Progressive resistance strength training for improving physical function in older adults.
Progressive resistance strength training for improving physical function in older adults.
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DOI：
10.1002/14651858.cd002759.pub2
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发表时间：
2009-07-08
影响因子：
8.4
通讯作者：
Latham, N. K.
中科院分区：
文献类型：
--
作者：
Liu, C. J.;Latham, N. K.
老年肌肉无力与身体功能衰退有关。渐进式抗阻力量训练(PRT)练习旨在增加力量。评估PRT对老年人的影响并确定不良事件。我们检索了Cochrane骨、关节和肌肉创伤组专门登记库(至2007年3月)、Cochrane对照试验中央登记库(Cochrane图书馆2007年第2期)、MEDLINE(1966至2008年5月1日)、EMBASE(1980至2007年2月6日)、CINAHL(1982至2007年7月1日)和其他两个电子数据库。我们还搜索了参考文献列表，审阅了会议摘要，并联系了作者。报告PRT对老年人的身体结果的随机对照试验也包括在内。两位综述作者独立选择试验，评估试验质量并提取数据。在适当的情况下，数据被汇集在一起。共纳入121项试验，6,700人参与。在大多数试验中，PRT每周进行两到三次，而且强度很高。PRT在体能方面有微小但显著的改善(33次试验，2172名参与者；SMD 0.14，95%CI 0.05至0.22)。功能限制措施也显示出改善：例如，步态速度有轻微的改善(24次试验，1179名参与者，MD 0.08m/S，95%可信区间0.04至0.12)；以及中等到较大的起立效果(11次试验，384名参与者，SMD-0.94，95%可信区间-1.49至-0.38)。PRT对肌肉力量有很大的积极影响(73次试验，3059名参与者，SMD为0.84，95%CI为0.67~1.00)。骨关节炎患者报告PRT后疼痛减轻(6项试验，503名参与者，SMD-0.30，95%CI-0.48至-0.13)。其他10项试验(587名参与者)没有证据表明PRT对身体疼痛有影响。不良事件的记录很少，但在许多前瞻性定义和监测这些事件的研究中，报告了与肌肉骨骼主诉相关的不良事件，如关节疼痛和肌肉酸痛。严重的不良事件很少见，没有与锻炼计划直接相关的严重事件的报告。这篇综述提供的证据表明，PRT是改善老年人身体功能的有效干预措施，包括提高力量和一些简单和复杂活动的表现。然而，在将这些练习转移到临床人群中使用时需要一些谨慎，因为不良事件没有得到充分的报道。
Muscle weakness in old age is associated with physical function decline. Progressive resistance strength training (PRT) exercises are designed to increase strength. To assess the effects of PRT on older people and identify adverse events. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized Register (to March 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 2), MEDLINE (1966 to May 01, 2008), EMBASE (1980 to February 06 2007), CINAHL (1982 to July 01 2007) and two other electronic databases. We also searched reference lists of articles, reviewed conference abstracts and contacted authors. Randomised controlled trials reporting physical outcomes of PRT for older people were included. Two review authors independently selected trials, assessed trial quality and extracted data. Data were pooled where appropriate. One hundred and twenty one trials with 6700 participants were included. In most trials, PRT was performed two to three times per week and at a high intensity. PRT resulted in a small but significant improvement in physical ability (33 trials, 2172 participants; SMD 0.14, 95% CI 0.05 to 0.22). Functional limitation measures also showed improvements: e.g. there was a modest improvement in gait speed (24 trials, 1179 participants, MD 0.08 m/s, 95% CI 0.04 to 0.12); and a moderate to large effect for getting out of a chair (11 trials, 384 participants, SMD -0.94, 95% CI -1.49 to -0.38). PRT had a large positive effect on muscle strength (73 trials, 3059 participants, SMD 0.84, 95% CI 0.67 to 1.00). Participants with osteoarthritis reported a reduction in pain following PRT (6 trials, 503 participants, SMD -0.30, 95% CI -0.48 to -0.13). There was no evidence from 10 other trials (587 participants) that PRT had an effect on bodily pain. Adverse events were poorly recorded but adverse events related to musculoskeletal complaints, such as joint pain and muscle soreness, were reported in many of the studies that prospectively defined and monitored these events. Serious adverse events were rare, and no serious events were reported to be directly related to the exercise programme. This review provides evidence that PRT is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.