运动处方研究进展

Research Progress on Exercise Prescription:A Systematic Review

目的本文试图通过对近半个世纪以来运动处方的产生及其发展过程,以及各阶段的特点进行分析和评价,为运动处方、运动康复疗法和机能评定在我国的普及应用提供理论和实践依据。方法采用计算机网络文献和资料收集法,对Medlin via Ovid、PubMed、Sport Discus、CINAHL、CAM、EMbase和EBM Cochrane Databaseof SR 7个数据库进行检索,检索词为exercise prescription、physical tness、exercise therapy、tness assessment、exercise test、randomized,检索时间均从建库至2008年6月。然后对其中的随机和非随机对照研究,以及资料较全者纳入分析讨论。结果共检索到318篇文献,但其中涉及运动处方和机能评定的随机对照试验(RCT)仅有7篇,系统评价和Meta分析各1篇。我们对其中资料较全又有代表性的93篇文献进行了系统分析讨论。结果显示:最早的运动处方和机能评定研究可以追溯到1950年,其发展与运动康复疗法的发展密不可分。二十世纪70年代是运动处方发展的初始期,首先是在身体活动与心血管健康方面提出了运动处方的概念,而后逐步提出了针对个体的运动处方,进而开始把运动处方与体能测试联系在一起讨论。二十世纪80年代运动处方开始进入了全面发展的阶段,开始用体能测试指导运动处方,并使运动处方和机能评定进入实验阶段。二十世纪90年代运动处方开始与多种运动康复疗法相结合,针对多种疾病进行干预和治疗,并与多种体能训练方法相结合指导训练和康复,成为一种主要的非药物治疗手段。进入本世纪以后,运动处方和机能评定的研究得到了全面提高,开始出现非随机对照试验和RCT,一些先进的测试手段和分析方法开始应用于机能评定和运动处方的实施。结论运动处方的发展与运动康复疗法和运动机能评定的发展是密不可分的,机能评定和体能测试是执行和实施运动处方的基础。当今,运动处方已从单一的体育锻炼方法提高到了针对多种疾病的非药物治疗手段。运动处方和机能评定的科学化已从观察性研究、群体研究,开始进入了非随机对照试验和RCT。相对其它生物学科而言,运动处方的RCT研究相对滞后,如何使运动处方获得最大的益处和最低的风险仍是值得研究的问题。

Objective In order to improve the standing on the studies of Exercise Prescription（EP）,a systematic review was conducted to provide reference and theory for further studies.Methods A broad computerized literature search of Medlin via Ovid,PubMed in all fields,Sport Discus,CINAHL,CAM,EMbase,EBM Cochrane Database of SR,and Web of Science was carried out till June 2008.Firstly,four categorical searches were conducted with the following keywords for searches：Exercise Prescription,Physical Fitness,Exercise Therapy,Fitness Assessment,Exercise Test and RCTs,and the searched results were checked by reviewers and duplicate results were removed.Then all titles were manually searched for potential inclusion in the review.Articles retrieved,review articles were examined for further relevant references.Results There were 318 relevant articles,however,the RCTs were only 7,and systematic review and meta-analysis were only one,respectively.Considering the importance and reference values there were 93 articles were included.1970s was the developing age of EP;1980s more specific EP were provided for many purposes;1990s with the techniques developing of physical fitness,exercise therapy,fitness assessment and exercise test,EP for treating and rehabilitating more chronics and civilizing diseases were developed;2000s the RCTs and CCTs were applied in the EP studies.Conclusions The developing of EP has close relationship with the developing of physical fitness,exercise therapy,fitness assessment,and exercise test.Although the RCTs researches in this field were limited,most of them were positive to support the advantage of EP.How to highly improve the advantages and greatly decrease the risk of EP is still valuable to study in the future.