《中国康复理论与实践》

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (9): 1003-1011.doi: 10.3969/j.issn.1006-9771.2022.09.002

• 专题 身体活动与运动康复 • 上一篇    下一篇

慢性病和功能障碍老年人身体活动的健康效果：系统综述的系统综述

袁媛1,2,杨剑1,2()   

  1. 1.华东师范大学青少年健康评价与运动干预教育部重点实验室,上海市 200241
    2.华东师范大学体育与健康学院,上海市 200241
  • 收稿日期:2022-08-23 修回日期:2022-08-29 出版日期:2022-09-25 发布日期:2022-10-08
  • 通讯作者: 杨剑 E-mail:yangjianxz@sina.com
  • 作者简介:袁媛(1992-),女,汉族,河南三门峡市人,博士研究生,主要研究方向：体育运动心理学、康复心理学、身体活动与健康促进。|杨剑(1970-),男,汉族,江苏徐州市人,博士,教授,世界卫生组织国际分类家族合作中心专家委员,主要研究方向：儿童青少年体育与健康、儿童青少年健康、ICF、康复科学、健康心理学、锻炼心理学、康复心理学、残疾研究。
  • 基金资助:
    上海高校"立德树人"人文社会科学重点研究基地子项目(1100-41222-16057);青少年体育教育研究上海市社会科学创新研究基地子项目(11001-412321-17006);华东师范大学青少年运动促进健康研究院子项目

Effect of physical activity on health conditions and functioning for aging people with chronic diseases and functioning: a systematic review of systematic reviews

YUAN Yuan1,2,YANG Jian1,2()   

  1. 1. Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China
    2. College of Physical Education and Health, East China Normal University, Shanghai 200241, China
  • Received:2022-08-23 Revised:2022-08-29 Published:2022-09-25 Online:2022-10-08
  • Contact: YANG Jian E-mail:yangjianxz@sina.com
  • Supported by:
    Shanghai University "Strengthening Morality" Humanities and Social Sciences Key Research Base Sub-project(1100-41222-16057);Adolescents Physical Education Research Shanghai Social Science Innovation Research Base Sub-project(11001-412321-17006);East China Normal University Adolescents Sports and Health Promotion Research Institute Sub-project

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摘要：

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建身体活动对慢性病和功能障碍老年人健康及健康相关状况的干预效果范畴及架构。
方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)对老年人的健康及健康状况进行系统分析。检索PubMed、CBM、Scopus、Web of Science、Embase、中国知网、维普、万方等数据库,收集建库至2022年8月8日关于身体活动干预对慢性病和功能障碍老年人健康及健康相关状况康复效果的系统综述进行综述。
结果 最终纳入系统综述11篇,来自6个国家,共涉及316项相关随机对照试验和28 169名参与者,主要包括老龄化、公共健康、康复、身体锻炼等领域。与老年人健康状况相关的疾病主要集中于痴呆、帕金森病、精神分裂症、抑郁症、认知障碍,骨质疏松症、关节炎、肌少症,慢性心力衰竭、冠心病、高血压、脑卒中,2型糖尿病,慢性肺病。干预方案中,活动形式有平衡、功能和耐力训练、灵活性训练,步行、伸展、上下肢训练、瑜伽、气功、太极拳等,活动频率每周1~7次,活动强度为中度,活动持续时间4周~10年。健康结局涉及降低疾病风险,促进整体认知功能、精神功能、肌肉耐力、心肺耐力、柔韧性等的改善和发展,改善步行、移动、平衡、灵活性、姿势控制等基本动作技能,改善睡眠质量,缓解焦虑,减少压力,增加社会参与和人际互动交流,提升幸福感等。
结论 基于WHO-FICs构建了慢性病和功能障碍老年人参与身体活动产生的健康效果的理论架构。老龄化导致的健康及健康相关状况主要涉及认知、心理和精神系统,骨骼肌肉关节系统,心血管系统,代谢系统,呼吸系统。身体活动的干预方案可以分为体适能类、技能类和运动项目类。健康和功能结局主要表现在降低慢性病的发病率,改善功能,提高身体活动水平,促进心理健康,提高生活质量和福祉。

关键词: 老年人, 慢性病, 功能障碍, 身体活动, 锻炼, 康复, 系统综述

Abstract:

Objective To construct the scope and framework of physical activity interventions on the health and health-related conditions (functioning) of old people with chronic diseases and dysfunction using World Health Organization Family of International Classifications (WHO-FICs).
Methods The health and health-related conditions of the old people were systematically analyzed using International Classification of Diseases, Eleventh Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). The systematic reviews about effects of physical activity interventions on the health and health-related conditions in the old people with chronic diseases and dysfunction were retrieved from PubMed, CBM, Scopus, Web of Science, Embase, CNKI, VIP and Wanfang Data from establishment to August 8th, 2022, and systematically reviewed.
Results Eleven systematic reviews were accepted, which were from six countries, involved 316 randomized controlled trials and 28 169 participants. The main topics included aging, public health, rehabilitation, physical exercise, etc. The main health and health related conditions for the old people were mainly dementia, Parkinson's disease, schizophrenia, depression, cognitive impairment; osteoporosis, osteoarthritis, sarcopenia; chronic heart failure, coronary heart disease, hypertension, stroke; type 2 diabetes; and chronic obstructive pulmonary disease; etc. For the interventions, physical activity mainly included balance, functional and endurance training, flexibility training; walking, stretching, upper and lower limb training; Yoga, Qigong, Taijiquan; etc. The proposed prescription was one to seven times a week, moderate intensity, and continued four weeks to ten years of duration. The health and health related outcomes included reduction of the risk of chronic diseases; improvement of overall cognitive function, mental function, muscular endurance, cardiopulmonary endurance, flexibility, etc.; enhancement of walking, movement, balance, flexibility, posture control, etc.; improvement of sleep quality, anxiety and stress; improvement of engagement in participation and interpersonal interaction, and happiness; etc.
Conclusion A conceptual framework of the health effects of participation in physical activity on the old people with chronic diseases and dysfunction is constructed using WHO-FICs. Health and health-related conditions for old people involve in the systems of cognitive, psychological and psychiatric system, skeletal, muscle and joints systems, cardiovascular and cerebrovascular systems, metabolic system, and respiratory system. The intervention programs include physical fitness, skills-oriented activity and sports event programs. The health and functional outcomes are mainly included reduction of risk of chronic disease, improvement of functioning, enhancement in physical activity skills, promotion of mental health, and improvement of quality of life and well-being.

Key words: elderly, chronic diseases, dysfunction, physical activity, exercise, rehabilitation, systematic review

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