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

Abstract

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

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.

Figures/Tables 10

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

References 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

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

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 10

References 35

Related Articles 15

Metrics

Comments

Recommended 0

[1]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[2]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[3]	ZHANG Guancong, HUANG Qiuchen, GU Rui, LIU Sihai, HU Chunying, LIU Kemin. Comparative effect of different neuromuscular exercises on pain and motor function of knee in patients with early knee osteoarthritis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1090-1097.
[4]	YANG Ya'nan, MU Liping, XING Fengmei, XUE Xinhong, WANG Xiaoguang, TAO Yangyu, SUN Zhumei, ZHANG Xiaoli. Effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 869-874.
[5]	YU Zhongqi, WANG Chao, HE Gang, DIAO Lianfu, LIU Mengting, YU Yao, ZHANG Liang, WANG Ruiyan. Effect of three intrinsic foot muscle exercises on cross-sectional area of abductor hallucis muscle and foot morphology in subjects with flatfoot [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 961-966.
[6]	TANG Liuquan, PENG Xingyun. Effect of exercise under blood flow restriction on risk of fragility fractures in postmenopausal patients with chronic obstructive pulmonary disease [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 761-769.
[7]	JIANG Changhao, GAO Xiaoyan. Effect of acute physical activity on cognitive function in children: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 667-672.
[8]	GU Bin, ZHANG Jinqin, XIA Yuanhao, HU Jingran, NAOKI Morohashi, HUANG Fubiao. Effect of repetitive facilitative exercise on hand function of stroke patients with hemiplegic during recovery period [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 697-702.
[9]	YU Zhongqi, WANG Chao, HE Gang, ZHANG Liang, WANG Ruiyan. Effect of short-foot exercise on adult flatfoot: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 551-557.
[10]	XUE Xinhong, WANG Xiaoguang, TAO Yangyu, LI Na, DONG Jing, XUE Zijiao, CAI Fengyu, XING Fengmei. Effect of nutrition combined with exercise on stroke patients with sarcopenia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 595-600.
[11]	YU Ge, WANG Lu, CHEN Yaping. Effects of whole body vibration training on postural stability in chronic ankle instability: a meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 423-432.
[12]	TIAN Junfu, YANG Jian. Health and functioning benefits of aerobic exercise rehabilitation for substance abuse-induced mental and behavioral disorders: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 443-451.
[13]	YUAN Yuan, ZHANG Guohui, ZHANG Hong. Exercise-induced muscle damage and physiotherapy: a visualized analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 312-319.
[14]	LI Muyao, WANG Mei, DU Liang, TONG Lu, XU Sanxiong. Functional effect of aerobic combined with resistance exercise on old patients with coronary heart disease and hypertension using WHO-FICs framework [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 326-334.
[15]	DOU Li, CHEN Huawei, LU Enjie, SHI Chongyan. Association between physical activity and exercise self-efficacy for adolescents with visual impairment [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 349-355.