运动改善老年人心肺功能存在剂量效应的系统综述与Meta分析

Systematic Review and Meta-Analysis on Dose Effect of Exercise Improving the Cardiopulmonary Fitness of the Elderly

目的:探讨运动干预与老年人心肺功能提高的剂量效应关系,明确改善老年人心肺功能的最佳运动剂量(强度、频率、时间等)。方法:检索PubMed、EBSCO、Web of Science、中国知网和万方等数据库,根据纳入排除标准筛选文献,并对文献进行质量评价与数据提取,对提取的数据经过编码后,采用Comprehensive Meta-Analysis V2与Revman 5.3进行Meta分析。结果:纳入62篇文献82项研究,2139名老年人,平均年龄为(67.3±6.3)岁。老年人心肺功能得到的有效改善(d>0.5)的运动强度、时间、频率和周期剂量分别为35%~50%HRR、25~35 min、1次/周和运动干预8周;获得大效应量(d>8.0)改善时,各要素的敏感区为70%~79%HRR、60 min、每周运动4次及以上和运动干预16周及以上。对各处方要素进行多要素交互效应的分析显示,每周进行150 min以上,每次40~45 min,强度为60%HRR的运动可能是大幅度(d>0.8)改善老年人心肺功能的最小有效剂量。结论:运动干预与老年人心肺功能改善存在剂量效应。每周1次,25~35 min,强度为35%~50%HRR的运动干预可改善老年人心肺功能;每周150 min以上,每次40~45 min,强度为60%HRR的运动,是大幅度提高老年人心肺功能的最小有效剂量。

Objective:To explore the dose effect relationship between exercise intervention and the improvement of cardiopulmonary fitness of the elderly,and determine the optimal exercise dose(intensity,frequency,time,etc.)to improve the cardiopulmonary fitness of the elderly.Methods:Searching data on PubMed,EBSCO,Web of Science,CNKI,Wanfang Data and other databases,screening literatures based on inclusion and exclusion criteria,and perform quality evaluation and data extraction on the literature.After coding the extracted data,Comprehensive Meta-Analysis V2 and Revman 5.3 were used for meta-analysis.Results:Included 82 studies of 62 literature,2139 elderly people with an average age of(67.3±6.3)years.The effective improvement(d>0.5)doses of the cardiopulmonary fitness of the elderly are 35% to 50% HRR,25 to 35 min,exercise once a week and exercise intervention for 8 weeks.When a large effect size(d>8.0)is obtained,the sensitive zone of each element exists in 70% to 79% HRR,60 min,exercise 4 times or more per week,and exercise intervention for 16 weeks or more.The analysis of the multi-element interaction effects of various factors shows that a 60% HRR exercise for more than 150 min a week and 40 to 45 min each time may be the minimum effect size(d>0.8)to greatly improve the cardiopulmonary fitness of the elderly.Conclusions:Exercise intervention and the improvement of cardiopulmonary fitness of the elderly have a dose effect.Exercise intervention with an intensity of 35% to 50% HRR for 25 to 35 min once a week can improve CRF in the elderly.More than 150 min a week,40 to 45 min of 60% HRR exercise each time is the minimum effective dose to greatly improve the cardiopulmonary fitness of the elderly.