老年人参与身体活动对改善健康、生活质量和福祉效果的系统综述

doi:10.3969/j.issn.1006-9771.2021.10.008

Abstract

Abstract:

Objective To establish the framework of physical activity and rehabilitation for the elderly, and systematically review the health and rehabilitation effects of physical activity for the elderly, based on the relevant important documents of World Health Organization (WHO).Methods The literatures about physical activities and health, quality of life for the older adults were retrieved with subject retrieval method, from the database of CNKI, Wanfang Data, PubMed and Web of Science, EBSCO, Google Scholar until June 30, 2021. This paper reviewed the rehabilitation effects of physical activities on health, quality of life and well-being of older adults through extracting the literature content.Results There were five typical physical activities: aerobic activity, muscle and bone development activities, improving balance activities and comprehensive activities. The effect of the elderly participating in physical activities on health and rehabilitation was mainly reflected in the improvement of physical and mental health, social adaptation and activity behavior and nutrition. Health and rehabilitation impacts were mainly reflected in increased healthy life expectancy, improved quality of life and well-being. In terms of improving physical health, it can promote physical fitness, chronic diseases and physical function for the aging people. In terms of improving mental health, cognitive function, mood, personality traits and sleep can be promoted. The elderly participating in physical activities was mainly influenced by both personal and environmental factors.Conclusion Participation in all physical activity by older adults provides health benefits, promoting healthy ageing, improving physical and mental health, facilitating social adjustment and activity behaviors and nutrition and then increasing healthy lifespan, quality of life and well-being. Physical activity is a health-related service, so scientific and reasonable physical activity of the elderly should be enhanced. It is necessary to combine physical activity with rehabilitation services to promote the health, function, well-being and quality of life of the elderly.

Key words: physical activity, health, healthy lifespan, quality of life, well-being, older adults, systematic review

CLC Number:

CUI De-gang,QIU Fen,QIU Fu-bing,LIU Jing,ZHU Xiao-xiao,TANG Xiu-qi. Effect of Participation Physical Activity on Health, Quality of Life and Well-being for Elderly Adults: a Systematic Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1176-1189.

Figures/Tables 7

分析架构与类别		内容定义
身体活动形式	有氧活动	健身、改善心脏及代谢功能,发展体适能,提高心、肺适能,防治冠心病、糖尿病、肥胖等的活动,涉及日常活动、体育活动、休闲活动、娱乐活动、康复训练活动等,如健步走、慢跑、交通往来、乒乓球、羽毛球、游泳、健身体操等。
	发展肌肉的活动	被动、主动、抗阻的肢体运动,增强肌肉力量和肌肉耐力,发展体适能的活动,肌肉力量活动如哑铃、深蹲、纵跳、引体向上等;肌肉耐力活动如长跑、游泳、自行车等,涉及日常活动、体育活动、休闲活动、娱乐活动、康复训练活动等。
	发展骨骼的活动	改善骨骼功能、关节的活动度和稳定性的活动,涉及日常活动、体育活动、休闲活动、娱乐活动、康复训练活动等,如太极拳、瑜伽、普拉提、舞蹈、快步走、跆拳道、远足、网球、壁球、高尔夫、力量训练等。
	平衡性活动	改善在运动或者受到外力作用时能够自动调整并维持姿势能力的活动,涉及日常活动、体育活动、休闲活动、娱乐活动、康复训练活动等,如太极拳、瑜伽、八段锦、五禽戏、毽子、毽球、滑冰、平衡球训练、自行车等。
	综合活动	平衡性活动、发展肌肉和骨骼活动、有氧活动的结合,兼具这些活动的功能,如步态训练、协调、身体功能训练等,涉及日常活动、体育活动、休闲活动、娱乐活动、康复训练活动等,如舞蹈、瑜伽、太极拳、健身体操、快步走、滑冰、自行车、足球、排球等。
身体活动效果	健康和康复效果	身体健康：体适能(身体各部位或各系统对突发状况的应变能力,包括速度、反应、耐力、肌力、平衡性、柔软性、协调性和敏捷性等),慢性疾病(慢性非传染性疾病,内分泌及代谢疾病、糖尿病、高血压、高血脂症、心脏病、关节炎等),功能(神经肌肉骨骼、心血管、呼吸、血液、免疫、消化、代谢、内分泌系统功能)。心理健康：认知(感知觉、注意、记忆、思维、决策、洞察力、判断力、执行功能等),情绪(情绪的适度性、情绪调节和范围),人格(外向、内向、随和、谨慎、精神稳定性、经验的开放性、乐观、自信、可依赖性等),睡眠等。社会适应：观念、行为方式与所处社会环境调适,以适应社会环境,与社会取得契合、融合。活动行为+营养：定期进行身体活动,形成运动习惯和健康生活方式;合理膳食、均衡营养。
身体活动效果	健康和康复影响	健康寿命：人体功能的完好状态和健康状况、健康水平,老化至临死之前没有功能障碍或疾病。涉及身体形态、生理生化功能水平、身体素质和运动能力、心理状态、适应能力等。生活质量：整体生活质量和疾病相关的生活质量;生活满意度,幸福感,满足感,获得感。涉及生理领域、心理领域、社会关系领域、环境领域、精神支柱等。福祉：整体精神健康状况;幸福,安康,福利,满足,成就感。
影响因素	环境因素	用品和技术：参与身体活动所需的器材辅具,如公共建筑和设施、交通工具、活动场地、器材、设施、辅助用具。
		自然环境和对环境的人为改变：参与身体活动的运动环境,包括自然地理环境、空气质量、气候条件和开展活动项目的周围环境,常包括社区、单位、家庭等各种活动所涉及的场所和场地。
		态度：参与身体活动的心理环境,常包括家人、同伴、朋友、社区成员、同事等的态度,社会观念、参与积极性、自我认知、自信、安全感、紧张、焦虑等。
		支持和相互关系：参与身体活动的社会环境,常包括家人、同伴、朋友、社区成员、同事等的支持及相互关系等。
		服务、体制和政策：参与身体活动的社会环境,常包括体制和政策的完善、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、锻炼习惯等。

研究	国家	研究受试者	方法与工具	身体活动	健康和康复效果	健康和康复影响	影响因素
Korniloff等^[15](2012)	美国	健康老年人：老年人(65~74岁)	休闲体育活动：回顾终身的休闲体育活动频率抑郁：Beck抑郁量表	综合活动：休闲体育活动(平均每月11.9次)	改善心理健康：降低患抑郁的风险,且活动频率与发生抑郁负相关改善身体健康：降低患病率社会适应：增加沟通与交流	提高健康寿命,改善生活质量和福祉	未提及
Reigal^[16](2013)	西班牙	健康老年人：老年人	访谈、问卷调查：一般自我效能量表(GSE)	有氧活动：体育活动(中等强度、每周3~4次、每次1 h左右)	改善心理健康：提高自我效能感(锻炼频率适中,即每周3~4次,比较低或较高频率有更高的自我效能感) 社会适应：促进人际交往和沟通交流	改善生活质量和福祉	未提及
Shah等^[17](2014)	澳大利亚	健康老年人：老年人	实验干预：体育锻炼干预、计算机认知训练、两者结合干预认知能力测试：Rey听觉语言学习测试、口头词汇联想测试	有氧活动、综合活动：身体锻炼干预(康复性训练)	改善心理健康：改善认知功能改善身体健康：增加大脑葡萄糖代谢	提高健康寿命,改善生活质量和福祉	未提及
Trayers ^[18](2014)	英国	健康老年人：老年人	客观测量身体活动：加速度计下肢功能：简易体能状况量表	有氧活动、发展肌肉和骨骼的活动：日常活动、体育活动	改善身体健康：改善下肢功能活动行为+营养：形成运动习惯和健康生活方式	提高健康寿命	未提及
Ortlieb等^[19](2014)	德国	健康老年人：老年人 (65~89岁)	客观测量身体活动：加速度计	综合活动：体育活动(中等至大强度、每周150 min)	改善身体健康：降低老年人多发病的发病率和致残率活动行为+营养：形成运动习惯	提高健康寿命,改善生活质量和福祉	未提及
Eshkoor等^[20](2015)	马来西亚	有慢病的老年人：患糖尿病的老年人	访谈法	有氧活动：日常活动、体育活动	改善心理健康：减少睡眠障碍、提高睡眠质量	提高健康寿命,改善生活质量	未提及
Chang等^[21](2015)	美国	有心理障碍的老年人：长期抑郁症状的老年人	纵向调查数据	综合活动：休闲活动	改善心理健康：减小由于长期抑郁症状而导致的认知能力下降	改善生活质量和福祉	个人因素：性别
Hegde等^[22](2016)	葡萄牙	健康老年人：社区老年人	客观测量	有氧活动：体育活动、休闲活动	改善身体健康：减轻预期的与年龄相关的心脏结构和功能的变化活动行为+营养：形成运动习惯和健康生活方式	提高健康寿命,改善生活质量和福祉	未提及
Lee等^[23](2016)	韩国	健康老年人：老年妇女	客观测量单轴加速度计 X线骨密度扫描仪	发展肌肉和骨骼的活动：体育活动	改善身体健康：改善肌少症和骨质疏松症	提高健康寿命	未涉及
Wang等^[24](2016)	美国	健康老年人：老年人	客观测量采用行为和神经电测量等,评估身体活动、久坐行为、脑电指标	有氧活动、综合活动：有规律的体育锻炼	改善心理健康：减缓与年龄相关的视觉空间认知能力的下降活动行为+营养：形成锻炼习惯和健康生活方式	提高健康寿命	未涉及
Ku等^[25](2016)	荷兰	健康老年人：老年人	8年纵向研究休闲体育活动：自我报告主观幸福感：生活满意度指数(the Life Satisfaction Index)	综合活动：日常身体活动、散步、集体锻炼	改善心理健康：提高主观幸福感(活动频率较高的参与者,幸福感水平更高) 活动行为+营养：形成运动习惯社会适应：促进人际交往,沟通交流,社会融入	改善生活质量(提高幸福感)和福祉	未提及
Kim等^[26](2016)	德国	健康老年人：老年人	利用健康与退休研究发布的数据	有氧活动：休闲体育活动	改善心理健康：增加乐观和积极情感社会适应：参加活动提供了丰富的体验和心理益处,提高生活满意度	改善生活质量(提高生活满意度)和福祉	未提及
Lok等^[27](2017)	土耳其	有心理障碍的老年人：养老院有抑郁症状的老年人	随机对照试验问卷调查：抑郁症状：Beck抑郁量表健康状况：SF-36	有氧活动：10周有组织的体育活动计划	改善心理健康：改善抑郁症状改善身体健康：生理功能和一般健康显著改善社会适应：促进体育活动参与,增加社会交往	改善生活质量和福祉	未提及
Condello等^[28](2017)	意大利	有心理障碍和慢病的老年人：有认知功能障碍风险的老年人和患糖尿病的老年人	客观测量臂带监测器测量日常身体活动	有氧活动、综合活动：日常身体活动	改善心理健康：有益于大脑处理速度和注意力控制	改善生活质量和福祉	未提及
Duray等^[29](2017)	土耳其	健康老年人：老年人	问卷调查：身体活动水平：身体活动量表跌倒风险：Berg平衡量表、跌倒效能量表、动态平衡体质量指数	有氧活动、发展肌肉和骨骼的活动、平衡性活动：高、低水平的身体活动	改善身体健康：改善身体素质指标(肌肉力量、肌肉耐力、有氧耐力),降低跌倒风险活动行为+营养：促进身体活动,形成运动习惯	提高健康寿命,改善生活质量和福祉	未提及
Ou等^[30](2017)	英国	健康老年人：老年人	数据来自老年人健康检查数据库	综合活动：体育锻炼	改善身体健康：降低患病风险(高血脂)和死亡风险	提高健康寿命	未提及
Gomez等^[31](2018)	西班牙	健康老年人：老年人	客观测量健康程度：通过8个特定的测试来评估问卷调查：身体活动问卷	有氧活动、发展肌肉的活动、平衡性活动：有组织的体育活动(体育锻炼、娱乐活动)	改善身体健康：提高平衡能力、上下肢力量、灵活性、行走速度、有氧能力活动行为+营养：形成运动习惯	提高健康寿命	个人因素：年龄
Son等^[32](2019)	韩国	有慢病的老年人：肌少症老年人	生理测量肌少症：以四肢骨骼肌质量评估肥胖状况：以腰围评估营养涉入	有氧活动、发展肌肉的活动：积极的体育锻炼	改善身体健康：减少肥胖状况,降低肌少症风险活动行为+营养：形成健康生活方式和积极的锻炼习惯,摄入充足营养(如维生素)	提高健康寿命,改善生活质量和福祉	未提及
Silva等^[33](2019)	葡萄牙	健康老年人：老年人	客观测量久坐和身体活动：加速度计	有氧活动：身体活动(小强度、中等至大强度)	改善身体健康：改善体质量指数、敏捷性、有氧耐力活动行为+营养：身体适应性增强,形成健康生活方式	提高健康寿命	未提及
Kozakiewicz等^[34](2019)	波兰	健康老年人：老年人	生理指标测量：红细胞裂解液中的丙二醛浓度和抗氧化酶活性	有氧活动：身体活动(中等强度)	改善身体健康：氧化应激标志物减少,提高抗衰老能力	提高健康寿命,改善生活质量	个人因素：年龄
Haider等^[35](2019)	德国	健康老年人：老年人	数据来自欧洲健康访谈调查、健康老龄和退休调查	有氧运动、发展肌肉的活动：有氧运动,力量训练	改善身体健康：减少体弱状态和患病率	提高健康寿命	未涉及
Ferre等^[36](2019)	法国	健康老年人：老年人	实验干预：每周3次、共3个月的体育锻炼	有氧活动、发展肌肉的活动和平衡性活动：结构化体育锻炼计划(每周3次)	改善身体健康：改善耐力、肌肉力量和平衡性等重要身体功能社会适应：促进人际交往和沟通交流活动行为+营养：形成锻炼习惯,长期锻炼计划	提高健康寿命,改善生活质量和福祉	未提及
Aoyagi等^[37](2019)	加拿大	健康老年人：老年人	客观测量身体活动：计步器/加速度计发酵乳制品摄入：问卷调查估计值	有氧活动：规律的体育锻炼(步行,每天不少于7000步或不少于15 min)	改善身体健康：增强肠道健康活动行为+营养：形成规律的锻炼习惯和合理膳食营养(习惯性摄入含干酪乳杆菌的发酵乳制品)	提高健康寿命,改善生活质量和福祉	未提及
Hasegawa等^[38](2019)	日本	健康老年人：寒冷多雪地区的老年人	实验干预加速度计测量每日步数身体功能	发展肌肉的活动、有氧活动：下肢力量训练、步行	改善身体健康：提高下肢力量活动行为+营养：每日步行步数增加,促进身体活动	提高健康寿命	环境因素：天气
Moriyama等^[39](2019)	日本	健康老年人：老年人	实验干预：身体活动集体干预问卷调查：主观幸福感	有氧活动、发展肌肉的活动：体育锻炼(每周1次)	改善心理健康：提高主观幸福感活动行为+营养：促进身体活动的参与,形成锻炼习惯社会适应：增加人际交往和社会融入	改善生活质量(提高幸福感)和福祉	未提及
Cammisuli等^[40](2019)	意大利	健康老年人：老年人	实验干预问卷调查：SF-36	综合活动：中等强度和大强度的身体活动,认知性的娱乐活动	改善身体健康：维持和改善健康状况活动行为+营养：促进身体活动参与	提高健康寿命,改善生活质量和福祉	未提及
Kim等^[41](2020)	美国	健康老年人：老年人	问卷调查：社会凝聚力(4个条目)的问卷心理健康：Kessler心理困扰量表身体活动：每周活动频率和时间	有氧活动：休闲活动、体育活动	改善心理健康：促进心理健康社会适应：促进人际交往和社会融入	改善生活质量和福祉	环境因素：感知邻里、社区凝聚力
Won等^[42](2020)	韩国	健康老年人：老年人	问卷调查：体育锻炼、主观幸福感	综合活动：定期体育锻炼	改善心理健康：提高主观幸福感(体育锻炼的持续时间对锻炼效果影响最大) 社会适应：增加人际交往活动行为+营养：形成锻炼习惯	改善生活质量(生活满意度、休闲满意度、运动满意度提高)和福祉	个人因素：性别环境因素：配偶或伴侣陪伴
Alarcón-Jiménez等^[43](2020)	瑞士	健康老年人：老年人(平均年龄71.5岁)	客观测量	有氧活动：日常活动、体育活动	改善心理健康：提高工作记忆,促进积极的情绪表达	改善生活质量和福祉	未提及
Dupre等^[44](2020)	法国	健康老年人：城市老年人	问卷调查：体育锻炼：Voorrips问卷	有氧活动、综合活动：日常活动(家庭活动、交通活动),休闲活动、体育活动	改善心理健康：降低老年痴呆风险	提高健康寿命,改善生活质量和福祉	未提及
Lee等^[45](2020)	德国	健康老年人：老年人	问卷调查：自我感知、自我控制、内在动机、社会关系知觉、精神投入、邻里安全感	有氧活动：步行、体育锻炼	改善心理健康：形成与健康行为相关的积极态度和内在动机活动行为+营养：促进体育活动参与,形成锻炼习惯	改善生活质量和福祉	个人因素：自我知觉、自我效能感、心理投入、社会关系知觉、邻里安全感
Raberin^[46](2020)	加拿大	健康老年人：老年人	问卷调查身体活动水平;生理指标测量: 多导睡眠图检测阻塞性睡眠呼吸暂停,数字压力计评估血管反应性	有氧活动：身体活动	改善身体健康：心血管危险因素降低	提高健康寿命	个人因素：性别
Papalia等^[47](2020)	意大利	有慢病的老年人：膝关节和髋关节置换的老年人	客观测量	发展肌肉和骨骼的活动、平衡性活动：身体活动,康复训练(水疗、骑自行车测功机)	改善身体健康：改善肌肉力量、步态速度和总体运动能力活动行为+营养：促进身体活动参与	提高健康寿命,改善生活质量和福祉	未提及
王红雨等^[48](2018)	中国	健康老年人：老年人	问卷调查：身体活动量表、简版老年抑郁症状量表、社会支持量表	有氧活动：日常身体活动、体育活动	改善心理健康：获得成就感、控制感和自我价值感,减少抑郁症状活动行为+营养：形成运动习惯	改善生活质量(提高生活满意度)和福祉	环境因素：社会支持

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分类	检索词
中文	(身体活动 OR 体育活动 OR 休闲活动 OR 娱乐活动 OR 康复性活动) AND (身体功能 OR 心理功能 OR 康复 OR 健康 OR 生活质量) AND 老年人
英文	(the elderly OR the older people OR the aging people OR older adults) AND (physical activity OR recreational physical activity OR leisure time physical activity OR rehabilitation training) AND (functioning OR rehabilitation OR health OR mental health) AND (quality of life OR well-being)

Effect of Participation Physical Activity on Health, Quality of Life and Well-being for Elderly Adults: a Systematic Review

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