Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial
Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial
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DOI：
10.1371/journal.pone.0182155
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发表时间：
2017-08-18
期刊：
影响因子：
3.7
通讯作者：
Rejeski, W. Jack
中科院分区：
文献类型：
--
作者：
Fielding, Roger A.;Guralnik, Jack M.;Rejeski, W. Jack
了解实现身体功能改善和降低残疾风险所需的最小身体活动剂量对于告知公共卫生建议是必要的。在生活方式干预和老年人独立性（LIFE）研究中，检查身体活动剂量对身体功能变化和主要活动障碍发生的影响。我们进行了一项多中心单盲随机对照试验，在2010年和2011年招募了参与者，并对他们进行了平均2.6年的随访。1，635名年龄在70-89岁之间的久坐不动的男性和女性，他们有功能限制，被随机分配到一个结构化的中等强度的步行，阻力和灵活性的身体活动计划或健康教育计划。在基线和24个月时，通过7天加速度计和自我报告评估体力活动剂量。结局包括基线、6、12和24个月时评估的400 m步行步态速度、短期体能成套测试（SPPB）和严重移动性残疾发作（客观定义为15分钟内丧失400 m步行能力）。当体力活动组或整个样本按体力活动从基线至24个月的变化分层时，6、12和24个月时步态速度和SPPB从基线的变化呈剂量依赖性增加。此外，24个月内体力活动的变化幅度与重大活动障碍的发生减少有关（总体P < 0.001）（体力活动变化的最高与最低四分位数HR 0.23（（95% CI：0.10-0.52）P = 0.001）。我们观察到客观监测的体力活动对身体功能和主要活动障碍的发生具有剂量依赖性影响。定期体力活动参与的相对较小的增加（每周> 48分钟）对这些结果具有显著和临床意义的影响。
Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70-89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI: 0.10-0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes.