基于ICF老年人身体活动与功能康复的Scoping综述

doi:10.3969/j.issn.1006-9771.2021.04.003

Abstract

Abstract: Objective

To review the categories of physical activities and rehabilitation exercise for aging people based on the theory and method of the International Classification of Functioning, Disability, and Health (ICF).

Methods

From the framework and coding of ICF, physical activities, rehabilitation exercise and functional improvement for the aging people were reviewed.

Results

There were three typical physical activities: physical fitness, skills and sports, mainly including regular exercises, cognitive amusements, leisure sports activities, recreational sports activities, rehabilitation exercises, etc. Physical activities promoted the functioning of the aging people, including mental function (b1), pain and sensory dysfunction (b2), cardiovascular, blood, the function of the immune system and respiratory system (b4), digestion, metabolism and function of the endocrine system (b5), nerve musculoskeletal function related to movement (b7), the function of skin and related structures (b8), activity (d4), and community, social and civic life (d9), etc., especially body mass index, cardiovascular, physical fitness (muscular strength and endurance, aerobic endurance), balance, flexibility, upper and lower extremities strength, sleep, metabolic capability, cognitive function and anti-aging ability. There were more gains at individual levels, including promotion of subjective happiness, quality of life, reducing depression, risk of sarcopenia, dementia and falling, etc. The environmental and personal factors related to activity and participation in physical activities included the products and technologies (e1), natural environment and man-made changes to the environment (e3), support and interpersonal relationships (e3), attitude, service system and policy (e5), such as urban environment, building environment, street pavement behavior, weather, caregivers, accompany of family and friends, etc.

Conclusion

The physical activities and rehabilitation exercise the aged joined include physical fitness activities, skills activities, and sports activities. The physical activities had effects on the rehabilitation of the aged including the function of the body(mental function, pain and sensory dysfunction, cardiovascular, blood, the function of the immune system and respiratory system, digestion, metabolism, and function of the endocrine system, nerve musculoskeletal function related to movement, the function of skin and related structures) and the participation in activities (activities, community, society and civic life). The function of the body works for the health of the aged to promote physical health, mental health, functional health, social adjustment and social well-being.

Key words: physical activity, rehabilitation exercise, International Classification of Functioning, Disability, and Health, aging people, scoping review

CLC Number:

R592

De-gang CUI,Fen QIU,Fu-bing QIU,Zhong-hao LI,Ya-ru ZHANG,You-ming LI,Xiao-xiao ZHU,Jing LIU,Xiu-qi TANG,Wen-wen SHI. Physical Activity and Functional Rehabilitation for Aging People Based on ICF: A Scoping Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(4): 394-404.

Figures/Tables 3

分析架构与类别		内容定义
身体活动形式	体适能类	肌肉力量体适能活动，如哑铃、深蹲、纵跳、引体向上等；肌肉耐力体适能活动，如长跑、游泳、自行车等；心肺耐力体适能活动，如健步走、慢跑等各类有氧活动；柔韧性体适能活动，如瑜伽、普拉提、舞蹈等
	技能类	粗大/精细技能活动，如举起、拾起、推、拉、搬运、抓住等；基本动作技能活动，如走、跑、跳、投掷、爬等；移动/转移技能活动，如步行、移动自身、交通往来等
	运动项目类	竞技类，如篮球、足球、排球、网球、乒乓球、羽毛球、游泳、自行车、举重、拳击、滑冰等；休闲类，如徒步、瑜伽、普拉提、舞蹈、健身体操、太极拳、跑步、飞镖、毽球、台球、保龄球、高尔夫、骑马、户外活动、日常生活活动等
身体活动的益处	身体功能	精神功能(b1)，感觉功能和疼痛(b2)，发声和言语功能(b3)，心血管、血液、免疫和呼吸系统功能(b4)，消化、代谢和内分泌系统功能(b5)，泌尿生殖和生育功能(b6)，神经肌肉骨骼和运动有关的功能(b7)，皮肤和有关结构的功能(b8)
身体活动的益处	活动和参与	学习和应用知识(d1)，一般任务与要求(d2)，交流(d3)，活动(d4)，自理(d5)，家庭生活(d6)，人际交往和人际关系(d7)，主要生活领域(d8)，社区、社会和公民生活(d9)
影响因素	用品和技术	包括公共建筑(e150)、交通工具(e120)、活动场地(e160)、器材(e140)，如运动场地、各类球和球拍、瑜伽垫、哑铃、杠铃、护腕、护膝等
	自然环境和对环境的人为改变	自然地理(e210)、空气质量(e260)、气候(e225)和开展活动项目的周围环境，包括社区、单位、家庭等各种活动所涉及的场所和场地
	态度	家人(e410)，同伴(e420)，朋友、社区成员、同事等(e425)，社会观念(e460)
	支持和相互关系	家人(e310)，同伴、朋友、社区成员、同事等(e325)
	服务、体制和政策	体制和政策的完善、相关制度的建立、社区活动场所的开发与使用、社会关注、社会态度、信息传播与推广、资金管理与投资等
	个人因素	性别、年龄、种族、教育、职业、生活方式、锻炼习惯、参与积极性、自我认知、自信、安全感、紧张、焦虑等

研究	国家	研究对象	方法与评价工具	身体活动方式	功能康复结果	对功能健康的效果	影响因素
Moriyama (2019)	日本	地震后经历过搬迁的老年人	体育锻炼的集体干预主观幸福感问卷	体适能类：体育锻炼每周1次	精神功能(b1)：提升主观幸福感	改善心理健康、社会福祉	未涉及
Lok(2017)	土耳其	养老院有抑郁症状的老年人	随机对照实验 Beck抑郁量表、SF-36	体适能类：10周有组织的体育活动计划	精神功能(b1)：改善抑郁症状活动(d4)，社区、社会和公民生活(d9)：提升生活质量	改善心理健康、社会福祉	未涉及
Cammisuli (2019)	意大利	老年人	实验干预健康调查简表(SF-36)	体适能类、技能类、运动项目类：身体活动，认知娱乐性活动	精神功能(b1)，神经肌肉骨骼和运动有关的功能(b7)，社区、社会和公民生活(d9)：改善健康状况和生活质量	改善身体健康、社会福祉	未涉及
Hegde (2016)	葡萄牙	社区老年人	客观测量	运动项目类(休闲类)：休闲体育活动	心血管、血液、免疫和呼吸系统功能(b4)：减轻与年龄相关的心脏结构和功能变化	改善功能健康	未涉及
Shah (2014)	澳大利亚	老年人	实验干预 Rey听觉语言学习测试、口头词汇联想测试	体适能类、技能类、运动项目类：身心锻炼	精神功能(b1)：改善认知功能消化、代谢和内分泌系统功能(b5)：增加葡萄糖代谢	改善心理健康、身体健康	未涉及
Dupre (2020)	法国	城市老年人	Voorrips问卷	体适能类、技能类、运动项目类：家庭、交通活动，休闲、体育活动	精神功能(b1)：降低痴呆风险	改善功能健康	未涉及
Reigal (2013)	西班牙	老年人	一般自我效能量表	体适能、技能类、运动项目类：有氧运动	精神功能(b1)：提高自我效能感	改善心理健康	未涉及
Trayers (2014)	英国	老年人	加速度计、简易体能状况量表	体适能类、技能类、运动项目类：体育活动	神经肌肉骨骼和运动有关的功能(b7)：改善下肢功能	改善功能健康	未涉及
Raberin (2020)	加拿大	老年人	问卷调查身体活动水平；多导睡眠图、数字压力计	体适能类、技能类、运动项目类：身体活动	心血管、血液、免疫和呼吸系统功能(b4)：心血管危险因素降低	改善身体健康	个人因素：性别
Kozakiewicz (2019)	波兰	老年人	红细胞中丙二醛浓度和抗氧化酶活性	体适能类、技能类、运动项目类：中等强度身体活动	心血管、血液、免疫和呼吸系统功能(b4)，消化、代谢和内分泌系统(b5)：氧化应激标志物减少	改善功能健康	个人因素：年龄
Gomez (2018)	西班牙	老年人	8个特定测试、身体活动问卷	体适能类、技能类、运动项目类：有组织的体育活动(体育锻炼、娱乐活动)	感觉功能和疼痛(b2)，心血管、血液、免疫和呼吸系统功能(b4)，神经肌肉骨骼和运动有关的功能(b7)：改善平衡能力、上下肢力量、灵活性、行走速度、有氧能力	改善身体健康、功能健康	个人因素：年龄
Trachte(2016)	德国	老年人	客观测量	体适能类、技能类、运动项目类：体育锻炼	精神功能(b1)：自我健康评估改善	改善身体健康	个人因素：教育、经济状况
Wu (2019)	中国	老年人	感知建筑环境问卷调查、身体活动自我报告	体适能类、技能类、运动项目类：身体活动，娱乐活动	未提及	未提及	产品和技术(e1)：街道路面坡度和街道车通性个人因素：月收入
Marquet (2015)	西班牙	社区老年人	每天出行次数和步行时间	体适能类、技能类、运动项目类：身体活动	未提及	未提及	产品和技术(e1)，自然环境和对环境的人为改变(e2)：建筑环境、城市环境
Akturk (2019)	土耳其	老年人	客观测量	体适能类、技能类、运动项目类：身体活动	未提及	未提及	支持和相互关系(e3)：看护人的存在个人因素：慢性疾病、抑郁症
Hasegawa(2018)	日本	寒冷地区的老年人	三维加速度传感器、坐-站测试、身体成分分析	体适能类、技能类、运动项目类：身体活动	神经肌肉骨骼和运动有关的功能(b7)：改善肌力	改善功能健康	环境和对环境的人为改变(e2)：天气(雪季和非雪季)
Bohm (2016)	巴西	老年人	国际体育活动问卷、体育活动社会支持量表	体适能类、技能类、运动项目类：步行，中度体育活动，剧烈体育活动	未涉及	未提及	支持和相互关系(e3)：家人、朋友陪伴
Silva(2019)	葡萄牙	老年人	加速度计	体适能类、技能类、运动项目类：轻度身体活动、中度至剧烈身体活动	消化、代谢和内分泌系统(b5)：改善体质量指数神经肌肉骨骼和运动有关的功能(b7)、活动(d4)：改善敏捷性心血管、血液、免疫和呼吸系统功能(b4)：改善有氧耐力	改善身体健康	未涉及
Son(2019)	韩国	肌少症老年人	阑尾骨骼肌质量、腰围、营养摄入	体适能类、技能类、运动项目类：积极的体育锻炼	消化、代谢和内分泌系统(b5)：降低肥胖状况神经肌肉骨骼和运动有关的功能(b7)、活动(d4)：降低肌少症风险	改善身体健康、功能健康	未涉及
Lee (2019)	韩国	有活动受限的老年人	患者健康问卷、欧洲生活质量量表维度5	体适能类、技能类、运动项目类：身体活动	精神功能(b1)：改善压力和抑郁活动(d4)，社区、社会和公民生活(d9)：生活质量提高	改善心理健康、社会适应和社会福祉	未涉及
Duray (2017)	土耳其	老年人	身体活动量表、Berg平衡量表、跌倒效能量表、动态平衡、体质量指数	体适能类、技能类、运动项目类：高、低水平的身体活动	心血管、血液、免疫和呼吸系统功能(b4)，消化、代谢和内分泌系统(b5)，神经肌肉骨骼和运动有关的功能(b7)：改善肌力、耐力、有氧耐力，降低跌倒风险	改善身体健康、功能健康	未涉及
Condello (2017)	意大利	有认知功能障碍风险的老年人和患糖尿病的老年人	臂带监测器	体适能类、技能类：日常身体活动	精神功能(b1)：有益于信息处理速度和注意力控制消化、代谢和内分泌系统(b5)：部分抵消衰老和糖尿病的不利影响	改善身体健康、心理健康、功能健康	未涉及
Lee (2016)	韩国	老年妇女	单轴加速度计、X线骨密度仪扫描	体适能类、技能类：日常身体活动	神经肌肉骨骼和运动有关的功能(b7)：改善肌少症和骨质疏松症	改善功能健康、身体健康	未涉及
Wang (2016)	中国	老年人	行为和神经电测量等，评估身体活动、久坐行为、脑电	体适能类、技能类、运动项目类：有规律的体育锻炼	精神功能(b1)、感觉功能和疼痛(b2)：减缓与年龄相关的视觉空间认知功能下降	改善功能健康	未涉及
Eshkoor (2015)	马来西亚	患糖尿病的老年人	访谈法	体适能类、技能类、运动项目类：体育活动	精神功能(b1)：减少睡眠中断	改善身体健康，功能健康	未涉及
Aoyagi (2019)	加拿大	老年人	计步器/加速度计、问卷调查发酵乳制品摄入	体适能类、技能类、运动项目类：规律的体育锻炼	消化、代谢和内分泌系统(b5)：增强肠道健康	改善身体健康	未涉及
Hasegawa (2019)	日本	寒冷多雪地区的老年人	实验干预身体功能、每日步数	体适能类：下肢力量训练、步行	神经肌肉骨骼和运动有关的功能(b7)：下肢力量提高，每日步行步数增加	改善功能健康	未涉及
Tasheva(2020)	瑞士	急性医学疾病住院的老年患者	腕部加速计、Barthel指数、压疮风险、住院时间、出院回家	体适能类、技能类、运动项目类：医院环境中的身体活动	消化、代谢和内分泌系统(b5)，血管、血液、免疫和呼吸系统功能(b4)，神经肌肉骨骼和运动有关的功能(b7)：降低医院获得的功能下降皮肤和有关结构的功能(b8)：降低压疮风险活动(d4)：缩短住院时间(能够出院回家)	改善身体健康、功能健康、社会福祉	未涉及
Papalia(2020)	意大利	全膝关节和髋关节置换的老年人	客观测量	体适能类、技能类、运动项目类：身体活动，康复训练(水疗、骑自行车测功机等)	活动(d4)，社区、社会和公民生活(d9)：提高生活质量肌神经肌肉骨骼和运动有关的功能(b7)：改善肌力，步速和总体运动	改善社会福祉、功能健康	未涉及
孟欣宇(2020)	中国	社区老年人	四肢骨骼肌质量、步行速度、握力、国际身体活动量表短问卷	体适能类、技能类、运动项目类：体育锻炼	神经肌肉骨骼和与运动有关的功能(b7)：肌少症风险减少	改善功能健康	未涉及

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Physical Activity and Functional Rehabilitation for Aging People Based on ICF: A Scoping Review

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