健身功法对老年人平衡能力的影响研究

运用实验法和数据统计法等,研究太极拳、健身气功及瑜伽这3大传统健身功法锻炼对老年人平衡能力的影响。结论:太极拳、健身气功和瑜伽对老年人平衡能力均有较好的改善作用,尤其以太极拳针对动态性平衡,而瑜伽针对静态性平衡的效果更为明显。建议:继续大力推广太极拳、健身气功和瑜伽之类的传统健身功法项目。同时,建立适合每位老年人自身需要的运动处方,并且酌情选择一至两项其它适宜的运动作为辅助项目来提高老年人的力量及协调性,以促进平衡能力的维持和改善。     

中等强度有氧运动对高血脂患者血脂水平影响的元分析——基于随机对照试验的证据

目的: 评价中等强度有氧运动对高血脂患者血脂水平的影响效果。方法: 检索Google Scholar、PubMed、Web of Science(WOS)、EMBASE、维普、知网和万方数据库中关于中等强度有氧运动干预高血脂患者血脂水平的随机对照试验(RCT),检索期限从各数据库收录时间起至2020年12月。采用Stata 14.0 软件进行meta分析。结果: 共纳入13个RCT,826例患者。与对照组相比,中等强度有氧运动对高血脂患者总胆固醇(TC)(SMD=-0.94,95% CI-0.15~-0.74, P<0.001)、甘油三酯(TG)(SMD=-0.95,95%CI:-1.41~-0.50, P<0.001)、高密度脂蛋白胆固醇(HDL-C)(SMD=0.95(95%CI: 0.79~-1.11,P<0.001),低密度脂蛋白胆固醇(LDL-C)(SMD=-1.36(95%CI:-1.53~-1.19,P< 0.001)水平均有显著影响。结论: 中等强度有氧运动降低了血清中TC总量、TG和LDL-C水平,升高了HDL-C水平。每周6~7次、每次30~90分钟、坚持24~48周的中等轻度有氧运动可以作为高血脂患者改善血脂水平的运动处方。鉴于该研究还存在一定的局限性,仍需高质量的RCT予以论证。     

有氧运动对Ⅱ型糖尿病心率变异性影响的Meta分析

目的采用Meta分析方法定量评价有氧运动对Ⅱ型糖尿病患者心率变异性的影响。方法以运动干预前后患者心率变异的时域指标MSSD标准化均值差(SMD),频域指标HF、LF、LF/HF标准化均值差(SMD)为统计量,检索1975至2019年的相关文献,制定文献筛选标准,对纳入的文献进行异质性检验、回归分析、亚组分析和数据合并。结果共涉及9项研究纳入Meta分析,共包含101例患者,进行数据合并后显示,Ⅱ型糖尿病患者(有自主神经病变)MSSD,SMD=1.40(95%CI=0.70,2.09),Z=3.95,p<0.05。Ⅱ型糖尿病患者(无自主神经病变)MSSD,SMD=0.19(95%CI=-0.28,0.65),Z=0.80,p>0.05。Ⅱ型糖尿病患者HF值SMD=0.65(95%CI=0.03,1.28),Z=2.04,p=0.04<0.05。Ⅱ型糖尿病患者LF值SMD=0.70(95%CI=0.02,1.37),Z=2.02,p=0.04<0.05。Ⅱ型糖尿病患者LF/HF值SMD=-0.05(95%CI=-0.38,0.28),Z=0.28,p>0.05。结论长期中等强度的有氧运动可改善Ⅱ型糖尿病患者心迷走神经的活动,而对心交感神经的活动并无改善作用。     

不同运动对原发性高血压患者血压及血脂影响的Meta分析

目的 通过网状Meta分析法系统评估和比较有氧运动、抗阻运动、间歇运动、有氧联合抗阻运动和身心运动对改善原发性高血压（EHT）患者血压和血脂水平的疗效,为EHT患者改善血压和血脂水平提供循证依据。方法 系统检索PubMed、Cochrane、Embase、Web of Science、EBSCO和CBM数据库中关于运动改善EHT患者血压和血脂的随机对照试验。采用STATA16.0和Rev Man 5.3软件对纳入研究的数据进行Meta分析。结果共有45项涉及3 560名患者的随机对照试验被纳入网状Meta分析。结果显示有氧联合抗阻运动对降低收缩压的效果最优（MD=-13.58,95%CI[-17.72,-9.44],p<0.05）;身心运动对降低舒张压（MD=-8.61,95%CI[-10.52,-6.70],p<0.05）、甘油三酯（SMD=-0.98,95%CI[-1.73,-0.23],p<0.05）和低密度脂蛋白（SMD=-1.07,95%CI[-1.57,-0.56],p<0.05）的效果最优;有氧运动对降低总胆固醇（SMD=-0.52,95%CI[-...     

运动干预对糖尿病前期人群糖脂代谢影响的网状Meta分析

目的：评价不同运动干预对糖尿病前期人群糖脂代谢的影响效果。方法：检索Web of Science、PubMed、EMBASE、CNKI及万方数据库,筛选符合纳入标准的随机对照试验,运用Cochrane偏倚风险评估工具进行文献质量评价,Stata 15.0软件进行网状Meta分析。结果：共纳入31篇文献,2 026例糖尿病前期患者。高强度间歇运动对空腹血糖(SMD=-2.48;95%CI:-3.14,-1.82)、餐后2 h血糖(SMD=-1.51;95%CI:-2.18,-0.85)、总胆固醇(SMD=-0.93;95%CI:-1.27,-0.59)、高密度脂蛋白(SMD=1.19;95%CI:0.89,1.49)及低密度脂蛋白(SMD=-0.76;95%CI:-1.16,-0.35)的改善效果显著。有氧结合抗阻运动对甘油三酯(SMD=-1.03;95%CI:-1.52,-0.54)的改善效果显著。结论：运动锻炼可明显改善糖尿病前期人群的糖脂代谢水平,其中高强度间歇运动及有氧结合抗阻运动的干预效果整体较好,但受个别干预措施研究数量及样本量的限制,明确的结论仍需更多高质量的研究予以验证。     

体力活动对痴呆患者认知功能干预效果的Meta分析

目的:系统评价体力活动对痴呆患者认知功能的干预效果。方法:计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、Medline、CBM、CNKI、VIP和Wan Fang Data数据库中有关体力活动对痴呆患者认知功能的随机对照试验(RCTs),检索时限均从各个数据库收录起始年限至2018年7月27日,使用PEDro量表进行方法学质量评价,采用Revman5.3软件进行Meta分析,采用Stata14.0软件进行发表偏倚检验。结果:共纳入24个RCT,包括1581例痴呆患者。Meta分析结果显示:体力活动对痴呆患者整体认知功能(MD=2.17,95%CI:1.50,2.84,P<0.00001)有积极的影响。亚组分析结果显示:体力活动对AD患者(MD=2.40,95%CI:1.58,3.23,P<0.00001)与合并AD患者(MD=1.45,95%CI:0.41,2.48,P=0.006)的整体认知功能优于对照组;有氧运动(MD=2.43,95%CI:1.63,3.23,P<0.00001)与混合运动(MD=1.48,95%CI:0.08,2.87,P=0.04)对痴呆患者整体认知功能优于对照组,但抗阻运动(MD=1.70,95%CI:-0.15,3.55,P=0.07)与太极拳运动(MD=0.92,95%CI:-2.98,4.82,P=0.64)与对照组差异无统计学意义;高频率体力活动(MD=1.64,95%CI:0.25,3.04,P=0.02)与低频率体力活动(MD=2.33,95%CI:1.57,3.09,P<0.00001)对痴呆患者的整体认知功能均优于对照组。不同认知领域Meta分析结果显示:体力活动对痴呆患者执行功能(SMD=0.08,95%CI:-0.05,0.20,P=0.22)、TMT-A与TMT-B(SMD=-0.05,95%CI:-0.26,0.16,P=0.63)和记忆功能(SMD=0.15,95%CI:-0.06,0.37,P=0.17)与对照组相比差异无统计学意义,只有注意力(SMD=0.18,95%CI:0.02,0.35,P=0.03)优于对照组。结论:体力活动干预对AD患者与合并AD患者的整体认知功能有积极影响,并且有氧与混合、高频率与低频率的体力活动干预对所有痴呆患者的整体认知功能同样有效,不同认知领域中只有注意力有改善效果。     

太极拳运动对中老年人运动耐力及肺功能的影响分析

通过对太极拳逆腹式呼吸和健步走腹式顺式呼吸的对比,并与未参加锻炼的普通人群对照,从6min步行实验(6MWT)、血氧饱和度(Sa O2)、肺功能角度探讨太极拳运动对中老年人运动耐力及肺功能的改善与提高情况,为太极拳健身功能提供一定的理论依据。     

太极拳运动对中老年人运动耐力及肺功能影响分析

通过对太极拳逆腹式呼吸和健步走腹式顺式呼吸的对比,并与未参加锻炼的普通人群对照,从6min步行实验（6MWT）、血氧饱和度（Sa）、肺功能角度探讨太极拳运动对中老年人运动耐力及肺功能的改善与提高情况,为太极拳健身功能提供一定的理论依据.     

呼吸肌训练对运动员呼吸肌功能及运动表现影响的Meta分析

目的 系统评价呼吸肌训练对运动员呼吸肌功能、肺通气功能及运动表现等相关指标的影响,通过对现有实证性研究结果进行统计分析,总结归纳出呼吸肌训练的最适宜方案。方法 检索Pub Med、Web of Science、EBSCO、中国知网、万方数据库,搜集呼吸肌训练对运动员呼吸肌功能、肺通气功能及运动表现影响的随机对照试验（RCT）,运用Stata16.0软件进行Meta分析。结果 共纳入31项RCT,包括各项目一般及高水平运动员610例。Meta分析结果显示：呼吸肌训练在提高运动员最大口腔吸气压（MIP）MD=27.93,95%CI[21.12,34.75],p <0.01;用力肺活量（FVC）MD=0.13,95%CI [0.03,0.23],p <0.05;每分最大通气量（MVV）MD=7.65,95%CI[1.86,13.44],p<0.05;计时测试（TT）SMD=-0.53,95%CI[-0.77,-0.29],p<0.01等方面均显著优于对照组,但两组在一秒用力呼气容积（FEV1.0） MD=0.11,95%CI[-0.01,0.22],p>0.05方面的差异无统计学意义。Meta回归分析发现,训练时间是引起MIP研究间异质性的主要因素来源。具体表现为吸气肌压力阈值负荷训练对MIP的影响达到非常显著性水平（p<0.01）,8～12周的训练效果优于4～6周,5～7天/周的训练频率优于2～4天/周。结论 呼吸肌训练能够有效改善运动员MIP及多种肺通气功能,提高运动表现,持续时间8～12周、训练频率5～7天/周的吸气肌压力阈值负荷训练更有可能收获理想的训练效果。     

健身气功·六字诀锻炼对心率的影响研究

主要研究了健身气功.六字诀功法习练的基本理论和方法(注:健身气功.六字诀是中国国家体育总局组织编创的四种健身功法之一),按照健身方法进行习练,同时摇测其即时心率变化,并以数据的方式记录下其习练的持续时间,心跳次数,最低心率,最高心率,平均心率,能量消耗等。在此基础上,进一步观察和分析功法的运动时间、运动强度,运动频率和动作结构。研究结果显示,心率的波动在正常范围内,符合有氧运动和健身的要求。根据习练对象、时间、目的的不同,练习的方法应有所侧重,以提高健身效果。     

Lack of Relationship Between Functional and Perceived Quality of Life Outcomes Following Pulmonary Rehabilitation

Individuals with chronic obstructive pulmonary disease (COPD) have been shown to benefit from participation in pulmonary rehabilitation (PR) programs that include exercise training and education. Purpose: To examine the relationship between improvements in 6 minute walk distance and perceived quality of life in individuals with COPD following completion of a PR program. Methods: The records of 139 individuals completing a PR program (3 times a week for 8 weeks) were retrospectively examined. Prior to entry and upon completion of the program each individual completed a 6 minute walk test (6MWT), the SF-36 Health survey, and the UCSD Shortness of Breath Questionnaire (SOB). SF-36 results were analyzed according to 8 subscales [Physical Functioning (PF), Role Physical (RF), Bodily Pain (BP), General Health (GH), Vitality (V), Social Functioning (SF), Role Emotional (RE), and Mental Health (MH)]. Results: PR resulted in significant improvements in 6MWTdistance (Pre = 845 ± 37 ft, Post = 1127 ± 32 ft, p < 0.001), PF (p < 0.001), RF (p = 0.001), Vitality (p = 0.002), SF (p < 0.001), RE (p = 0.037), MH (p < 0.001) and SOB (Pre = 53 ± 2, Post = 47 ± 2, p < 0.001). The change in 6MWT distance was not related to changes in PF (r = 0.17), RF (r = 0.03), GH (r = 0.03), Vitality (r = −0.001), SF (r = 0.01), RE (r = 0.06), MH (r = −0.04) or SOB (r = 0.12). The magnitude of improvement in 6MWT distance (68%) was much greater than that observed in PF (15%), RF (16%), GH (6%), VT (18%), SF (20%), RE (14%), MH (14%), or SOB (8%). Conclusions: PR has a positive impact on 6 minute walk distance and perceived quality of life in individuals with COPD; however, changes in 6 minute walk distance appear to have no relationship to changes in perceived quality of life.     

Effects of exercise by type and duration on quality of life in patients with digestive system cancers: A systematic review and network meta-analysis

BackgroundThere is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.MethodsA systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model.ResultsThe analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD) = 0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMD = 0.38, 95%CrI: –0.05 to 0.81) and role function (SMD = 0.48, 95%CrI: –0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMD = 0.69, 95%CrI: –0.07 to 1.50) and effective in alleviating fatigue (SMD = –0.77, 95%CrI: –1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMD = –1.20, 95%CrI: –2.40 to 0.06), depression (SMD = –0.51, 95%CrI: –1.50 to 0.45), and anxiety (SMD = –0.45, 95%CrI: –1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (–0.87 to –5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMD = –0.33, 95%CrI: –1.70 to 1.00), physical health (SMD = –0.18, 95%CrI: –1.30 to 0.90), and role function (SMD = –1.20, 95%CrI: –2.50 to 0.11).ConclusionThis study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.     

The Evidence Regarding Exercise Training in the Management of Cystic Fibrosis: A Systematic Review

Purpose: To conduct a systematic review of the evidence regarding the efficacy of exercise training in the management of cystic fibrosis (CF).Methods: Articles were found by searching PEDRO, MEDLINE, and CINAHL databases. Included articles involved exercise-related interventions for long-term adaptations (ie, not acute effects of exercise). Articles were excluded if the language was other than English or if other non-exercise interventions were used. Date of publication was not a factor for exclusion. Two independent reviewers evaluated the included articles using Sackett''s levels of evidence and select scoring criteria.Results: Twelve articles were eligible for inclusion. Interventions studied included various aspects of exercise training: anaerobic, aerobic, or resistance training. Study end-points included pulmonary function, aerobic capacity, strength, and health-related quality of life (HRQL).Conclusions: Exercise training in individuals with CF is beneficial, with aerobic and resistance training having the greatest support in the literature for improved aerobic capacity and strength, respectively. Exercise training does not appear to have an effect of improving pulmonary function, but may have a preservation effect. Strong conclusions about improvement in HQRL from exercise training cannot be made. However, greater consistency in measuring this outcome is needed in future trials. There is a paucity of evidence regarding the role of exercise training in reducing hospitalization and health care utilization, and questions raised by this review should be considered in the design of future trials.Key Words: cystic fibrosis, aerobic exercise, review     

Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease: The State of the Evidence

Purpose: The purpose of the present review was to assess the quality of evidence in the literature regarding the specific benefits of inspiratory muscle training (IMT) with an emphasis on training intensity and the relationships between changes in inspiratory muscle function and other clinical outcome measures. Methods: Articles were found by searching CINAHL, PubMed, Medline via First Search, and ProQuest databases. Articles used in the review were randomized trials of IMT vs. sham IMT or no intervention, published in English in a peer-reviewed journal, included patients with chronic obstructive pulmonary disease (COPD), and specified the intensity of training. The quality of the studies was evaluated by 2 independent reviewers using the methodological rigor scale described by Medlicott and Harris as well as Sackett''s levels of evidence. Fifteen articles met the inclusion criteria and were used in this review. Results: Consistent improvements in maximal inspiratory pressures (ranging from −11 to −30 cm H₂O) and inspiratory muscle endurance were found. Improvements in dyspnea and health-related quality of life were also observed. Inspiratory muscle training may result in improved exercise tolerance as measured using walking tests. High-intensity IMT resulted in improved training efficiency with respect to inspiratory muscle strength, but evidence of the effect of high-intensity IMT on other clinical outcomes is lacking. Conclusion: Despite research spanning decades, there are numerous limitations in the literature regarding IMT. IMT appears to improve dyspnea, waking test distance, and health-related quality of life in individuals with COPD, but it is not clear whether this improvement is mediated through improved inspiratory muscle strength and endurance. This review discussed several considerations critical to the design of future trials.Key Words: inspiratory muscle training, COPD     

Skeletal Muscle Strength and Endurance in Recipients of Lung Transplants

Purpose: Exercise limitation in recipients of lung transplant may be a result of abnormalities in the skeletal muscle. However, it is not clear whether these abnormalities are merely a reflection of the changes observed in the pretransplant condition. The purpose of this paper was to compare thigh muscle volume and composition, strength, and endurance in lung transplant recipients to people with chronic obstructive pulmonary disease (COPD).Methods: Single lung transplant recipients (n=6) and people with COPD (n=6), matched for age, sex, and BMI participated in the study. Subjects underwent MRI to determine muscle size and composition, lower extremity strength testing and an isometric endurance test of the quadriceps.Results: Lung transplant recipients had similar muscle volumes and intramuscular fat infiltration of their thigh muscles and similar strength of the quadriceps and hamstrings to people with COPD who had not undergone transplant. However, quadriceps endurance tended to be lower in transplant recipients compared to people with COPD (15 ± 7 seconds in transplant versus 31 ± 12 seconds in COPD, p = 0.08).Conclusions: Recipients of lung transplant showed similar changes in muscle size and strength as people with COPD, however muscle endurance tended to be lower in people with lung transplants. Impairments in muscle endurance may reflect the effects of immunosuppressant medications on skeletal muscle in people with lung transplant.Key Words: lung transplant, muscle function, MRI     

Effectiveness of Interval Exercise Training in Patients with COPD

Physical training is beneficial and should be included in the comprehensive management of all patients with COPD independently of disease severity. Different rehabilitative strategies and training modalities have been proposed to optimize exercise tolerance. Interval exercise training has been used as an effective alternative modality to continuous exercise in patients with moderate and severe COPD.Although in healthy elderly individuals and patients with chronic heart failure there is evidence that this training modality is superior to continuous exercise in terms of physiological training effects, in patients with COPD, there is not such evidence. Nevertheless, in patients with COPD application of interval training has been shown to be equally effective to continuous exercise as it induces equivalent physiological training effects but with less symptoms of dyspnea and leg discomfort during training.The main purpose of this review is to summarize previous studies of the effectiveness of interval training in COPD and also to provide arguments in support of the application of interval training to overcome the respiratory and peripheral muscle limiting factors of exercise capacity. To this end we make recommendations on how best to implement interval training in the COPD population in the rehabilitation setting so as to maximize training effects.Key Words: interval exercise training, chronic obstructive pulmonary disease, exercise tolerance, pulmonary rehabilitation     

Does exercise have a protective effect on cognitive function under hypoxia? A systematic review with meta-analysis

ObjectiveThis study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia.MethodsDesign: Systematic review with meta-analysis. Data sources: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1).ResultsIn total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference (SMD) = –0.4), executive function (SMD = –0.18), and memory function (SMD = –0.26), but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95% confidence interval: 0.14 – 0.45, I² = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function.ConclusionExercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.     

慢性阻塞性肺病传统康复运动处方的制定

目的：制定传统中医康复锻炼的规范化运动处方。方法：选择第一秒用力呼气容积（FEVI）／用力肺活最（FVC）〈70％．且30％〈FEVI占预计值的百分比（FEVI％）〈80％的慢性阻塞性肺病（COPD）稳定期患者90例（最后完成的有85例），按入组先后随机分为对照组、传统中医锻炼组（中医组）和传统中医锻炼运动处方组（处方组），后2组进行为期8周的运动训练。处方组训练内容为按规范化运动处方要求制定的中医养生呼吸操。治疗前、后进行运动能力、呼吸困难评定。结果：锻炼后6min步行距离（6MWD）中医组从（337．68±59．18）m增加至（386．14±76．71）m．处方组从（348．00±55．94）m增加至（425．17±53．22）m，Borg计分中医组从（3．14±1．94）分降至（2．32±1．25）分，处方组从（3．45±1．84）分降至（1．72±0．70）分，差异均有统计学意义（P≤0．001）。且处方组的变化较中医组更为明显。结论：中医养生锻炼运动处方简单易行，能改善缓解期COPD患者的运动能力，减轻呼吸困难程度，且较传统中医康复锻炼方法更有效，具有可行性。