Rose Grace A, Bruni Pietra T, Wingood Mariana, Kallmi Selmi, Finer Elizabeth, Bamonti Patricia M
Research & Development, VA Boston Healthcare System, Boston, MA.
VA Boston Healthcare System, Boston, MA.
Arch Rehabil Res Clin Transl. 2025 Mar 19;7(2):100447. doi: 10.1016/j.arrct.2025.100447. eCollection 2025 Jun.
To evaluate the effects of therapeutic exercise and psychological interventions on disability and personal outcomes in older adults.
Articles published from January 2013 to February 2025 are available in PubMed, Embase, ProQuest Health & Medical and Psychology, PsycINFO, and PsycArticles.
Inclusion criteria were as follows: (1) intervention included therapeutic exercise combined or integrated with a psychological intervention; (2) randomized controlled trial; (3) sample mean age ≥60 years; (4) primary or secondary outcome(s) of disability. Two authors independently screened trials (n=7391) for inclusion; a third author verified results and resolved discrepancies.
Data were extracted by a primary reviewer and verified by a second reviewer. The risk of bias assessment was performed using the risk of bias in randomized controlled trials.
Thirty-eight trials (n=18,550 participants) were included. Therapeutic exercise included: exercise programs (34%), physical activity counseling and monitoring (37%), rehabilitation (18%), or other (eg, Tai Chi; 13%). Psychological interventions were primarily motivational interviewing (53%) or cognitive-behavioral therapy/strategies (39%). Significant improvement in body functions and structures (n=14, 37%), activity (n=6, 16%), participation (n=20, 53%), and personal factors (n=11, 29%) was observed.
Therapeutic exercise with psychological interventions have a positive effect on disability and personal outcomes, especially in participation. Heterogeneity in the study design, intervention, and population challenged data synthesis. Nonetheless, the current review identified gaps within the literature and directions for future research. Testing the additive effect of these interventions compared to active comparators is a priority for future investigations.
评估治疗性运动和心理干预对老年人残疾状况及个人结局的影响。
2013年1月至2025年2月发表的文章可在PubMed、Embase、ProQuest健康与医学数据库以及心理学数据库PsycINFO和PsycArticles中获取。
纳入标准如下：（1）干预措施包括与心理干预相结合或整合的治疗性运动；（2）随机对照试验；（3）样本平均年龄≥60岁；（4）残疾的主要或次要结局。两位作者独立筛选试验（共7391项）以确定是否纳入；第三位作者核实结果并解决分歧。
由一位主要审阅者提取数据，并由另一位审阅者进行核实。使用随机对照试验中的偏倚风险评估方法进行偏倚风险评估。
纳入了38项试验（共18550名参与者）。治疗性运动包括：运动项目（34%）、身体活动咨询与监测（37%）、康复治疗（18%）或其他（如太极拳；13%）。心理干预主要是动机访谈（53%）或认知行为疗法/策略（39%）。观察到身体功能和结构（n = 14，37%）、活动能力（n = 6，16%）、参与度（n = 20，53%）和个人因素（n = 11，29%）有显著改善。
治疗性运动与心理干预对残疾状况和个人结局有积极影响，尤其是在参与度方面。研究设计、干预措施和研究人群的异质性给数据综合带来了挑战。尽管如此，当前的综述确定了文献中的空白以及未来研究的方向。与积极对照相比，测试这些干预措施的叠加效应是未来研究的重点。
