PDF(Pubmed)
Abstract：
BACKGROUND: Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults?
METHODS: Eight databases were searched up to December 2nd, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects.
RESULTS: The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I2=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I2=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I2=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes.
CONCLUSIONS: Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals.
BACKGROUND: Registration Number: INPLASY202230118.
METHODS: Eight databases were searched up to December 2nd, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects.
RESULTS: The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I2=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I2=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I2=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes.
CONCLUSIONS: Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals.
BACKGROUND: Registration Number: INPLASY202230118.
摘要：
背景：基于计步器的步行计划有望成为社区老年人预防中风的健康促进策略，特别是针对体力活动相关的可改变的危险因素。问题出现了：基于计步器的步行计划干预措施在改善社区居住的老年人中可改变的中风危险因素方面的有效性是什么？
方法：截至12月2日，共搜索了八个数据库，2023年，遵循系统评价和荟萃分析方案的首选报告项目。纳入标准侧重于涉及社区居住老年人的随机对照试验（RCTS），并以英语报道。两名独立审稿人利用物理治疗证据数据库(PEDro)工具提取数据，评估资格，评估研究质量，并识别潜在的偏见。标准化平均差(SMD)被用作主要-体力活动水平-和与心血管功能(血压)和代谢综合征相关的次要结局的汇总统计。包括肥胖（以体重指数和腰围衡量），空腹血糖,糖化血红蛋白,高密度脂蛋白胆固醇（HDL-C），和甘油三酯。使用随机效应模型来生成效应的汇总估计。
结果：该综述分析了8项研究，涉及1546名60-85岁的参与者，1348成功完成研究。在这些研究中，基于计步器的步行计划每周实施2-3次，会议持续40-60分钟，持续4-26周。偏见的风险从高到中等不等。我们的叙事综合揭示了HDL-C水平的积极趋势，空腹血糖,和糖化血红蛋白，提示改善血糖控制和长期血糖管理。然而,对甘油三酯的影响只是微不足道的。主要荟萃分析表明，身体活动行为显着改善（SMD=0.44,95CI：0.26，0.61，p=<0.00001；I2=0％；4项研究；532名参与者）和收缩压（SMD=-0.34,95CI：-0.59，-0.09；p=<0.008；I2=65％，2项研究；249名参与者），与舒张压不同（SMD=0.13,95CI：-0.13，-0.38，p=0.33；I2=91％；2项研究；237名参与者）。基于社会认知的干预，自我效能感,和自我效率理论(ies)，以及在生态框架中应用的社会认知理论，与成功的身体活动行为结果有关。
结论：基于计步器的步行程序，利用人际健康行为理论/生态框架，增强社区居住的老年人的体育锻炼行为并具有抗高血压作用。虽然它们不会显著影响舒张压，这些项目有可能成为符合全球健康目标的初级卒中预防策略.
背景：注册号：INPLASY202230118。
方法：截至12月2日，共搜索了八个数据库，2023年，遵循系统评价和荟萃分析方案的首选报告项目。纳入标准侧重于涉及社区居住老年人的随机对照试验（RCTS），并以英语报道。两名独立审稿人利用物理治疗证据数据库(PEDro)工具提取数据，评估资格，评估研究质量，并识别潜在的偏见。标准化平均差(SMD)被用作主要-体力活动水平-和与心血管功能(血压)和代谢综合征相关的次要结局的汇总统计。包括肥胖（以体重指数和腰围衡量），空腹血糖,糖化血红蛋白,高密度脂蛋白胆固醇（HDL-C），和甘油三酯。使用随机效应模型来生成效应的汇总估计。
结果：该综述分析了8项研究，涉及1546名60-85岁的参与者，1348成功完成研究。在这些研究中，基于计步器的步行计划每周实施2-3次，会议持续40-60分钟，持续4-26周。偏见的风险从高到中等不等。我们的叙事综合揭示了HDL-C水平的积极趋势，空腹血糖,和糖化血红蛋白，提示改善血糖控制和长期血糖管理。然而,对甘油三酯的影响只是微不足道的。主要荟萃分析表明，身体活动行为显着改善（SMD=0.44,95CI：0.26，0.61，p=<0.00001；I2=0％；4项研究；532名参与者）和收缩压（SMD=-0.34,95CI：-0.59，-0.09；p=<0.008；I2=65％，2项研究；249名参与者），与舒张压不同（SMD=0.13,95CI：-0.13，-0.38，p=0.33；I2=91％；2项研究；237名参与者）。基于社会认知的干预，自我效能感,和自我效率理论(ies)，以及在生态框架中应用的社会认知理论，与成功的身体活动行为结果有关。
结论：基于计步器的步行程序，利用人际健康行为理论/生态框架，增强社区居住的老年人的体育锻炼行为并具有抗高血压作用。虽然它们不会显著影响舒张压，这些项目有可能成为符合全球健康目标的初级卒中预防策略.
背景：注册号：INPLASY202230118。
