维持社区老年人身体活动能力的最佳证据总结和实践建议

Summary of the best evidence and practical suggestions on strategies for maintaining physical activity ability of the elderly in the community

目的以证据的转化和应用为目标,聚焦维持社区老年人身体活动能力的策略,全面检索、整合相关最佳证据,形成实践建议,为相关证据的实施提供科学、可靠、与时俱进的依据。方法根据6S证据资源金字塔模型由上至下循序逐层检索BMJ Best Practice、UpToDate、DynaMed、世界卫生组织、中华医学会、英国国家卫生与保健优化研究所、苏格兰校际指南网络、新西兰指南工作组、PubMed、中国生物医学文献服务系统等数据库,获取2017年1月1日—2022年3月1日与维持社区老年人身体活动能力相关的所有循证知识库资源、临床实践指南、专家共识、系统综述等类型的所有文献,根据文献纳入及排除标准进行筛选,按工具要求由2~4名研究员对不同类型文献进行独立的方法学质量评价,提取、汇总最佳证据,形成实践建议。结果共纳入14篇文献,其中循证决策2篇、指南6篇、专家共识1篇、系统评价3篇、系统评价再评价2篇。从"整体建议、健康收益、多样化运动训练、有氧训练、平衡训练、肌肉强化/抗阻训练、柔韧性训练"7个维度提取汇总了22条最佳证据,并形成实践建议。结论医护人员应采用基于循证方法学的实践建议对社区老年人维持身体活动能力进行管理指导和提供咨询,帮助老年人群更好地维持身体活动能力,从而获得更多健康收益。

Objective To focus on the physical activity strategy to maintain the activity ability of the elderly in the community,comprehensively retrieve and integrate the best evidence,form practical suggestions with the goal of the transformation and practice of evidence,so as to provide scientific,reliable and up-to-date basis for the implementation of relevant evidence.Methods According to the 6S pyramid model,the British Medical Journal(BMJ)Best Practice,UpToDate,DynaMed,World Health Organization,Chinese Medical Association,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,New Zealand Guidelines Group,PubMed,SinoMed and other databases were retrieved layer by layer from top to bottom.This study obtained all articles of evidence-based knowledge base resources,clinical practice guidelines,expert consensus,systematic review and other types related to physical activity strategies to maintain the activity ability of the elderly in the community from January 1,2017 to March 1,2022.According to the inclusion and exclusion criteria of the article,2 to 4 researchers conducted independent methodological quality evaluation on different types of article according to the tool requirements,extracted and summarized the best evidence,and formed practical suggestions.Results A total of 14 articles were included,including 2 evidence-based decision-making,6 guidelines,1 expert consensus,3 systematic reviews,and 2 overviews of systematic review.Seven dimensions such as"overall advice,health benefits,diversified sports training,aerobic training,balance training,muscle strengthening/resistance training,flexibility training"and 22 best pieces of evidence were extracted and summarized,and practical suggestions were formed.Conclusions Medical and nursing staff should adopt evidence-based methodological practical suggestions to provide management guidance and consultation for the maintenance of physical activity ability of the elderly in the community,so as to help the elderly to maintain physical activity ability and gain health benefits.