运动改善社区居家老年肌少症患者肌肉健康剂量效应的Meta分析  

Meta-analysis of dose-effect of exercise on improving muscle health in community-dwelling older adults with sarcopenia

作　　者：蒋思琪 黄欢欢 余馨雨 彭颖 周薇 赵庆华[1] Jiang Siqi;Huang Huanhuan;Yu Xinyu;Peng Ying;Zhou Wei;Zhao Qinghua(Nursing Department,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院护理部,重庆市400016

出　　处：《中国组织工程研究》2025年第29期6295-6304,共10页Chinese Journal of Tissue Engineering Research

基　　金：重庆市体育局科研项目重点项目(B202301),项目负责人:赵庆华;重庆医科大学研究生智慧医学专项研发计划(YJSZHYX202206),项目负责人:黄欢欢。

摘　　要：目的:运动干预在肌少症防治中的积极作用已受到广泛关注,但针对老年肌少症患者的最佳运动剂量仍需进一步确定。探讨运动处方各要素与社区居家老年肌少症患者的肌肉质量、肌肉力量和躯体功能改善之间的剂量效应关系,旨在为社区居家老年肌少症患者运动处方的制定提供科学支撑。方法:系统检索PubMed、EMBASE、Scopus、Web of Science、中国知网、万方数据、维普和中国生物医学文献数据库从建库至2024-10-09发表的文献,使用RevMan 5.3软件进行Meta分析,采用标准化均数差(SMD)及其95%CI作为效应统计量。结果:①共纳入11篇随机对照试验,包括试验组患者348例,对照组患者304例;②Meta分析结果显示,运动对老年肌少症患者的四肢骨骼肌质量指数、握力和步速均有改善作用(SMD分别为0.46,0.63,067,P<0.05);③当运动频率为每周两三天时,老年肌少症患者的四肢骨骼肌质量指数(SMD=0.57,95%CI:0.28-0.86,P<0.001)、握力(SMD=0.70,95%CI:0.37-1.02,P<0.001)和步速(SMD=0.69,95%CI:0.20-1.18,P=0.006)均能得到有效改善;④当运动时间为每次25-60 min时,老年肌少症患者的四肢骨骼肌质量指数(SMD=0.28,95%CI:0.07-0.50,P=0.01)、握力(SMD=0.37,95%CI:0.16-0.59,P<0.001)和步速(SMD=0.39,95%CI:0.06-0.73,P=0.02)均能得到有效改善;⑤当运动强度为中等强度时,老年肌少症患者的四肢骨骼肌质量指数(SMD=0.69,95%CI:0.35-1.03,P<0.001)、握力(SMD=0.36,95%CI:0.09-0.64,P=0.009)和步速(SMD=0.91,95%CI:0.34-1.47,P=0.002)均能得到有效改善;⑥当运动周期剂量为8-12周时,老年肌少症患者的四肢骨骼肌质量指数(SMD=0.42,95%CI:0.20-0.64,P<0.001)、握力(SMD=0.45,95%CI:0.26-0.64,P<0.001)和步速(SMD=0.76,95%CI:0.27-1.25,P=0.002)均能得到有效改善。结论:积极、规律的运动可促进老年肌少症患者肌肉健康的提升;建议老年肌少症患者每周至少运动两三天、每次25-60 min、持续8-12周的中等强度运动以改善肌�OBJECTIIVE:The positive role of exercise intervention in the prevention and treatment of sarcopenia has received widespread attention,but the optimal exercise dose for elderly sarcopenic patients still needs to be further determined.The article explored the dose-effect relationship between various elements of exercise prescription and the improvement of muscle mass,muscle strength and physical function in community-dwelling elderly patients with sarcopenia,aiming to provide scientific support for the development of exercise prescription for community-dwelling elderly patients with sarcopenia.METHODS:Literature published from the inception to October 9,2024 in PubMed,EMBASE,Scopus,Web of Science,CNKI,WanFang,VIP,and CBMdisc databases was systematically searched.Meta-analysis was performed using RevMan 5.3 software.Standardized mean difference(SMD)and its 95%CI were used as effect statistics.RESULTS:(1)A total of 11 randomized controlled trials were included,with 348 in the trial group and 304 in the control group.(2)Meta-analysis results showed that exercise improved appendicular skeletal muscle mass index,grip strength,and walking speed in elderly patients with sarcopenia(SMDs 0.46,0.63,0.67,P<0.05).(3)When the frequency of exercise was 2-3 days/week,appendicular skeletal muscle mass index(SMD=0.57,95%CI:0.28-0.86,P<0.001),grip strength(SMD=0.70,95%CI:0.37-1.02,P<0.001),and walking speed(SMD=0.69,95%CI:0.20-1.18,P=0.006)were effectively improved in elderly patients with sarcopenia.(4)When the duration of exercise was 25-60 minutes per session,appendicular skeletal muscle mass index(SMD=0.28,95%CI:0.07-0.50,P=0.01),grip strength(SMD=0.37,95%CI:0.16-0.59,P<0.001),and walking speed(SMD=0.39,95%CI:0.06-0.73,P=0.02)were effectively improved in elderly patients with sarcopenia.(5)When the exercise intensity was moderate,appendicular skeletal muscle mass index(SMD=0.69,95%CI:0.35-1.03,P<0.001),and grip strength(SMD=0.36,95%CI:0.09-0.64,P=0.009),and walking speed(SMD=0.91,95%CI:0.34-1.47,P=0.002)were effectively improved

关 键 词：肌少症 运动 剂量效应 运动剂量 META分析 肌肉质量 肌肉力量 躯体功能 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R592