中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (26): 5662-5672.doi: 10.12307/2025.740

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

不同运动方案组成要素对老年人跌倒风险影响效果的Meta分析

朱天瑞，史冀鹏，孙嘉禾，王鲁艺，张  陈，徐红旗，权赫龙   

  1. 东北师范大学体育学院运动能力测评与提升研究中心，吉林省长春市  130024
  • 收稿日期:2024-09-14 接受日期:2024-11-04 出版日期:2025-09-18 发布日期:2025-02-28
  • 通讯作者: 史冀鹏，博士，副教授，硕士生导师，东北师范大学体育学院运动能力测评与提升研究中心，吉林省长春市 130024
  • 作者简介:朱天瑞，男，1998年生，东北师范大学体育学院在读硕士，主要从事运动与健康科学研究。
  • 基金资助:
    国家社会科学基金项目(22BTY075)，项目负责人：徐红旗

Effectiveness of different exercise regimens to reduce fall risks in older adults: a Meta-analysis

Zhu Tianrui, Shi Jipeng, Sun Jiahe, Wang Luyi, Zhang Chen, Xu Hongqi, Quan Helong   

  1. Research Center of Exercise Capacity Assessment and Promotion, School of Physical Education, Northeast Normal University, Changchun 130024, Jilin Province, China
  • Received:2024-09-14 Accepted:2024-11-04 Online:2025-09-18 Published:2025-02-28
  • Contact: Shi Jipeng, PhD, Associate professor, Master’s supervisor, Research Center of Exercise Capacity Assessment and Promotion, School of Physical Education, Northeast Normal University, Changchun 130024, Jilin Province, China
  • About author:Zhu Tianrui, Master’s candidate, Research Center of Exercise Capacity Assessment and Promotion, School of Physical Education, Northeast Normal University, Changchun 130024, Jilin Province, China
  • Supported by:
    National Social Science Foundation of China, No. 22BTY075 (to XHQ)

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摘要：


文题释义：
老年人跌倒风险筛查指标：跌倒风险筛查指标是用于评估老年人跌倒风险的工具和标准。这些指标通常包括生理、心理、健康和环境因素的综合评估，通过全面的筛查可以识别高风险个体并制定相应的预防措施。 
量效关系：指某一特定干预措施(如运动)对老年人跌倒风险影响的程度和效果，它涉及多个方面，包括运动的类型、频率、强度和持续时间等。通过系统的评估和Meta分析，可以明确不同运动方案的量效关系，为老年人制定个体化的运动处方提供科学依据，从而有效降低跌倒风险。

目的：探究不同运动方案组成要素对降低老年人跌倒风险的干预效果。
方法：检索PubMed、Embase、Web of Science、The Cochrane Library、万方、中国知网等数据库中关于运动干预对60岁以上健康老年人跌倒风险影响的研究，检索时限为各数据库建库至2023年7月。采用Cochrane风险偏倚评估工具对纳入文献进行方法学质量评价，通过Review Manager 5.3和Stata 16.0软件对文献进行Meta分析、敏感性分析、亚组分析和发表偏倚检验。
结果：共纳入45篇文献，包含54项研究，总样本量为3 074名。研究表明运动干预可以有效提高老年人平衡能力(睁眼单脚站立、功能性前伸、起立-行走测试、Berg平衡量表测试)、下肢肌力(30 s坐立测试、5次坐立测试、简易体能状况量表)、心理效能(国际版跌倒效能量表)，降低跌倒风险(P < 0.05)。Meta分析结果显示不同运动方案对降低老年人跌倒风险存在剂量效应，身心运动有利于改善老年人单脚站立(睁眼)能力[MD=6.81，95%CI(2.17，11.44)，P < 0.01]；抗阻运动更有利于提高起立-行走测试成绩[MD=-3.12，95%CI(-5.72，-0.52)，P < 0.05]和30 s坐立能力[MD=1.22，95%CI(0.37，2.08)，P < 0.01]；多成分运动更有利于改善功能性前伸能力[MD=4.50，95%CI(2.58，6.42)，P < 0.01]、Berg量表测试成绩[MD=1.05，95%CI(0.39，1.71)，P < 0.01]、5次坐立能力[MD=-3.15，95%CI(-4.80，-1.50)，P < 0.01]、简易体能状况量表测试成绩[MD=0.55，95%CI(0.37，0.74)，P < 0.01]和国际版跌倒效能量表测试成绩[MD=-0.41，95%CI(-0.69，-0.13)，P < 0.01]。
结论：运动干预能有效提高老年人平衡能力、下肢肌力和活动能力，减少对跌倒的恐惧，降低老年人跌倒风险。不同方案组成要素(运动方式、周期、频率和单次运动时间)对老年人跌倒风险相关筛查测试结果有着不同量效关系。

关键词: 跌倒风险, 老年人, 运动干预, Meta分析, 平衡能力, 下肢肌力, 心理效能, 量效关系

Abstract: OBJECTIVE: To explore the efficacy of different exercise regimens to reduce fall risks in older adults. 
METHODS: PubMed, Embase, Web of Science, The Cochrane Library, WanFang, and CNKI were searched for studies about exercise interventions on fall risk in healthy older adult individuals at the age of 60 years and above. The search timeframe should cover from the inception of each database to July 2023. Quality assessment and risk-of-bias were assessed using the Cochrane risk of bias tool. Meta-analysis, subgroup analysis, sensitivity analysis, and publication bias were conducted using Review Manager 5.3 and Stata 16.0. 
RESULTS: A total of 45 papers containing 54 studies with 3 074 participants were included in the analysis. Overall, exercise intervention can improve the interventional effects on balance (the unipedal stance test with eyes open, functional reach, Timed “Up & Go”, and Berg balance scale), lower limb muscle strength (30-second chair-stand test, Five-Times Sit-To-Stand Test, and Short Physical Performance Battery), and fall-efficacy (Falls Efficacy Scale-International), leading to reduced fall risk (P < 0.05). The Meta-analysis results revealed a dosage effect of different exercise regimens to reduce fall risk in the elderly. Mind-body exercise could efficiently increase scores of the unipedal stance test [mean difference (MD)=6.81, 95% confidence interval (CI) (2.17, 11.44), P < 0.01]; resistance exercise could efficiently increase the scores of the Timed “Up & Go” [MD=-3.12, 95%CI (-5.72, -0.52), P < 0.05] and the 30-second chair-stand test [MD=1.22, 95%CI (0.37, 2.08), P < 0.01]; and multicomponent physical activity could efficiently increase the scores of functional reach [MD=4.50, 95%CI (2.58, 6.42), P < 0.01], Berg Balance Scale [MD=1.05, 95%CI (0.39, 1.71), P < 0.01], Five-Times Sit-To-stand Test [MD=-3.15, 95%CI (-4.80, -1.50), P < 0.01], Short Physical Performance Battery [MD=0.55, 95%CI (0.37, 0.74), P < 0.01], and Falls Efficacy Scale-International [MD=-0.41, 95%CI (0.69, -0.13), P < 0.01]. 
Conclusion: Exercise interventions can effectively improve balance, enhance limb strength and functional ability, and reduce fear of falling, and lower the risk of falls in older adults. The components of different intervention programs (such as type of exercise, duration, frequency, and session length) have varying dose-response relationships with the results of fall risk screening tests in older adults.

Key words: fall risk, elderly, exercise intervention, Meta-analysis, balance, lower limb muscle strength, fall-efficacy, dosage effect

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