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A within-subject examination of grandparents' physical activity and sedentary behavior levels in the presence or absence of grandchild care provision. 对祖父母在有无照顾孙辈的情况下的体育活动和久坐行为水平进行受试者内部研究。
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-05-07 DOI: 10.1186/s11556-024-00345-8
Maxine Vanhove, Eva D'Hondt, Yanni Verhavert, Tom Deliens, Benedicte Deforche, Marie Vermote

Background: This study aimed to examine within-subject differences in levels of physical activity (PA) and sedentary behavior (SB) among Flemish grandparents aged 50 years and older during a day of providing versus not providing grandchild care. Additionally, grandparents' PA and SB levels of the specific caregiving moment within the included care day were also compared with those of the corresponding specific time frame on the matching non-care day.

Methods: Data were obtained and pooled from three assessment time points of the Healthy Grandparenting Project. Objectively measured PA and SB levels were assessed through ActiGraphs wGT3x(+) worn during waking hours for seven consecutive days and expressed relative to the total wear time of the selected days or moments (i.e., percentage of time per day or per moment). Generalized linear mixed models were used to evaluate the within-subject differences in grandparents' light intensity PA (LIPA), moderate-to-vigorous intensity PA (MVPA) and SB levels between a care and non-care day as well as between the care and non-care moment of those respective days.

Results: A total of 92 grandparents (64.6 ± 4.8 years, 67.4% women) were included in the analyses. During the care day and care moment, grandparents showed higher relative levels of LIPA (∆=4.0% and ∆=7.9%, respectively) and lower relative levels of SB (∆=3.7% and ∆=6.7%, respectively) as compared to their respective non-care day and non-care moment (all p < 0.001). While there was no significant difference in relative MVPA levels between a day of providing versus not providing grandchild care (∆=0.3%, p = 0.500), the grandparents showed significantly lower relative levels of MVPA during the specific care moment against the non-care moment (∆=1.3%, p = 0.029).

Conclusions: The higher percentage of time of LIPA and lower percentage of time spent on SB during a care day and care moment compared to a non-care day and non-care moment, highlight the positive impact of grandchild care provision on grandparents' activity levels, potentially improving other health-related outcomes. Furthermore, grandparents seem to compensate for their lower MVPA levels during the actual care moment since no differences in MVPA levels were found at day level when compared to a day without grandchild care.

Trial registration: clinicaltrials.gov, Identifier: NTC04307589. Registered March 2020.

研究背景本研究旨在考察弗拉芒 50 岁及以上祖父母在照顾孙子和不照顾孙子的一天中体力活动(PA)和久坐行为(SB)水平的受试者内部差异。此外,还将祖父母在照看日特定照看时刻的 PA 和 SB 水平与非照看日相应特定时间段的 PA 和 SB 水平进行了比较:方法:从 "健康祖父母养育项目 "的三个评估时间点获取并汇总数据。连续七天在清醒时佩戴 ActiGraphs wGT3x(+),对客观测量的 PA 和 SB 水平进行评估,并与所选日子或时刻的总佩戴时间相对比(即每天或每个时刻的时间百分比)。采用广义线性混合模型来评估祖父母在护理日和非护理日之间以及在护理日和非护理日的护理时刻之间的轻度运动强度(LIPA)、中度至剧烈运动强度(MVPA)和SB水平的受试者内差异:共有 92 名祖父母(64.6 ± 4.8 岁,67.4% 为女性)参与了分析。与非护理日和非护理时刻相比,祖父母在护理日和护理时刻的 LIPA 相对水平较高(分别为 ∆=4.0% 和 ∆=7.9%),SB 相对水平较低(分别为 ∆=3.7% 和 ∆=6.7%)(均为 p 结论:祖父母在护理日和护理时刻的 LIPA 和 SB 相对水平较高,而在非护理日和非护理时刻的 LIPA 和 SB 相对水平较低:与非照看日和非照看时刻相比,照看日和照看时刻的 LIPA 时间比例较高,而用于 SB 的时间比例较低,这凸显了照看孙辈对祖父母活动水平的积极影响,有可能改善其他与健康相关的结果。此外,祖父母在实际照看过程中似乎可以弥补其较低的 MVPA 水平,因为与不照看孙辈的一天相比,祖父母一天的 MVPA 水平没有差异:NTC04307589.注册时间:2020 年 3 月。
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引用次数: 0
Resistance training's impact on blood biomarkers and cognitive function in older adults with low and high risk of mild cognitive impairment: a randomized controlled trial 阻力训练对轻度认知障碍低风险和高风险老年人血液生物标志物和认知功能的影响:随机对照试验
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-04-10 DOI: 10.1186/s11556-024-00344-9
Wouter A. J. Vints, Evrim Gökçe, Julija Šeikinaitė, Simona Kušleikienė, Vida J. Česnaitienė, Jeanine Verbunt, Oron Levin, Nerijus Masiulis
The aging brain exhibits a neuroinflammatory state, driven partly by peripheral pro-inflammatory stimuli, that accelerates cognitive deterioration. A growing body of evidence clearly indicates that physical exercise partly alleviates neuroinflammation and positively affects the aging process and cognition. In this randomized controlled trial, we aimed to observe the effect of 12 weeks of resistance training (RT) on peripheral biomarker levels, cognitive function changes and their interrelationship, and explore differences in those exercise-induced changes in older adults with high risk of mild cognitive impairment (MCI) compared to older adults with low risk of MCI. Fifty-two participants (aged 60–85 years old, 28 female) were randomly allocated to a 12 week lower limb RT program consisting of two training sessions per week or waiting list control group. The Montreal Cognitive Assessment (MoCA) was used to stratify participants screened as high (< 26/30) or low risk (≥ 26/30) of MCI. We assessed serum Interleukin 6 (IL-6), Insulin-like Growth Factor-1 (IGF-1), and Kynurenine (KYN) levels. Cognitive measurement consisted of and four subtests of Automated Neuropsychological Assessment Metrics (ANAM), the two-choice reaction time, go/no-go, mathematical processing, and memory search test. Twelve weeks of RT improved Go/No-go test results in older adults with high MCI risk. RT did not significantly affect blood biomarkers. However, IGF-1 level increases were associated with improvements in response time on the mathematical processing test in the exercise group, and IL-6 level increases were associated with improvements in response time on the memory search test in the total group of participants. Finally, KYN levels significantly differed between older adults with low and high MCI risk but no significant associations with performance were found. Our study results suggest a different effect of RT on inhibitory control between older adults with low compared to high MCI risk. IGF-1 may play a role in the mechanism behind the cognitive benefit of RT and KYN may be a surrogate biomarker for neurodegeneration and cognitive decline.
衰老的大脑表现出神经炎症状态,部分原因是外周促炎症刺激,这种状态会加速认知能力的退化。越来越多的证据清楚地表明,体育锻炼能部分缓解神经炎症,并对衰老过程和认知能力产生积极影响。在这项随机对照试验中,我们旨在观察为期 12 周的阻力训练(RT)对外周生物标志物水平、认知功能变化及其相互关系的影响,并探讨轻度认知障碍(MCI)高风险老年人与轻度认知障碍低风险老年人在这些运动引起的变化方面的差异。52 名参与者(60-85 岁,28 名女性)被随机分配到为期 12 周的下肢 RT 计划(每周两节训练课)或候补对照组。蒙特利尔认知评估(MoCA)用于将筛选出的参与者分为 MCI 高风险组(< 26/30)和低风险组(≥ 26/30)。我们评估了血清白细胞介素 6(IL-6)、胰岛素样生长因子-1(IGF-1)和犬尿氨酸(KYN)的水平。认知测量包括自动神经心理评估指标(ANAM)的四个子测试、双选反应时间、走/不走、数学处理和记忆搜索测试。为期 12 周的 RT 可改善 MCI 高危老年人的去/不去测试结果。RT 对血液生物标志物没有明显影响。然而,IGF-1水平的增加与运动组数学处理测试反应时间的改善有关,IL-6水平的增加与所有参与者记忆搜索测试反应时间的改善有关。最后,KYN水平在低MCI风险和高MCI风险的老年人中存在显著差异,但与成绩没有发现明显关联。我们的研究结果表明,与 MCI 风险高的老年人相比,RT 对抑制控制的影响有所不同。IGF-1可能在RT对认知能力有益的机制中发挥作用,而KYN可能是神经变性和认知能力下降的替代生物标志物。
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引用次数: 0
Do changes in the frailty score differ by the type of group sports and exercises participated in? A 3-year longitudinal study 参加的集体运动和锻炼类型不同,虚弱评分的变化也不同吗?一项为期 3 年的纵向研究
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-03-20 DOI: 10.1186/s11556-024-00342-x
Taishi Tsuji, Satoru Kanamori, Ryota Watanabe, Meiko Yokoyama, Yasuhiro Miyaguni, Masashige Saito, Katsunori Kondo
Older adults who engage in group sports and exercises achieve greater health benefits than those who exercise by themselves. The benefits of group participation may vary depending on the type of sports/exercise they engage in. The present study aimed to identify the association between specific sports and exercise types performed in groups and evaluate the longitudinal changes in multidimensional frailty scores among community-dwelling older adults in Japan. We used 3-year follow-up data from the Japan Gerontological Evaluation Study and analyzed 33,746 men and 36,799 women aged ≥ 65 years. To elucidate the relationship between participation in 20 types of group sports/exercises in 2016 (baseline) and the change in frailty score (using the Kihon Checklist, KCL) from 2016 to 2019, we performed linear regression analyses through multivariate adjustments for age group, self-rated health, marital status, living alone, occupational status, years of education, alcohol drinking status, smoking status, equivalent income, and disease status using an inverse probability weighting method. P < 0.05 was considered statistically significant. The mean change in KCL scores over 3 years was + 0.62 and + 0.61 points in men and women, respectively, implying the degree of frailty worsened. The sports/exercise types that significantly prevented increments in KCL scores for both sexes compared to non-participants were hiking (men: B, − 0.36; women: B, − 0.29), walking (men: B, − 0.26; women: B, − 0.24), tennis (men: B, − 0.23; women: B, − 0.24), ground golf (men: B, − 0.21; women: B, − 0.19), and weight exercises (men: B, − 0.19; women: B, − 0.16). Participation in specific sports and exercise groups offer significant physical and psychological benefits for frailty prevention among older adults in Japan. The results of this study may offer substantive evidence to encourage older adults to participate in group activities for the prevention of multidimensional frailty. It will also help public health stakeholders to decide which type of sports and exercise groups to promote in a community.
与单独锻炼的老年人相比,参加集体运动和锻炼的老年人能获得更大的健康益处。集体参与的益处可能因参与的运动/锻炼类型而异。本研究旨在确定集体进行的特定运动和锻炼类型之间的关联,并评估日本社区老年人多维度虚弱评分的纵向变化。我们使用了日本老年学评估研究(Japan Gerontological Evaluation Study)的 3 年随访数据,分析了 33746 名男性和 36799 名女性(年龄≥ 65 岁)。为了阐明2016年(基线)参加20种集体运动/锻炼与2016年至2019年虚弱评分(使用Kihon检查表,KCL)变化之间的关系,我们使用反概率加权法,通过对年龄组、自评健康状况、婚姻状况、独居、职业状况、受教育年限、饮酒状况、吸烟状况、同等收入和疾病状况进行多变量调整,进行了线性回归分析。P<0.05为具有统计学意义。男性和女性的 KCL 评分在 3 年内的平均变化分别为 + 0.62 分和 + 0.61 分,这意味着虚弱程度有所加重。与未参加者相比,明显阻止男女 KCL 分数增加的运动/锻炼类型是徒步旅行(男性:B,- 0.36;女性:B,- 0.29)、步行(男性:B,- 0.26; women: B, - 0.24), tennis (men: B, - 0.23; women: B, - 0.24), ground golf (men: B, - 0.21; women: B, - 0.19), and weight exercises (men: B, - 0.19; women: B, - 0.16).参加特定的运动和锻炼团体对日本老年人预防虚弱有很大的身心益处。这项研究的结果可为鼓励老年人参加集体活动以预防多方面的虚弱提供实质性证据。它还有助于公共卫生相关人员决定在社区推广哪种类型的体育锻炼团体。
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引用次数: 0
Protective effects of physical activity on episodic memory during aging are explained by executive functioning. 执行功能解释了体育锻炼对衰老过程中外显记忆的保护作用。
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-03-09 DOI: 10.1186/s11556-024-00341-y
Ilona Moutoussamy, Laurence Taconnat, Lucie Angel, Kristell Pothier, Lucette Toussaint, Séverine Fay

Aging is marked by a memory decline related to an executive function decline. Physical activity (PA) has beneficial effects on both executive functions and memory, especially in aging. The protective effects of PA on these two cognitive abilities have always been studied separately, despite the well-established relationship between memory and executive functions. Our objective was to explore whether the benefits of PA on memory could be explained by reduced age-related changes in executive functions.Nineteen young adults (27.16 years old) and 25 older adults (69.64 years old) performed a resource-dependent memory task, three executive tasks and completed a PA questionnaire (measuring sports and leisure PA). Age group and PA effects on memory and executive performance were analyzed with generalized linear models. Mediation analyses were calculated using method of causal steps approach with a non-parametric bootstrapping procedure.The results confirmed the effects of age and PA on memory and executive performance. A significant interaction confirmed the protective effect of PA on age-related cognitive performance. PA was positively correlated with performance in both memory and executive tasks, but only in the older adults. Although each predictor alone (age, executive functions and PA) significantly explained memory performance in older adults, only the effect of PA on memory performance remained significant when all the predictors were introduced in the analyses.PA mediates the effects of age and executive functions on memory performance. This suggests that PA protects older adults against memory decline by reducing the decline in executive functioning.

衰老的特征是记忆力下降,而记忆力下降与执行功能下降有关。体育锻炼(PA)对执行功能和记忆力都有益处,尤其是在衰老过程中。尽管记忆力和执行功能之间的关系已得到证实,但人们一直将体育锻炼对这两种认知能力的保护作用分开研究。我们的目的是探索 PA 对记忆力的益处是否可以通过减少执行功能中与年龄相关的变化来解释。19 名年轻人(27.16 岁)和 25 名老年人(69.64 岁)完成了一项资源依赖型记忆任务、三项执行任务,并填写了一份 PA 问卷(测量运动和休闲 PA)。采用广义线性模型分析了年龄组和 PA 对记忆力和执行力的影响。结果证实了年龄组和 PA 对记忆力和执行力的影响。结果证实了年龄和 PA 对记忆力和执行力的影响,两者之间明显的交互作用证实了 PA 对年龄相关认知能力的保护作用。PA与记忆和执行任务的表现均呈正相关,但仅适用于老年人。虽然每个单独的预测因子(年龄、执行功能和 PA)都能显著解释老年人的记忆表现,但在分析中引入所有预测因子时,只有 PA 对记忆表现的影响仍然显著。这表明,PA 可通过减少执行功能的下降来保护老年人,防止其记忆力下降。
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引用次数: 0
Differential association between physical activity behaviours and dynapenia by comorbid diseases in community-dwelling Korean older adults. 在社区居住的韩国老年人中,体育锻炼行为与合并疾病之间的差异。
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-03-08 DOI: 10.1186/s11556-024-00340-z
Jae Hyeon Park, Hyung Seok Nam, Mina Park, Yeo Hyung Kim

Background: Physical activity (PA) behaviours and comorbid diseases are associated with muscle strength. However, the association between dynapenia and detailed PA behaviours, including participation in aerobic and resistance exercises and sedentary behaviour (SB), in relation to comorbid diseases has not yet been investigated. Using nationwide data, this study aimed to evaluate the independent association of dynapenia with detailed PA behaviour (participation in aerobic and resistance exercises and SB), and assess the differential associations of detailed PA behaviour with dynapenia according to comorbid diseases with prevalent sarcopenia.

Methods: A total of 7,558 community-dwelling older adults aged ≥ 65 years who were included in the Korea National Health and Nutrition Examination Survey from 2014 to 2019 were included in the present study. Cross-sectional associations between PA behaviours (participation in aerobic exercise, participation in resistance exercise, and SB) and dynapenia were analysed using complex-sample multivariable-adjusted logistic regression models according to the type of comorbid disease (cardiovascular disease [CVD], diabetes mellitus [DM], and chronic lung disease [CLD]).

Results: Sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time of < 420 min/day showed independent negative associations with dynapenia (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.60-0.83; OR, 0.54; 95% CI, 0.42-0.69; and OR, 0.84; 95% CI, 0.72-0.97, respectively). Among the participants with CVD or CLD, the associations of sufficient resistance exercise (OR, 0.46; 95% CI, 0.26-0.82 and OR, 0.51; 95% CI, 0.35-0.75 for CVD and CLD, respectively) and low sedentary time (OR, 0.66; 95% CI, 0.45-0.98 and OR, 0.71; 95% CI, 0.55-0.93 for CVD and CLD, respectively) with dynapenia were significant, whereas the association of sufficient aerobic exercise with dynapenia was insignificant. Meanwhile, in participants with DM, sufficient aerobic exercise (OR, 0.70; 95% CI, 0.52-0.94) and sufficient resistance exercise (OR, 0.45; 95% CI, 0.29-0.70) were independently associated with dynapenia, whereas no association between SB and dynapenia was found.

Conclusion: We observed an independent inverse association between PA behaviours and dynapenia. Disease-specific associations between each PA behaviour (sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time) and dynapenia differed in the older adults. Therefore, these differences should be acknowledged during interventions for this population.

背景:体力活动(PA)行为和合并疾病与肌肉力量有关。然而,尚未研究过动态肌力减退症与详细的体力活动行为(包括参加有氧运动和阻力运动以及久坐行为)之间的关系,以及与合并疾病的关系。本研究利用全国性数据,旨在评估达英尼亚症与详细的体育锻炼行为(参与有氧运动、抗阻力运动及久坐不动)之间的独立关联,并评估详细的体育锻炼行为与达英尼亚症之间的不同关联,这取决于合并症与肌肉疏松症的流行程度:本研究共纳入了 7 558 名年龄≥ 65 岁的社区老年人,他们都参加了 2014 年至 2019 年韩国国民健康与营养调查。根据合并疾病的类型(心血管疾病[CVD]、糖尿病[DM]和慢性肺部疾病[CLD]),使用复杂样本多变量调整逻辑回归模型分析了PA行为(参与有氧运动、参与阻力运动和SB)与动态关节炎之间的横断面关联:充分的有氧运动、充分的阻力运动和较少的久坐时间均有助于减少合并症:我们观察到 PA 行为与动态关节炎之间存在独立的反向关联。在老年人中,每种 PA 行为(充足的有氧运动、充足的阻力运动和较少的久坐时间)与动态肌无力症之间的疾病特异性关联各不相同。因此,在对这一人群进行干预时,应认识到这些差异。
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引用次数: 0
Associations of resistance training levels with low muscle mass: a nationwide cross-sectional study in Korea 阻力训练水平与低肌肉质量的关系:韩国一项全国性横断面研究
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-03-07 DOI: 10.1186/s11556-024-00339-6
Jae Ho Park, Nam-Kyoo Lim, Hyun-Young Park
Low muscle mass is associated with adverse health outcomes such as functional decline and all-cause mortality. This study investigated the relationship between the risk of low muscle mass and the training period and/or frequency of resistance training (RT). We included 126,339 participants (81,263 women) from nationwide cohorts in Korea. Low muscle mass was defined based on the fat-free mass index. To investigate the presence of an inverse dose–response relationship between RT levels and the risk of low muscle mass, the training period (months) and frequency (per week) of RT were used. Multiple logistic regression models were used to assess the risk of low muscle mass according to the RT levels. Prevalence rates for low muscle mass in our study population were 21.27% and 6.92% in men and women, respectively. When compared with not performing RT, performing RT for 3–4 days/week and ≥5 days/week decreased the risk of low muscle mass by 22% and 27%, respectively, and performing RT for 12–23 months and ≥24 months decreased the risk by 19% and 41%, respectively. When simultaneously considering both training period and frequency, performing RT for either 3–4 days/week or ≥5 days/week was significantly related to risk reduction, provided that the training period was at least 1 year. Importantly, performing RT for more than 2 years resulted in an additional risk reduction. However, there was no additional effect of performing RT for ≥5 days/week compared to 3–4 days/week, regardless of whether the RT duration was 1–2 years or more than 2 years. Since performing RT for 5 days/week or more did not yield any additional effects on the risk of low muscle mass, performing RT for 3–4 days/week was sufficient to prevent low muscle mass. The effectiveness of this preventive measure can be further enhanced by engaging in long-term RT, specifically for more than 2 years.
肌肉质量低与机能下降和全因死亡率等不良健康后果有关。本研究调查了低肌肉质量风险与阻力训练(RT)的训练时间和/或频率之间的关系。我们纳入了韩国全国性队列中的 126,339 名参与者(81,263 名女性)。低肌肉质量的定义基于去脂质量指数。为了研究 RT 水平与低肌肉质量风险之间是否存在剂量-反应反比关系,我们使用了 RT 的训练周期(月)和频率(每周)。采用多元逻辑回归模型,根据 RT 水平评估低肌肉质量的风险。在我们的研究人群中,男性和女性的低肌肉质量患病率分别为 21.27% 和 6.92%。与不进行 RT 相比,进行 3-4 天/周和≥5 天/周的 RT 可使低肌肉质量风险分别降低 22% 和 27%,进行 12-23 个月和≥24 个月的 RT 可使低肌肉质量风险分别降低 19% 和 41%。同时考虑训练时间和频率时,如果训练时间至少为一年,那么每周进行3-4天或每周≥5天的RT训练与风险降低有显著关系。重要的是,进行 RT 超过 2 年还能进一步降低风险。然而,与 3-4 天/周相比,无论 RT 持续时间是 1-2 年还是 2 年以上,RT ≥5 天/周都没有额外的效果。由于进行 5 天/周或更长时间的 RT 对低肌肉质量风险没有产生任何额外影响,因此进行 3-4 天/周的 RT 足以预防低肌肉质量。长期(尤其是 2 年以上)进行 RT 可以进一步提高这一预防措施的效果。
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引用次数: 0
The effects of respiratory muscle training on respiratory function and functional capacity in patients with early stroke: a meta-analysis 呼吸肌训练对早期中风患者呼吸功能和功能能力的影响:一项荟萃分析
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-22 DOI: 10.1186/s11556-024-00338-7
Yun-Shan Zhang, Kai Zhang, Lang Huang, Jing-Xue Wei, Zi-Ting Bi, Jing-Hua Xiao, Jian Huang, Chao-Song Luo, Ying-Dong Li, Jia-Mei Zhang
Respiratory muscle training is a continuous and standardized training of respiratory muscles, but the evidence of the effects on early stroke patients is not clear. This meta-analysis aimed to investigate the effects of respiratory muscle training on respiratory function and functional capacity in patients with early stroke. PubMed, Embase, PEDro, ScienceDirect, AMED, CINAHL, and China National Knowledge Infrastructure databases were searched from inception to December 8, 2023 for articles about studies that 1) stroke patients with age ≥ 18 years old. Early stroke < 3 months at the time of diagnosis, 2) respiratory muscle training, including inspiratory and expiratory muscle training, 3) the following measurements are the outcomes: respiratory muscle strength, respiratory muscle endurance, pulmonary function testing, dyspnea fatigue score, and functional capacity, 4) randomized controlled trials. Studies that met the inclusion criteria were extracted data and appraised the methodological quality and risk of bias using the Physiotherapy Evidence Database scale and the Cochrane Risk of Bias tool by two independent reviewers. RevMan 5.4 with a random effect model was used for data synthesis and analysis. Mean differences (MD) or standard mean differences (SMD), and 95% confidence interval were calculated (95%CI). Nine studies met inclusion criteria, recruiting 526 participants (mean age 61.6 years). Respiratory muscle training produced a statistically significant effect on improving maximal inspiratory pressure (MD = 10.93, 95%CI: 8.51–13.36), maximal expiratory pressure (MD = 9.01, 95%CI: 5.34–12.69), forced vital capacity (MD = 0.82, 95%CI: 0.54–1.10), peak expiratory flow (MD = 1.28, 95%CI: 0.94–1.63), forced expiratory volume in 1 s (MD = 1.36, 95%CI: 1.13–1.59), functional capacity (SMD = 0.51, 95%CI: 0.05–0.98) in patients with early stroke. Subgroup analysis showed that inspiratory muscle training combined with expiratory muscle training was beneficial to the recovery of maximal inspiratory pressure (MD = 9.78, 95%CI: 5.96–13.60), maximal expiratory pressure (MD = 11.62, 95%CI: 3.80–19.43), forced vital capacity (MD = 0.87, 95%CI: 0.47–1.27), peak expiratory flow (MD = 1.51, 95%CI: 1.22–1.80), forced expiratory volume in 1 s (MD = 0.76, 95%CI: 0.41–1.11), functional capacity (SMD = 0.61, 95%CI: 0.08–1.13), while inspiratory muscle training could improve maximal inspiratory pressure (MD = 11.60, 95%CI: 8.15–15.05), maximal expiratory pressure (MD = 7.06, 95%CI: 3.50–10.62), forced vital capacity (MD = 0.71, 95%CI: 0.21–1.21), peak expiratory flow (MD = 0.84, 95%CI: 0.37–1.31), forced expiratory volume in 1 s (MD = 0.40, 95%CI: 0.08–0.72). This study provides good-quality evidence that respiratory muscle training is effective in improving respiratory muscle strength, pulmonary function, and functional capacity for patients with early stroke. Inspiratory muscle training combined with expiratory muscle training seems to promote functional recover
呼吸肌训练是一种持续、标准化的呼吸肌训练,但对早期脑卒中患者的效果尚无明确证据。本荟萃分析旨在研究呼吸肌训练对早期卒中患者呼吸功能和功能能力的影响。从开始到 2023 年 12 月 8 日,在 PubMed、Embase、PEDro、ScienceDirect、AMED、CINAHL 和中国国家知网数据库中检索了有关以下研究的文章:1)年龄≥18 岁的脑卒中患者。2)呼吸肌训练,包括吸气肌训练和呼气肌训练;3)以下测量结果:呼吸肌力量、呼吸肌耐力、肺功能测试、呼吸困难疲劳评分和功能能力;4)随机对照试验。符合纳入标准的研究均提取了数据,并由两名独立审稿人使用物理治疗证据数据库量表和 Cochrane 偏倚风险工具对其方法学质量和偏倚风险进行了评估。RevMan 5.4 采用随机效应模型进行数据综合与分析。计算了平均差 (MD) 或标准平均差 (SMD) 以及 95% 置信区间 (95%CI)。九项研究符合纳入标准,共招募了 526 名参与者(平均年龄 61.6 岁)。呼吸肌训练对改善最大吸气压力(MD = 10.93,95%CI:8.51-13.36)、最大呼气压力(MD = 9.01,95%CI:5.34-12.69)、强迫生命容量(MD = 0.82,95%CI:0.54-1.10)、呼气峰流速(MD = 1.28,95%CI:0.94-1.63)、1 秒内用力呼气量(MD = 1.36,95%CI:1.13-1.59)、早期卒中患者的功能能力(SMD = 0.51,95%CI:0.05-0.98)。亚组分析显示,吸气肌训练联合呼气肌训练有利于最大吸气压(MD = 9.78,95%CI:5.96-13.60)、最大呼气压(MD = 11.62,95%CI:3.80-19.43)、强迫生命容量(MD = 0.87,95%CI:0.47-1.27)、呼气流量峰值(MD = 1.51,95%CI:1.22-1.80)、1 s 内强迫呼气量(MD = 0.76,95%CI:0.41-1.11)、功能容量(SMD = 0.61,95%CI:0.08-1.13),而吸气肌训练可改善最大吸气压力(MD = 11.60,95%CI:8.15-15.05)、最大呼气压力(MD = 7.06,95%CI:3.50-10.62)、用力肺活量(MD = 0.71,95%CI:0.21-1.21)、呼气峰流速(MD = 0.84,95%CI:0.37-1.31)、1 秒内用力呼气量(MD = 0.40,95%CI:0.08-0.72)。本研究提供了高质量的证据,证明呼吸肌训练能有效改善早期卒中患者的呼吸肌力量、肺功能和功能能力。与单纯的吸气肌训练相比,吸气肌训练结合呼气肌训练似乎更能促进早期卒中患者的功能恢复。Prospero 注册号:CRD42021291918。
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引用次数: 0
Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process 界定和报告老年人干预措施中的运动强度:改良德尔菲程序
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-02 DOI: 10.1186/s11556-024-00337-8
Bettina Wollesen, Mona Herden, Nicola Lamberti, Christoforos D. Giannaki
Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology. Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1–10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%). In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate. The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article. - Experts highlight the importance of reporting exercise intensity for individualization and participant safety - International interdisciplinary participants with expertise in exercise gained a common understanding of the categorization of exercise intensity for future intervention studies with older adults. - Conflicting results for exercise types such as yoga, balance, and coordination training present categorization challenges
包括老年人在内的许多运动研究都没有报告所有相关的运动特征。尤其是对运动强度的描述缺失,而且大多没有进行控制。这给解释研究结果和总结系统综述或荟萃分析中的证据带来了困难。因此,本德尔菲研究的目的是由运动科学和生理学专家就运动强度的分类以及未来针对老年人的干预研究的开展和特征报告提出建议。来自欧盟 COST 行动的 297 名国际跨学科参与者受邀参加了 2023 年 4 月/5 月的三轮在线问卷调查。每一轮最多有 N = 93 名专家参与。第 1 轮包括开放式问题,以征求可能的建议,并对轻度、中度、剧烈和高强度进行分类。在第二轮中,专家们使用李克特量表(1-10)对所揭示的类别和建议进行评分。平均评分 M = 8.0 较高的群组被汇总到第 3 轮。在最后一轮中,专家们给出了最终的同意度(基于简单多数>50%)。在第一轮中,13 个问题共提供了 416 个定性陈述。从第一轮到第三轮,共剔除了 38 个项目,保留了 205 个项目以达成最终共识。在第三轮中,37 名参与者完成了整个问卷。专家们对最终分类的总体意见一致,利克特量表满分为 6.7 至 8.8 分(满分为 10 分)。他们还就报告运动强度的相关性以及今后开展和报告研究结果的建议达成了广泛共识。然而,瑜伽、平衡和协调训练等运动类型导致了轻度或中度运动分类结果的冲突。本次调查的结果可用于对运动强度进行分类,并提出了一种实用的方法,可供科学界采用,并在进行系统综述和荟萃分析文章时,当原始文章中缺乏有关运动强度的重要客观信息时加以应用。- 专家们强调了报告运动强度对个体化和参与者安全的重要性--具有运动专业知识的国际跨学科参与者就运动强度的分类达成了共识,以便今后对老年人进行干预研究。- 瑜伽、平衡和协调训练等运动类型的结果相互矛盾,给分类带来了挑战
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引用次数: 0
The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB) 哥本哈根中老年生物数据库(CAMB)参与者的自我感觉疲劳、肌肉耐力和循环炎症标记物之间的关系
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-31 DOI: 10.1186/s11556-024-00336-9
Ivan Bautmans, Veerle Knoop, Ingo Beyer, Helle Bruunsgaard, Drude Molbo, Erik Lykke Mortensen, Rikke Lund
Fatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife. A total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions). Overall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015). Middle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.
疲劳、肌肉耐力低下、肌肉无力和低度炎症与高龄虚弱密切相关。当自我感觉疲劳和肌肉耐力低下的迹象与中年期的低度炎症相互关联时,它们可能被用作体弱的早期标志物。本研究探讨了在中年是否可以观察到自我感觉疲劳、肌肉耐力和炎症之间的相互关系。研究人员对哥本哈根老龄化和中年生物库中的 965 名参与者(年龄为 52 ± 4 岁,男性 536 人,女性 426 人)进行了自我感觉疲劳(20 项多维疲劳量表)、肌肉耐力(握力)、炎症循环标志物(hsCRP、IL-6、IL-10、TNF-α 和 IFN-γ)、日常体力活动(PAS-2)、身体成分(通过生物阻抗评估体脂百分比)和自我健康状况评估。根据高疲劳度和/或低肌肉耐力对参与者进行分类(校正年龄和性别),并通过方差分析(校正 PAS-2、体脂百分比和炎症状况)评估疲劳类别之间炎症状况的差异。总体而言,肌肉耐力、疲劳和炎症指标之间存在显著的相互关联。在肌肉耐力低和疲劳度高的参与者中观察到较高水平的 hsCRP(p < 0.001)、IL-6(p < 0.001)、IL-10(p = 0.035)和 TNF-α(p = 0.028)。IFN-γ在高疲劳但肌肉耐力正常的参与者中含量最高(p = 0.015)。疲劳度较高且肌肉耐力较低的中年参与者的炎症水平较高,这与体力活动、体脂和炎症病理无关。应找出其潜在的机制,未来的研究还应调查这些人是否表现出生理储备能力降低的早期迹象,并在晚年通过虚弱的方式充分表现出来。
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引用次数: 0
Movement patterns during gait initiation in older adults with various stages of frailty: a biomechanical analysis 不同虚弱阶段的老年人步态启动时的运动模式:生物力学分析
IF 6.3 1区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-13 DOI: 10.1186/s11556-024-00335-w
Jana Maria Hommen, João P. Batista, L. Cornelius Bollheimer, Frank Hildebrand, Thea Laurentius, Hannah Lena Siebers
Gait initiation is challenging for older individuals with poor physical function, particularly for those with frailty. Frailty is a geriatric syndrome associated with increased risk of illness, falls, and functional decline. This study examines whether spatial and temporal parameters of gait initiation differ between groups of older adults with different levels of frailty, and whether fear of falling, and balance ability are correlated with the height of lifting the food during gait initiation. Sixty-one individuals aged > 65 years, classified by Fried frailty phenotype, performed five self-paced gait initiation trials. Data was collected using a three-dimensional passive optical motion capture system, consisting of 10 cameras with the ability to perceive reflective markers, and two force plates. The total duration of gait initiation and the duration of its four sub-phases, the first step length, and the maximum foot clearance during the first step were derived, and compared statistically between groups. Additionally, an association analysis was conducted between foot clearance and fear of falling, and confidence in balance in older individuals. Frail individuals had significantly longer unloading durations, and total durations of gait initiation compared to non-frail older adults. Additionally, they had shorter first step lengths compared to non-frail older adults. Pre-frail older adults also showed shorter steps compared to the non-frail group. However, there were no significant differences between groups for the maximum foot clearance during the first step. Nevertheless, the maximum foot clearance of older individuals correlated significantly with their fear of falling and confidence in balance. Older adults with reduced physical function and signs of frailty mainly display longer duration of gait initiation and decreased first step length compared to non-frail older adults. The release phase is decreased as the double support phase is prolonged in frail patients. This information can guide the development of specialized exercise programs to improve mobility in this challenging motion between static and dynamic balance.
对于身体机能较差的老年人,尤其是体弱的老年人来说,步态启动是一项挑战。虚弱是一种老年综合症,与疾病、跌倒和功能衰退的风险增加有关。本研究探讨了步态起始的空间和时间参数在不同虚弱程度的老年人群体中是否存在差异,以及对跌倒的恐惧和平衡能力是否与步态起始时抬起食物的高度相关。根据弗里德虚弱表型分类的 61 名 65 岁以上的老年人进行了五次自步速步态启动试验。数据是通过三维被动光学运动捕捉系统收集的,该系统由 10 个能感知反射标记的摄像头和两个力板组成。得出了步态启动的总持续时间及其四个子阶段的持续时间、第一步长度和第一步期间脚的最大间隙,并对各组进行了统计比较。此外,还对老年人的足部间隙、跌倒恐惧和平衡信心进行了关联分析。与不虚弱的老年人相比,虚弱者的卸力持续时间和步态启动的总持续时间明显较长。此外,与非虚弱老年人相比,他们的第一步长度较短。与非虚弱组相比,虚弱前老年人的步长也较短。不过,在第一步的最大脚间隙方面,各组之间没有明显差异。不过,老年人的最大脚间隙与他们对跌倒的恐惧和对平衡的信心有很大关系。与不虚弱的老年人相比,身体功能减退和有虚弱迹象的老年人主要表现为步态启动持续时间更长,第一步长度减少。体弱患者的释放阶段会缩短,而双支撑阶段则会延长。这些信息可以为制定专门的锻炼计划提供指导,以改善这种介于静态和动态平衡之间的高难度运动的活动能力。
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European Review of Aging and Physical Activity
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