Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial.
Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial.
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DOI：
10.1001/jama.2014.5616
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发表时间：
2014-06-18
影响因子：
120.7
通讯作者：
Williamson, Jeff D.
中科院分区：
文献类型：
--
作者：
Pahor, Marco;Guralnik, Jack M.;Ambrosius, Walter T.;Blair, Steven;Bonds, Denise E.;Church, Timothy S.;Espeland, Mark A.;Fielding, Roger A.;Gill, Thomas M.;Groessl, Erik J.;King, Abby C.;Kritchevsky, Stephen B.;Manini, Todd M.;McDermott, Mary M.;Miller, Michael E.;Newman, Anne B.;Rejeski, W. Jack;Sink, Kaycee M.;Williamson, Jeff D.
在老年人中，活动能力降低是常见的，是发病率、住院、残疾和死亡率的独立危险因素。有限的证据表明，体力活动可能有助于预防行动不便；然而，目前还没有明确的临床试验来检验身体活动是否能预防或延缓行动不便。为了验证这样一种假设，即长期的结构化体力活动计划在降低主要行动能力障碍的风险方面比健康教育计划(也称为成功的老龄化计划)更有效。生活方式干预和老年人独立性(LIFE)研究是一项多中心随机试验，在2010年2月至2011年12月期间招募参与者，平均参与时间为2.6年。后续行动于2013年12月结束。结果评估员对干预任务视而不见。参与者来自全美8个田野中心的城市、郊区和农村社区。我们随机抽取了1,635名年龄在70-89岁之间的久坐不动的男性和女性，他们的身体缺陷被定义为身体缺陷，但能够行走400米。参与者被随机分配到中心和家里进行有组织的中等强度体育活动计划(n=818)，其中包括有氧、阻力和灵活性训练活动，或者参加健康教育计划(n=817)，该计划包括与老年人和上肢伸展运动相关的主题研讨会。30.1%(n=246/818)体力活动和35.5%(n=290/817)健康教育参与者发生重大活动障碍(HR=0.82，95%CI=0.69~0.98，P=0.03)。体力活动组和健康教育组的持续性活动障碍发生率分别为14.7%和19.8%(HR=0.72，95%CI=0.57~0.91，P=0.006)。404/818(49.4%)的体力活动参与者和373/817(45.7%)的健康教育参与者报告了严重不良事件(风险比=1.08；95%CI=0.98~1.20)。与健康教育计划相比，有组织的中等强度体力活动计划在2.6年内减少了有残疾风险的老年人的主要行动障碍。这些发现表明，在脆弱的老年人中，这样的计划有利于行动能力。ClinicalsTrials.gov标识符NCT01072500。
In older adults reduced mobility is common and is an independent risk factor for morbidity, hospitalization, disability, and mortality. Limited evidence suggests that physical activity may help prevent mobility disability; however, there are no definitive clinical trials examining if physical activity prevents or delays mobility disability. To test the hypothesis that a long-term structured physical activity program is more effective than a health education program (also referred to as a successful aging program) in reducing the risk of major mobility disability. The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial that enrolled participants between February 2010 and December 2011, who participated for an average of 2.6 years. Follow-up ended in December 2013. Outcome assessors were blinded to the intervention assignment. Participants were recruited from urban, suburban and rural communities at 8 field centers throughout the US. We randomized a volunteer sample of 1,635 sedentary men and women aged 70–89 years who had physical limitations, defined as a score on the Short Physical Performance Battery of 9 or below, but were able to walk 400 m. Participants were randomized to a structured moderate intensity physical activity program (n=818) done in a center and at home that included including aerobic, resistance and flexibility training activities or to a health education program (n=817) consisting of workshops on topics relevant to older adults and upper extremity stretching exercises. The primary outcome was major mobility disability objectively defined by loss of ability to walk 400 m. Incident major mobility disability occurred in 30.1% (n=246/818) of physical activity and 35.5% (n=290/817) of health education participants (HR=0.82, 95%CI=0.69–0.98, p=0.03). Persistent mobility disability was experienced by 120/818 (14.7%) physical activity and 162/817 (19.8%) health education participants (HR=0.72; 95%CI=0.57–0.91; p=0.006). Serious adverse events were reported by 404/818 (49.4%) of the physical activity and 373/817 (45.7%) of the health education participants (Risk Ratio=1.08; 95%CI=0.98–1.20). A structured moderate intensity physical activity program, compared with a health education program, reduced major mobility disability over 2.6 years among older adults at risk of disability. These findings suggest mobility benefit from such a program in vulnerable older adults. ClinicalsTrials.gov identifier NCT01072500.
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影响因子：
12.7
作者：
BRANCH, LG;JETTE, AM
通讯作者：
JETTE, AM
DOI：
10.1093/gerona/glt064
发表时间：
2013-12-01
影响因子：
5.1
作者：
Marsh, Anthony P.;Lovato, Laura C.;Guralnik, Jack M.
通讯作者：
Guralnik, Jack M.
影响因子：
120.7
作者：
Ettinger, WH;Burns, R;Craven, T
通讯作者：
Craven, T
影响因子：
3
作者：
Andresen, EM;Rothenberg, BM;Kaplan, RM
通讯作者：
Kaplan, RM
影响因子：
120.7
作者：
CORTI, MC;GURALNIK, JM;SORKIN, JD
通讯作者：
SORKIN, JD