Community-based Exercise Programs as a Strategy to Optimize Function in Chronic Disease A Systematic Review
Community-based Exercise Programs as a Strategy to Optimize Function in Chronic Disease A Systematic Review
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DOI：
10.1097/mlr.0000000000000065
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发表时间：
2014-03-01
期刊：
影响因子：
3
通讯作者：
Brooks, Dina
中科院分区：
文献类型：
--
作者：
Desveaux, Laura;Beauchamp, Marla;Brooks, Dina
背景：慢性病是世界范围内死亡和残疾的主要原因。初步证据表明，以社区为基础的运动（CBE）提高功能能力（FC）和健康相关的生活质量（HRQL）。目的：描述慢性病人群的CBE计划的结构和交付，并比较其对FC和HRQL的影响，以标准care.Research Design：随机试验检查CBE计划的个人中风，慢性阻塞性肺疾病，骨关节炎，糖尿病和心血管疾病被确定。使用科克伦偏倚风险工具评估质量。使用Review Manager 5.1进行荟萃分析。该方案已在PROSPERO（CRD 42012002786）上注册。结果：16项研究（2198例，平均年龄66.8 ± 4.9岁）被纳入描述程序结构，其设计和组成相当，无论慢性疾病。有氧运动和阻力训练是85%研究的主要干预措施。9项研究被纳入荟萃分析。使用6分钟步行试验评价的FC加权平均差异为41.7 m（95%置信区间[CI]，20.5-62.8）。所有FC指标的标准化平均差异为0.18（95% CI，0.05-0.3）。HRQL措施的物理组成部分的标准化平均差异为0.21（95%CI，0.05-0.4）和0.38（95%CI，0.04-0.7）的总score.Conclusions：CBE计划在慢性病人群中有相似的结构。在骨关节炎患者中，这些方案在优化FC和HRQL方面上级标准治疗;然而，超出该人群的影响尚不清楚。这些方案的长期可持续性仍有待建立。
Background:Chronic diseases are the leading cause of death and disability worldwide. Preliminary evidence suggests that community-based exercise (CBE) improves functional capacity (FC) and health-related quality of life (HRQL).Objective:To describe the structure and delivery of CBE programs for chronic disease populations and compare their impact on FC and HRQL to standard care.Research Design:Randomized trials examining CBE programs for individuals with stroke, chronic obstructive pulmonary disease, osteoarthritis, diabetes, and cardiovascular disease were identified. Quality was assessed using the Cochrane risk of bias tool. Meta-analyses were conducted using Review Manager 5.1. The protocol was registered on PROSPERO (CRD42012002786).Results:Sixteen studies (2198 individuals, mean age 66.8 +/- 4.9 y) were included to describe program structures, which were comparable in their design and components, irrespective of the chronic disease. Aerobic exercise and resistance training were the primary interventions in 85% of studies. Nine studies were included in the meta-analysis. The weighted mean difference for FC, evaluated using the 6-minute walk test, was 41.7 m (95% confidence interval [CI], 20.5-62.8). The standardized mean difference for all FC measures was 0.18 (95% CI, 0.05-0.3). The standardized mean difference for the physical component of HRQL measures was 0.21 (95% CI, 0.05-0.4) and 0.38 (95% CI, 0.04-0.7) for the total score.Conclusions:CBE programs across chronic disease populations have similar structures. These programs appear superior to standard care with respect to optimizing FC and HRQL in individuals with osteoarthritis; however, the effect beyond this population is unknown. Long-term sustainability of these programs remains to be established.