臨床問題：運動訓練是否可以改善社區老人之衰弱現象？

Clinical Question: Can Exercise Training Help Improving "Frailty" in Community-dwelling Older Adults?

王靜怡(Ching-Yi Wang)

《長期照護雜誌》 17卷2期 (2013/08) Pp. 89-96

https://doi.org/10.6317/LTC.201308_17(2).0003

摘要

目的：探討運動訓練是否能有效改善社區老人衰弱（frailty）之現象。方法：以frailty、older adults、exercise、systematic review為關鍵字，搜尋PubMed和Cochrane library兩個資料庫從2008到2013年發表的系統回顧及綜合分析的文獻，共5篇。結果：第一篇研究發現多成份運動訓練（包括肌力、耐力、平衡訓練）似乎是改善衰弱老人跌倒危險、步行能力、平衡及肌力表現的最佳策略；第二篇報告運動介入可以有效改善衰弱老人的步行速度、平衡功能及日常生活活動能力；第三篇特別指出對於衰弱者的運動計畫處方應不同於一般老人。發現以每週三次、每次30～45分鐘、長時間（≥5個月）、多成分訓練（multi-component training intervention）的運動處方比其他的處方有更佳的效果；第四篇結果發現亦支持以長時期、高強度、多成分運動計畫對於社區衰弱老人身體失能預防有正面的效果；第五篇結果建議規律運動訓練對於不同身體功能狀態的長者具提昇功能表現的效果。結論：以上五篇系統回顧文章的結果發現相當一致，均支持運動介入對社區老人身體功能衰弱之療效，建議每週三次、每次30～45分鐘、長時間（≥5個月）、多成分訓練（multi-component training）的運動處方效果較佳。

關鍵字

衰弱 ； 老人 ； 運動訓練

並列摘要

Purpose: To discuss the effects of exercise training on frailty of community-dwelling older adults. Method: Systematic review or meta-analysis of literature published in 2008 to 2013 and listed in the PubMed and/or Cochrane library, found using the following keywords: frailty, older adults, exercise, and systematic review. Five papers met the criteria and were included in this study. Results: The first article concluded that the multi-component exercise intervention including strength, endurance, and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults. The second report found that exercise can increase gait speed, improve balance, and improve performance in ADLs in frail older adults. The third study reported that structured exercise training (multi-component training interventions, of long duration (≥5 months), performed three times per week, for 30-45 minutes per session) seems to have a positive impact on frail older adults and generally has outcomes superior to those of other exercise programs. The fourth study suggested that relatively long-lasting and high-intensive multi-component exercise programs have a positive effect on physical disability for community-living, moderately physically frail older persons. The fifth study reported that older adults with different levels of abilities can improve their functional performance by regular exercise training. Conclusion: The five articles reviewed had relatively consistent results supporting the effects of exercise training on frailty in community-dwelling older adults. Based on current evidence, the best exercise prescription appears to be multi-component, three sessions per week, 30-45 minutes per session, for a long duration (≧5 months).

並列關鍵字

frailty ； older adults ； exercise training