不同运动干预方式对老年人肌少症改善效果的Meta分析

doi:10.3969/j.issn.1006-9771.2021.11.008

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (11): 1291-1298.doi: 10.3969/j.issn.1006-9771.2021.11.008

不同运动干预方式对老年人肌少症改善效果的Meta分析

温鹏天¹,张瑞丽¹(),胡文清²(),王娴¹,吴景梅¹,李慧娟¹

1.河北医科大学第四医院护理教学办公室,河北石家庄市 050011
2.河北医科大学第三医院康复医学科,河北石家庄市 050011

收稿日期:2021-08-17 修回日期:2021-10-18 出版日期:2021-11-25 发布日期:2021-12-03
通讯作者: 张瑞丽,胡文清 E-mail:ruilizhou2003@163.com;18533112315@163.com
作者简介:温鹏天(1992-),女,汉族,河北邯郸市人,硕士,护士,主要研究方向：老年护理学。|张瑞丽(1966-),女,博士,主任护师,主要研究方向：老年护理学;|胡文清(1963-),女,硕士,主任技师,主要研究方向：脊柱脊髓损伤康复、四肢骨折术后康复、臂丛神经损伤康复等临床研究。

Effect of Different Modes of Exercise on Sarcopenia in Older Adults: A Meta-analysis

WEN Peng-tian¹,ZHANG Rui-li¹(),HU Wen-qing²(),WANG Xian¹,WU Jing-mei¹,LI Hui-juan¹

1. Department of Nursing Teaching, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China
2. Department of Rehabilitation, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China

Received:2021-08-17 Revised:2021-10-18 Published:2021-11-25 Online:2021-12-03
Contact: ZHANG Rui-li,HU Wen-qing E-mail:ruilizhou2003@163.com;18533112315@163.com

摘要/Abstract

摘要：

目的评价单一和多种运动干预对老年人肌少症的改善效果。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、维普和万方7个数据库,收集从建库至2021年7月发表的关于探讨单一与多种运动对老年人肌少症改善效果的随机对照研究。由两名研究人员进行文献检索与筛选,并独立对纳入文献进行质量评价。采用RevMan 5.3软件进行Meta分析。结果最终纳入15篇文献,共816例患者。与空白对照组相比,单一运动(MD = -0.05, 95%CI -0.14~0.04, P > 0.05)和多种运动(MD = 0.15, 95%CI -0.01~0.31, P > 0.05)对骨骼肌质量指数的效果不显著;单一运动(MD = 2.06, 95%CI 0.25~3.87, P < 0.05)和多种运动(MD = 2.36,95%CI 1.10~3.63, P < 0.001)能改善最大握力;多种运动能显著改善膝关节伸展肌力(SMD = 0.49, 95%CI 0.26~0.73, P < 0.001)和步速(SMD = 0.24, 95%CI 0.19~0.29, P < 0.001)。结论单一运动能改善肌少症老年人的最大握力,多种运动能改善最大握力、膝关节伸展肌力和步速。

关键词: 肌少症, 老年, 运动, Meta分析

Abstract:

Objective To evaluate the effectiveness of single modal and multimodal exercise interventions on sarcopenia in the elderly.Methods Randomized controlled trials about the effects of single modal and multimodal exercises on the improvement of sarcopenia in the elderly were retrieved from seven databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and Wanfang data) from the establishment of the databases to July, 2021. Two researchers selected the literatures independently, and evaluated the quality of methodology. The meta-analysis was performed with RevMan 5.3.Results A total of 15 studies were incorporated, including 816 cases of sarcopenia. Compared to the blank control group, the skeletal muscle mass index improved little with single (MD = -0.05, 95%CI -0.14 to 0.04, P > 0.05) and multiple (MD = 0.15, 95%CI -0.01 to 0.31, P > 0.05) exercises. The maximum grip force improved with both single (MD = 2.06, 95%CI 0.25 to 3.87, P < 0.05) and multiple (MD = 2.36, 95%CI 1.10 to 3.63, P < 0.001) exercises. The knee extensors strength (SMD = 0.49, 95%CI 0.26 to 0.73, P < 0.001) and the walking speed (MD = 0.24, 95% CI 0.19 to 0.29, P < 0.001) improved with multimodal exercises.Conclusion Single modal exercise may improve maximal grip strength in the elderly with sarcopenia, and multimodal exercise may be effective on maximal grip strength, knee extensors strength and walking speed.

Key words: sarcopenia, aged, exercise, meta-analysis

温鹏天,张瑞丽,胡文清,王娴,吴景梅,李慧娟. 不同运动干预方式对老年人肌少症改善效果的Meta分析[J]. 《中国康复理论与实践》, 2021, 27(11): 1291-1298.

WEN Peng-tian,ZHANG Rui-li,HU Wen-qing,WANG Xian,WU Jing-mei,LI Hui-juan. Effect of Different Modes of Exercise on Sarcopenia in Older Adults: A Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1291-1298.

图/表 10

图1

表1

纳入文献基本特征"

纳入研究	国家	诊断依据	研究对象(n)		性别	干预时间	干预措施		结局指标
纳入研究	国家	诊断依据	干预组	对照组	性别	干预时间	干预组	对照组	结局指标
Huang等^[11] 2017	中国	DEXA	18	17	女	3个月	SE：渐进性弹力带RT,3次/周,55 min/次	健康教育	①
Chen等^[12] 2018	中国	AWGS	17	16	女	2个月	SE：运用壶铃进行RT,2次/周,1 h/次	空白	①②
Cebrià I Iranzo等^[13] 2018	西班牙	EWGSOP	组1: 9 组2: 11	17	男女	3个月	SE：组1针对呼吸肌进行RT,3次/周;组2针对外周肌进行RT,3次/周	空白	①②③
Chiu等^[14] 2018	中国	BIA	36	34	男女	3个月	SE：RT,2次/周	空白	①
Vasconcelos等^[15] 2016	巴西	BIA	14	14	女	10周	SE：渐进性RT,2次/周,1 h/次	空白	③
Hassan等^[16] 2015	澳大利亚	EWGSOP	21	21		6个月	ME：渐进性RT,2次/周;平衡训练,总时间> 50 h	放松练习 1次/周	①②③
Tsekoura等^[17] 2018	希腊	EWGSOP	组1: 18 组2: 18	18	男女	3个月	ME：组1进行力量、平衡和步态训练,2次/周,1 h/次;组2进行步行,每周不少于100 min,3次/周,力量、平衡和步态训练,2次/周,1 h/次	健康教育	①②③
Chen等^[18] 2017	中国	BIA	RT组: 15 AT组: 15 ME组: 15	15	男女	2个月	SE：RT组进行RT,2次/周;AT组进行AT,2次/周 ME：ME组先行RT,48 h后行AT,1次/周	空白	①②
王丽珍等^[19] 2019	中国	FNIH	RT组: 20 AT组: 20 ME组: 20	20	男女	2个月	SE：RT组进行RT,2次/周,20 min/次;AT组进行AT,2次/周,20 min/次 ME：ME组先行RT 10 min,再行AT 20 min,2次/周	空白	①②
Kim等^[20] 2012	日本	BIA	39	39	女	3个月	ME：RT、平衡和步态训练,2次/周,1 h/次	健康教育	①②③
Kim等^[21] 2013	日本	BIA	32	32	女	3个月	ME：RT、平衡和步态训练,2次/周,1 h/次	健康教育 1次/2周	①②③
Kim等^[22] 2016	日本	DEXA	35	34	女	3个月	ME：RT、力量训练和AT(蹬自行车),2次/周	健康教育 1次/月	①②③
Jung等^[23] 2019	韩国	AWGS	13	13	女	3个月	ME：RT和AT交替进行,训练动作包括原地行走、举重和下蹲、扭弓步、跳跃、后踢腿、俯卧撑、仰卧起坐等,3次/周	空白	①②③
Wei等^[6] 2016	中国	BIA	高频组: 20 中频组: 20 低频组: 20	20	男女	3个月	SE：WBV,高频组60 Hz,240 s,中频组40 Hz,360 s,低频组20 Hz,720 s,1次/d,3次/周	空白	③
Wei等^[7] 2017	中国	BIA	中频组: 20 低频组: 20	20	男女	3个月	SE：WBV,中频组40 Hz,360 s,低频组20 Hz,720 s,1次/d,3次/周	空白	①②

表1

表2

图2

图3

图4

图5

图6

图7

图8

参考文献 35

[1]	CRUZ-JENTOFT A J, SAYER A A. Sarcopenia[J]. Lancet, 2019, 393(10191):2636-2646. doi: 10.1016/S0140-6736(19)31138-9
[2]	MONTERO-FERNANDEZ N, SERRA-REXACH J A. Role of exercise on sarcopenia in the elderly[J]. Eur J Phys Rehabil Med, 2013, 49:131-143.
[3]	NASEEB M A, VOLPE S L. Protein and exercise in the prevention of sarcopenia and aging[J]. Nutr Res, 2017, 40:1-20. doi: 10.1016/j.nutres.2017.01.001
[4]	VELDEMA J, JANSEN P. Resistance training in stroke rehabilitation: systematic review and meta-analysis[J]. Clin Rehabil, 2020, 34(9):1173-1197. doi: 10.1177/0269215520932964
[5]	陈恒亭, 马信龙, 马剑雄, 等. 肌肉减少症运动疗法[J]. 中华骨质疏松和骨矿盐疾病杂志, 2017, 10(6):582-588.
	CHEN H T, MA X L, MA J X, et al. Kinesitherapy for sarcopenia[J]. Chin J Osteoporos Bone Miner Res, 2017, 10(6):582-588.
[6]	WEI N, PANG M Y, NG S S, et al. Optimal frequency/time combination of whole body vibration training for developing physical performance of people with sarcopenia: a randomized controlled trial[J]. Clin Rehabil, 2016, 31(10):1-9.
[7]	WEI N, PANG M Y, NG S S, et al. Optimal frequency/time combination of whole-body vibration training for improving muscle size and strength of people with age-related muscle loss (sarcopenia): a randomized controlled trial[J]. Geriatr Gerontol Int, 2017, 17(10):1-9. doi: 10.1111/ggi.12912
[8]	YOSHIMURA Y, WAKABAYASHI H, YAMADA M, et al. Interventions for treating sarcopenia: a systematic review and meta-analysis of randomized controlled studies[J]. J Am Med Dir Assoc, 2017, 18(6): 553. e1-553.e16.
[9]	VLIETSTRA L, HENDRICKX W, WATERS D L. Exercise interventions in healthy older adults with sarcopenia: a systematic review and meta-analysis[J]. Australas J Ageing, 2018, 37(3):169-183. doi: 10.1111/ajag.2018.37.issue-3
[10]	JADAD A R, MOORE R A, CARROLL D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12. doi: 10.1016/0197-2456(95)00134-4
[11]	HUANG S W, KU J W, LIN L F, et al. Body composition influenced by progressive elastic band resistance exercise of sarcopenic obesity elderly women: a pilot randomized controlled trial[J]. Eur J Phys Rehabil Med, 2017, 53(4):556-563.
[12]	CHEN H T, WU H J, CHEN Y J, et al. Effects of 8-week kettlebell training on body composition, muscle strength, pulmonary function, and chronic low-grade inflammation in elderly women with sarcopenia[J]. Exp Gerontol, 2018, 112:112-118. doi: 10.1016/j.exger.2018.09.015
[13]	CEBRIÀ I IRANZO M À, BALASCH-BERNAT M, TORTOSA-CHULIÁ M Á, et al. Effects of resistance training of peripheral muscles versus respiratory muscles in institutionalized older adults with sarcopenia: a randomized controlled trial[J]. J Aging Phys Act, 2018, 26(4):1-32.
[14]	CHIU S C, YANG R S, YANG R J, et al. Effects of resistance training on body composition and functional capacity among sarcopenic obese residents in long-term care facilities: a preliminary study[J]. BMC Geriatr, 2018, 18(1):1-11. doi: 10.1186/s12877-017-0691-1
[15]	VASCONCELOS K S S, DIAS J M D, ARAÚJO MARÍLIA C, et al. Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial[J]. Braz J Phys Ther, 2016, 20(5):432-440. doi: 10.1590/bjpt-rbf.2014.0174
[16]	HASSAN B H, HEWITT J, KEOGH J W L, et al. Impact of resistance training on sarcopenia in nursing care facilities: a pilot study[J]. Geriatr Nurs, 2015, 37(2):1-6. doi: 10.1016/S0197-4572(16)00005-7
[17]	TSEKOURA M, BILLIS E, TSEPIS E, et al. The effects of group and home-based exercise programs in elderly with sarcopenia: a randomized controlled trial[J]. J Clin Med, 2018, 7(12):1-18. doi: 10.3390/jcm7010001
[18]	CHEN H T, CHUNG Y C, CHEN Y J, et al. Effects of different types of exercise on body composition, muscle strength, and IGF-1 in the elderly with sarcopenic obesity[J]. J Am Geriatr Soc, 2017, 65(4):827-832. doi: 10.1111/jgs.2017.65.issue-4
[19]	王丽珍, 郭颖彬, 骆俊宏. 居家运动训练对老年肥胖型肌少症的效果[J]. 中国康复理论与实践, 2019, 25(1):90-96.
	WANG L Z, GUO Y B, LUO J H. Effect of home exercise on sarcopenia obesity for aging people[J]. Chin J Rehabil Theory Pract, 2019, 25(1):90-96.
[20]	KIM H, SUZUKI T, SAITO K, et al. Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial[J]. J Am Geriatr Soc, 2012, 60(1):16-23. doi: 10.1111/jgs.2012.60.issue-1
[21]	KIM H, SUZUKI T, SAITO K, et al. Effects of exercise and tea catechins on muscle mass, strength and walking ability in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial[J]. Geriatr Gerontol Int, 2013, 13(2):458-465. doi: 10.1111/ggi.2013.13.issue-2
[22]	KIM H, KIM M, KOJIM N, et al. Exercise and nutritional supplementation on community-dwelling elderly Japanese women with sarcopenic obesity: a randomized controlled trial[J]. J Am Med Dir Assoc, 2016, 17(11):1011-1019. doi: 10.1016/j.jamda.2016.06.016
[23]	JUNG W S, KIM Y Y, PARK H Y. Circuit training improvements in Korean women with sarcopenia[J]. Percept Mot Skills, 2019, 126(5):828-842. doi: 10.1177/0031512519860637
[24]	杨丽君, 吴永华, 张俐, 等. 苏州市老年人肌少症的相关因素[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019, 12(3):213-220.
	YANG L J, WU Y H, ZHANG L, et al. Sarcopenia and its related factors in elderly people in Suzhou[J]. Chin J Osteoporos Bone Miner Res, 2019, 12(3):213-220.
[25]	荣湘江, 梁丹丹, 钱京京. 太极拳对中老年人握力及反应时的影响[J]. 中国康复医学杂志, 2010, 25(4):343-345.
	RONG X J, LIANG D D, QIAN J J. The effects of Taijiquan on the grip strength and reacting time of middle aged and aged people[J]. Chin J Rehabil Med, 2010, 25(4):343-345.
[26]	REID K F, PASHA E, DOROS G, et al. Longitudinal decline of lower extremity muscle power in healthy and mobility-limited older adults: influence of muscle mass, strength, composition, neuromuscular activation and single fiber contractile properties[J]. Eur J Appl Physiol, 2014, 114(1):29-39. doi: 10.1007/s00421-013-2728-2
[27]	CASAÑA J, CALATAYUD J, EZZATVAR Y, et al. Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial[J]. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4):1057-1066. doi: 10.1007/s00167-018-5246-2
[28]	HUGHES V A, FRONTERA W R, WOOD M, et al. Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(5):B209-217. doi: 10.1093/gerona/56.5.B209
[29]	龚红燕. 探讨运动处方对老年性肌少症患者下肢肌力及功能性活动的影响[J]. 中国老年保健医学, 2018, 16(5):118-119.
	GONG H Y. To explore the effect of active clinical intervention on muscle strength and functional activities of lower extremities in patients with senile muscular[J]. Chin J Geriatr Care, 2018, 16(5):118-119.
[30]	施宇云. 积极临床干预对老年性肌肉减少症患者下肢肌力及功能性活动的影响[J]. 航空航天医学杂志, 2018, 29(1):81-82.
	SHI Y Y. Effect of active clinical interventions on muscle strength and physical functional of lower extremities in patients with sarcopenia[J]. J Aerosp Med, 2018, 29(1):81-82.
[31]	AUYEUNG T W, LEE S W J, LEUNG J, et al. Age-associated decline of muscle mass, grip strength and gait speed: a 4-year longitudinal study of 3018 community-dwelling older Chinese[J]. Geriatr Gerontol Int, 2014, 14(Suppl 1):76-84. doi: 10.1111/ggi.12213
[32]	芦雪峥, 李欣欣, 田楠, 等. 运动想象训练联合有氧运动对脑卒中后偏瘫患者下肢功能恢复的作用[J]. 中国医学前沿杂志(电子版), 2018, 10(3):66-70.
	LU X Z, LI X X, TIAN N, et al. Analysis of effects of motor imagery training combined with aerobatic training on the functional recovery of lower lambs in patients with hemiplegia after stroke[J]. Chin J Front Med Sci (Electronic Version), 2018, 10(3):66-70.
[33]	杨琦琦, 孙颖. 肌少症中骨骼肌质量减少的分子机制研究进展[J]. 临床和实验医学杂志, 2020, 19(9):1006-1009.
	YANG Q Q, SUN Y. Research progress on the molecular mechanism of skeletal muscle mass reduction in sarcopenia[J]. J Exp Clin Med, 2020, 19(9):1006-1009.
[34]	HAM D J, BÖRSCH A, LIN S, et al. The neuromuscular junction is a focal point of mTORC1 signaling in sarcopenia[J]. Nat Commun, 2020, 11:4510. doi: 10.1038/s41467-020-18140-1
[35]	BECKWÉE D, DELAERE A, AELBRECHT S, et al. Exercise interventions for the prevention and treatment of sarcopenia. a systematic umbrella review[J]. J Nutr Health Aging, 2019, 23(6):494-502. doi: 10.1007/s12603-019-1196-8

纳入研究	随机序列产生	随机化隐藏	盲法	撤出与退出	Jadad 评分
Huang等^[11]2017	恰当	恰当	不清楚	恰当	6
Chen等^[12]2018	不清楚	不清楚	不清楚	恰当	4
Cebrià I Iranzo等^[13] 2018	不清楚	恰当	不恰当	恰当	4
Chiu等^[14]2018	不清楚	不清楚	不清楚	恰当	4
Vasconcelos等^[15] 2016	恰当	恰当	不恰当	恰当	5
Hassan等^[16]2015	恰当	恰当	不清楚	恰当	6
Tsekoura等^[17]2018	恰当	恰当	不恰当	恰当	5
Chen等^[18]2017	不清楚	不清楚	不清楚	恰当	4
王丽珍等^[19]2019	恰当	恰当	不恰当	恰当	5
Kim等^[20]2012	恰当	恰当	不恰当	恰当	5
Kim等^[21]2013	恰当	不清楚	不清楚	不恰当	4
Kim等^[22]2016	恰当	不清楚	不恰当	恰当	4
Jung等^[23]2019	恰当	恰当	不恰当	恰当	5
Wei等^[6]2016	恰当	恰当	不清楚	恰当	6
Wei等^[7]2017	恰当	恰当	不清楚	恰当	6

不同运动干预方式对老年人肌少症改善效果的Meta分析

Effect of Different Modes of Exercise on Sarcopenia in Older Adults: A Meta-analysis

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