运动对预防老年人跌倒效果的网状Meta分析  

Efficacy of Exercise on Fall in Old Adults:A Network Meta-analysis

作　　者：郭静霞 陈亮[1,2] 余启超 吴渔 GUO Jing-xia;CHEN Liang;YU Qi-chao;WU Yu(Provincial University Key Laboratory of Sport and Health Science,School of Physical Education and Sport Sciences,Fujian Normal University,Fuzhou,Fujian 350117,China;School of Physical Education and Sport Science,Fujian Normal University,Fuzhou,Fujian 350117,China)

机构地区：[1]福建师范大学体育科学学院运动与健康福建省高校重点实验室,福建福州市350117 [2]福建师范大学体育科学学院,福建福州市350117

出　　处：《中国康复理论与实践》2021年第5期563-573,共11页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家社会科学基金青年项目(No.15CTY019);福建省社会科学规划项目(No.FJ2020B082)。

摘　　要：目的系统评价运动对预防老年人跌倒的疗效。方法检索1980年至2020年7月Web of Science、PubMed、Cochrane Library、中国知网数据库有关运动对预防老年人跌倒的随机对照试验,采用Review Manager 5.3对纳入文献进行质量评价,应用R-Studio和Addis 1.16.6软件进行网状Meta分析。结果纳入172项研究,共9种运动干预手段。运动与认知结合训练减少老年人跌倒率最有效(OR=0.26,95%CI 0.14~0.49,P<0.05);全身振动结合运动训练对提高老年人Berg平衡量表评分(d=6.3,95%CI 3.5~9.2,P<0.05)和计时起立-行走测试成绩(d=-4.5,95%CI-6.8~-2.1,P<0.05)方面最有效;血流限制训练对提高下肢肌力最有效(d=12,95%CI 7.4~16,P<0.05)。结论认知与运动结合训练是降低老年人跌倒率最优先推荐的运动方式,太极拳和组合运动方式次之,单纯步态训练或抗阻训练效果最差。多种新型干预手段(血流限制、全身振动与运动结合、体感游戏等)对提高老年人身体功能有一定优势,可继续深入研究。Objective To evaluate the efficacy of exercise on preventing falls in the elderly.Methods Literatures of randomized controlled trials about exercises for prevention of falls in the elderly were retrieved from Web of Science,PubMed,Cochrane Library and CNKI from 1980 to July,2020.The qualities were evaluated with Review Manager 5.3,and the data were analyzed with R-Studio and Addis 1.16.6.Results A total of 172 randomized controlled trials were finally included,with nine kinds of exercise intervention.The cognition and movement multitask training was the most effective to decrease fall rate(OR=0.26,95%CI 0.14 to 0.49,P<0.05).The combined physical and whole body vibration training was the most effective to improve the score of Berg Balance Scale(d=6.3,95%CI 3.5 to 9.2,P<0.05)and the time of Timed'Up&Go'Test(d=-4.5,95%CI-6.8 to-2.1,P<0.05).The blood flow restriction training was the most effective to increase the lower limb muscle strength(d=12,95%CI 7.4 to 16,P<0.05).Conclusion The cognition and movement multitask training is the first recommended exercise to prevent falls in the elderly,followed by Taiji Quan and multimodal training.Gait practice or resistance training are the least effective.A variety of new intervention methods(blood flow restriction training,combined physical and whole body vibration training,Wit Fit training,etc.)may improve the physical function of the elderly,and need further researches.

关 键 词：运动 老年 跌倒 平衡 移动 下肢肌力 网状meta分析 

分 类 号：R592[医药卫生—老年医学]