PDF(Pubmed)
Abstract：
BACKGROUND: Weak lower body strength and balance impairments are fundamental risk factors for mobility impairments and falls that can be improved by physical activity (PA). Previous meta-analyses have focused on these risk factors in adults aged ≥ 65 years. Yet, the potential of PA for improving these risk factors in middle-aged populations has not been systematically investigated. This systematic review and meta-analysis aim to examine the effect of general and structured PA on lower limb strength, postural balance and falls in middle-aged adults.
METHODS: A computerized systematic literature search was conducted in the electronic databases MEDLINE, CINAHL, Web of Science and Cochrane Library. PA intervention types were classified according to the ProFaNE taxonomy. Randomized controlled trials exploring the effects of PA on strength (e.g., leg press one-repetition-maximum), balance (e.g., single limb stance) and falls (e.g., fall rates) in adults aged 40-60 years were systematically searched and included in a network analysis. Moderator analyses were performed for specific subgroups (age, sex, low PA). The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale.
RESULTS: Out of 7170 articles screened, 66 studies (median PEDro score 5) with 3387 participants were included. Strong, significant effects on muscle strength were found for strength (SMD = 1.02), strength-aerobic (SMD = 1.41), strength-endurance (SMD = 0.92) and water-based (SMD = 1.08) training (52 studies, I2 = 79.3%). Strength training (SMD = 1.16), strength-aerobic (SMD = 0.98) and 3D training (SMD = 1.31) improved postural balance (30 studies, I2 = 88.1%). Moderator analyses revealed significant effects of specific intervention types on certain subgroups and subdomains of strength and balance. No studies were found measuring falls.
CONCLUSIONS: Structured PA interventions in middle-aged adults improve strength and balance outcomes related to functional impairments and falls. Strength training increases both strength and balance and can be recommended to prevent age-related functional decline. However, the interpretability of the results is limited due to considerable heterogeneity and the overall low methodological quality of the included studies. Long-term trials are needed to determine the preventive potential of PA on strength, balance and falls. This meta-analysis may inform guidelines for tailored training during middle age to promote healthy aging. Prospero registration: CRD42020218643.
METHODS: A computerized systematic literature search was conducted in the electronic databases MEDLINE, CINAHL, Web of Science and Cochrane Library. PA intervention types were classified according to the ProFaNE taxonomy. Randomized controlled trials exploring the effects of PA on strength (e.g., leg press one-repetition-maximum), balance (e.g., single limb stance) and falls (e.g., fall rates) in adults aged 40-60 years were systematically searched and included in a network analysis. Moderator analyses were performed for specific subgroups (age, sex, low PA). The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale.
RESULTS: Out of 7170 articles screened, 66 studies (median PEDro score 5) with 3387 participants were included. Strong, significant effects on muscle strength were found for strength (SMD = 1.02), strength-aerobic (SMD = 1.41), strength-endurance (SMD = 0.92) and water-based (SMD = 1.08) training (52 studies, I2 = 79.3%). Strength training (SMD = 1.16), strength-aerobic (SMD = 0.98) and 3D training (SMD = 1.31) improved postural balance (30 studies, I2 = 88.1%). Moderator analyses revealed significant effects of specific intervention types on certain subgroups and subdomains of strength and balance. No studies were found measuring falls.
CONCLUSIONS: Structured PA interventions in middle-aged adults improve strength and balance outcomes related to functional impairments and falls. Strength training increases both strength and balance and can be recommended to prevent age-related functional decline. However, the interpretability of the results is limited due to considerable heterogeneity and the overall low methodological quality of the included studies. Long-term trials are needed to determine the preventive potential of PA on strength, balance and falls. This meta-analysis may inform guidelines for tailored training during middle age to promote healthy aging. Prospero registration: CRD42020218643.
摘要：
背景：较低的身体力量和平衡障碍是行动不便和跌倒的基本危险因素，可以通过体育锻炼（PA）来改善。以前的荟萃分析集中在年龄≥65岁的成年人中的这些危险因素。然而，PA改善中年人群这些危险因素的潜力尚未得到系统研究.本系统综述和荟萃分析旨在研究一般和结构化PA对下肢力量的影响。中年人的姿势平衡和跌倒。
方法：在电子数据库MEDLINE中进行了计算机化的系统文献检索，CINAHL,WebofScience和Cochrane图书馆。PA干预类型根据ProFNE分类法进行分类。探索PA对力量影响的随机对照试验(例如，腿部按压一次重复最大)，平衡(例如，单肢站立)和跌倒(例如，对40-60岁成年人的跌倒率）进行了系统搜索，并纳入网络分析。对特定亚组进行了主持人分析(年龄，性别,低PA）。使用物理治疗证据数据库（PEDro）量表评估纳入研究的方法学质量。
结果：在筛选的7170篇文章中，66项研究（PEDro评分中位数为5）纳入3387名参与者。坚强,强度对肌肉强度有显著影响(SMD=1.02)，强度-有氧（SMD=1.41），强度-耐力(SMD=0.92)和水基(SMD=1.08)训练(52项研究，I2=79.3%）。力量训练（SMD=1.16），力量有氧（SMD=0.98）和3D训练（SMD=1.31）改善了姿势平衡（30项研究，I2=88.1%)。主持人分析显示，特定干预类型对强度和平衡的某些亚组和亚域具有重大影响。没有发现测量跌倒的研究。
结论：对中年人进行结构性PA干预可改善与功能障碍和跌倒相关的力量和平衡结果。力量训练增加力量和平衡，可以建议防止与年龄相关的功能下降。然而,由于纳入研究的异质性和总体方法学质量较低,结果的可解释性受到限制.需要长期试验来确定PA在强度方面的预防潜力，平衡和跌倒。这种荟萃分析可能会为中年期间进行量身定制的培训以促进健康衰老提供指导。Prospero注册：CRD42020218643。
方法：在电子数据库MEDLINE中进行了计算机化的系统文献检索，CINAHL,WebofScience和Cochrane图书馆。PA干预类型根据ProFNE分类法进行分类。探索PA对力量影响的随机对照试验(例如，腿部按压一次重复最大)，平衡(例如，单肢站立)和跌倒(例如，对40-60岁成年人的跌倒率）进行了系统搜索，并纳入网络分析。对特定亚组进行了主持人分析(年龄，性别,低PA）。使用物理治疗证据数据库（PEDro）量表评估纳入研究的方法学质量。
结果：在筛选的7170篇文章中，66项研究（PEDro评分中位数为5）纳入3387名参与者。坚强,强度对肌肉强度有显著影响(SMD=1.02)，强度-有氧（SMD=1.41），强度-耐力(SMD=0.92)和水基(SMD=1.08)训练(52项研究，I2=79.3%）。力量训练（SMD=1.16），力量有氧（SMD=0.98）和3D训练（SMD=1.31）改善了姿势平衡（30项研究，I2=88.1%)。主持人分析显示，特定干预类型对强度和平衡的某些亚组和亚域具有重大影响。没有发现测量跌倒的研究。
结论：对中年人进行结构性PA干预可改善与功能障碍和跌倒相关的力量和平衡结果。力量训练增加力量和平衡，可以建议防止与年龄相关的功能下降。然而,由于纳入研究的异质性和总体方法学质量较低,结果的可解释性受到限制.需要长期试验来确定PA在强度方面的预防潜力，平衡和跌倒。这种荟萃分析可能会为中年期间进行量身定制的培训以促进健康衰老提供指导。Prospero注册：CRD42020218643。
