10.1136/bmjopen-2024-092775.
This systematic review and meta-analysis synthesised the evidence and evaluated the effect of exercise programmes delivered using instructional videos compared with control on physical performance and falls in community-dwelling older people aged 60 years and older.
A systematic review and meta-analysis conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Central Register of Controlled Trials, TRIP and PEDro. Grey literature sources included theses and dissertations from Ethos and ProQuest.
Studies were included if they involved community-dwelling older people (aged >60 years) participating in exercise programmes delivered through instructional videos.
Treatment effects were estimated using a random-effects model, reporting 95% CIs, mean differences (MD) and standardised MDs (SMD, Hedges' g) for outcomes measured in different units. The risk of bias was assessed using ROB2, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
A total of 7487 records were screened, with 16 studies (n=1910) meeting the inclusion criteria. Meta-analysis of 11 studies revealed significant effects of video-delivered exercise programmes in lower extremity strength (SMD=0.35, 95% CI 0.11 to 0.59; I=70.35%, p<0.001, GRADE moderate quality), balance (SMD=0.45, 95% CI 0.07 to 0.83; I=85.07%, p=0.02, GRADE low quality), mobility (MD=0.96, 95% CI 0.46 to 1.46; I=53.31%, p<0.001, GRADE moderate quality) and physical performance SMD=0.36, 95% CI 0.17 to 0.56; I=13.49%, p<0.001, GRADE moderate quality). No evidence of an effect of video-delivered exercise programmes on fear of falling was found (SMD=0.5, 95% CI -0.30 to 1.29; I=95.48%, p=0.22, GRADE very low quality). There were insufficient data for reporting falls.
Video-delivered exercise programmes improved physical performance, particularly lower extremity strength, balance and mobility, with low to moderate quality evidence. There is uncertainty about the effect of video-delivered exercise programmes on the number of falls, number of fallers and fear of falling.
CRD42023415530.
本系统评价和荟萃分析综合了相关证据，并评估了与对照组相比，使用教学视频进行的锻炼计划对60岁及以上社区居住老年人身体机能和跌倒情况的影响。
按照系统评价和荟萃分析的首选报告项目指南进行系统评价和荟萃分析。
MEDLINE、EMBASE、CINAHL、PsycINFO、Cochrane对照试验中央注册库、TRIP和PEDro。灰色文献来源包括来自Ethos和ProQuest的论文和学位论文。
纳入的研究需涉及通过教学视频参与锻炼计划的社区居住老年人（年龄>60岁）。
使用随机效应模型估计治疗效果，报告不同单位测量结果的95%置信区间、平均差（MD）和标准化平均差（SMD，Hedges' g）。使用ROB2评估偏倚风险，并使用推荐分级评估、制定和评价（GRADE）方法评估证据的确定性。
共筛选了7487条记录，16项研究（n=1910）符合纳入标准。对11项研究的荟萃分析显示，视频锻炼计划对下肢力量（SMD=0.35，95%CI 0.11至0.59；I=70.35%，p<0.001，GRADE中等质量）、平衡能力（SMD=0.45，95%CI 0.07至0.83；I=85.07%，p=0.02，GRADE低质量）、活动能力（MD=0.96，95%CI 0.46至1.46；I=53.31%，p<0.001，GRADE中等质量）和身体机能（SMD=0.36，95%CI 0.17至0.56；I=13.49%，p<0.001，GRADE中等质量）有显著影响。未发现视频锻炼计划对跌倒恐惧有影响的证据（SMD=约0.5，95%CI -0.30至1.29；I=95.48%，p=0.22，GRADE极低质量）。报告跌倒情况的数据不足。
视频锻炼计划改善了身体机能，尤其是下肢力量、平衡能力和活动能力，证据质量低至中等。视频锻炼计划对跌倒次数、跌倒者数量和跌倒恐惧的影响尚不确定。
PROSPERO注册号：CRD42023415530。
