EFFECTS OF PHYSICAL-ACTIVITY ON HEALTH-STATUS IN OLDER ADULTS .2. INTERVENTION STUDIES
EFFECTS OF PHYSICAL-ACTIVITY ON HEALTH-STATUS IN OLDER ADULTS .2. INTERVENTION STUDIES
复制标题
DOI：
10.1146/annurev.pu.13.050192.002345
复制
发表时间：
1992-01-01
影响因子：
20.8
通讯作者：
WAGNER, EH
中科院分区：
文献类型：
--
作者：
BUCHNER, DM;BERESFORD, SAA;WAGNER, EH
这篇评论集中在运动与健康关系的一个特定部分。支持运动对健康有益的整体证据是大量的，最近已经进行了严格的审查（18，94）。因此，美国预防服务工作组建议所有成年人定期锻炼（94）。下面总结的关于老年人的结论并不影响这一基本建议。有确凿的证据表明，锻炼可以改善老年人的健康状况，特别是力量和有氧能力。这些运动效应发生在慢性病患者和健康成年人身上。由于身体健康是功能状态的决定因素，因此询问运动是否可以预防或改善老年人功能状态的损害是合乎逻辑的。运动改善功能状态的证据是有希望的，但不确定。现有研究的问题包括缺乏随机对照试验，缺乏运动效果可以长期持续的证据，统计能力不足，以及未能针对身体不健康的个体。现有的研究表明，运动可能会改善步态和平衡。关节炎患者可能会从运动中获得长期的功能状态益处，包括改善流动性和减少疼痛症状。非随机试验表明，运动可以提高骨密度，从而降低骨折风险。最近的研究普遍得出结论，短期运动不会改善认知功能。然而，这些研究的统计能力有限，并不能排除运动对认知可能产生的适度但有功能意义的影响。未来的研究，除了纠正现有研究中的方法学缺陷外，还应该系统地研究运动对功能状态的影响如何随运动的类型、强度和持续时间而变化。它应该解决的问题，在招募功能受损的老年人进行运动研究，促进长期坚持运动的问题，以及目前在监督类运动相关损伤的低发生率是否可以维持在更具有成本效益的干预措施，需要更少的监督。
This review has focused on a specific part of the relationship of exercise to health. The overall evidence supporting the health benefits of exercise is substantial and has been critically reviewed recently (18, 94). Thus, the United States Preventive Services Task Force recommends that all adults exercise regularly (94). The conclusions summarized below regarding older adults do not affect this basic recommendation. There is solid evidence that exercise can improve measures of fitness in older adults, particularly strength and aerobic capacity. These exercise effects occur in chronically ill adults, as well as in healthy adults. Because physical fitness is a determinant of functional status, it is logical to ask whether exercise can prevent or improve impairments in functional status in older adults. The evidence that exercise improves functional status is promising, but inconclusive. Problems with existing studies include a lack of randomized controlled trials, a lack of evidence that effects of exercise can be sustained over long periods of time, inadequate statistical power, and failure to target physically unfit individuals. Existing studies suggest that exercise may produce improvements in gait and balance. Arthritis patients may experience long-term functional status benefits from exercise, including improved mobility and decreased pain symptoms. Nonrandomized trials suggest exercise promotes bone mineral density and thereby decreases fracture risk. Recent studies have generally concluded that short-term exercise does not improve cognitive function. Yet the limited statistical power of these studies does not preclude what may be a modest, but functionally meaningful, effect of exercise on cognition. Future research, beyond correcting methodologic deficiencies in existing studies, should systematically study how functional status effects of exercise vary with the type, intensity, and duration of exercise. It should address issues in recruiting functionally impaired older adults into exercise studies, issues in promoting long-term adherence to exercise, and whether the currently low rate of exercise-related injuries in supervised classes can be sustained in more cost-effective interventions that require less supervision.