運動訓練對過重／肥胖兒童及青少年生理適能影響之系統性回顧

Effectiveness of Exercise Training on Physiological Fitness in Overweight/Obese Children and Adolescents: A Systematic Review

蔡孟書(Meng-Shu Tsai) ； 吳英黛(Ying-Tai Wu)

《物理治療》 33卷6期 (2008/12) Pp. 397-408

摘要

背景與目的：肥胖是兒童及青少年目前嚴重的健康議題，肥胖兒童易伴隨多種慢性疾病，研究發現他們的生理適能(Physiological fitness)包含代謝適能(metabolic fitness)、形態適能(morphological fitness)及骨骼強度(bone integrity, bone strength)也會降低。本篇研究目的在利用系統回顧的方法，檢視運動訓練對過重／肥胖兒童或青少年生理適能的效果。方法：由MEDLINE、CINAHL、PubMed及CEPS資料庫利用關鍵詞合併收尋截至2008年6月所有隨機控制研究設計(randomized controlled trials, RCTs)、受試者為6-18歲過重／肥胖的兒童或青少年、必須要有運動訓練或身體活動介入且必須包含生理適能一項以上測量項目之研究。結果：共搜尋到20篇符合條件之研究，其中8篇的介入組只有運動訓練，另12篇運動訓練組及控制組均有飲食控制、行為治療或生活型態的教育介入，運動訓練的型式則包含有氧運動訓練或阻力運動訓練。僅有部分文獻資料支持運動訓練可以改善過重／肥胖兒童及青少年的高密度脂蛋白、低密度脂蛋白、三酸甘油酯、胰島素、胰島素阻抗、收縮壓、身體質量指數、身體脂肪、內臟脂肪、皮下脂肪、腰臀圍比、腰圍、骨質密度及骨質量等生理適能指標，無證據顯示運動訓練可改善總膽固醇、空腹血糖、糖化血色素值、舒張壓或平均壓。結論：以運動促進過重／肥胖兒童及青少年生理適能指標良多，仍需更多優質的實驗性研究來支持其療效。

關鍵字

運動 ； 肥胖 ； 兒童 ； 生理適能 ； 系統性回顧

並列摘要

Background and Purpose: Childhood and adolescent obesity is associated with many health problems. Physiological fitness, including metabolic fitness, morphological fitness, and bone integrity, decreases in obese children and young youth. The purpose of this review was to identify the effects of exercise training on physiological fitness in overweight/obese children and adolescents. Methods: Electronic databases. including MEDLINE, CINAHL, PubMed and CEPS, were searched up until June 2008. Randomized controlled trials were selected using the following criteria: (a) overweight/obese children and adolescents were aged 6-18 years; (b) subjects took part in exercise or physical activities; and, (c) at least one outcome of physiological fitness was studied. Results: Twenty randomized control trials met these criteria; 8 investigated the effects of exercise alone and 12 combined exercise with lifestyle education, diet or behavior therapy. Exercise modes included aerobic and resistance exercise. Only some studies supported the beneficial effects of exercise training on physiological fitness. Improvement in high-density lipoprotein, low-density lipoprotein, triglyceride, and insulin levels, and insulin resistance, systolic blood pressure, body mass index, body fat, visceral adipose tissue, abdominal subcutaneous adipose tissue, waist hip ratio, waist circumference, bone mineral density and bone mineral content after exercise training were noted in some studies. No evidence supported the beneficial effects of exercise training on total cholesterol, fasting glucose, hemoglobin A1c, diastolic or mean blood pressure. Conclusions: Exercise may have a positive effect on physiological fitness in overweight/obese children and adolescents. More research of higher methodological quality is needed.

並列關鍵字

Exercise training ； Obese ； Children ； Physiological fitness ； Systematic review