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家庭抗药性培训老年人健康福利:加强生理功能的循证办法

标题、摘要和全文为机器翻译。 英文原文

  • Hamid Arazi1
  • Mani Izadi Sharifi2
  1. Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran ROR
  2. Energy Pro Sports Medicine Center, Gilan Private Clinic of Sports Medicine, Ministry of Education Iran, Norwegian University of Science and Technology, University of Guilan ROR
下载 PDF (336.1 KB) 引用方式 doi:10.5455/umj.20170531035008

摘要

背景:老年人的特点是身体虚弱、残疾、摔跤、骨折、丧失依赖性和慢性病。 利用体重、加权背心和腰带、弹性带、哑铃或其他便携式工具进行家用抵抗训练,可以对老年人的身体和生理能力产生积极影响。 家居抵抗训练可以保持精瘦的体质,这反过来又为正确执行日常任务提供了必要的力量. 此外,由于肌肉质量增加,休息代谢率上升,可以减少一些多种心血管和代谢风险因素。 此外,机械装载的致骨反应可能会提高骨矿的密度和含量。 这减少了与秋季有关的骨折. 结论:以家庭为基地的抵抗训练是锻炼训练的一个重要部分,它为老年人提供了宝贵的机会,可以增加体育活动,利用锻炼的好处促进整体健康和生活质量。 然而,需要进行更多的研究,以提供可靠的建议.

关键词

全文

全文为机器翻译；以英文原文为准。 英文原文

导言

人类生理能力下降是生物老化过程的必然影响。 心血管、呼吸系统、代谢系统和神经肌肉系统的功能缺陷是功能能力下降以及老化时出现的疲劳和缓慢运动的原因。 与年龄有关的生理系统能力下降不仅使锻炼表现恶化,而且导致日常生活活动能力下降。(1)老龄化通常与肌肉质量下降和脂肪质量增加相吻合。 肌肉质量的下降与骨质疏松,跌落频率和骨折的风险有关. 在整个生命期内,保持肌肉和脂肪质量之间的平衡至关重要。 肌肉质量的降低可能损害代谢率,脂肪沉积的增加使个人面临第二类糖尿病、高血压和其他心血管疾病和代谢疾病。 (2)因此,寿命越长,慢性疾病的概率就越大,使人们面临脆弱、残疾和丧失独立的风险。 (3)。 。 。

虽然年龄,基因类型和性别被认为是不可改变的,但运动是生理功能的主要可改变要素. (4)众所周知,抗药性培训,特别是纳入综合健身方案时,可导致肌肉形态和功能的积极改变,从而增强日常生活中的功能性能。 (5–7)此外,抗药性培训可以产生有利的健康结果;对心血管系统产生积极影响,例如降低血压和休息心率。 (8–10);减少与非胰岛素依赖性糖尿病有关的风险因素 (11, 12); 防止骨质疏松 (13, 14)。 。 。

然而,人们知道,对锻炼方案缺乏坚持性是阻碍老年人,特别是那些没有活动生活方式和面临功能限制的老年人增加体育活动的障碍。 大量个人选择在群体基础上进行锻炼。 基于家庭的锻炼方案允许个人在家庭周围的个人氛围中锻炼,而无需旅行。 这帮助了个人,特别是在锻炼时间、设施无障碍和交通方面受到限制的个人,从而减少了体育活动的障碍。 (15)。 。 。

因此,这次简短审查的目的是,在初步简要讨论与年龄有关的结构变化和生理变化时,描述老年家庭抗药性培训的健康效益。

人体组成和人体测量

老龄化过程伴随着无脂肪质量的减少和进一步沉积在消化过程中,肥胖症已被证明是导致老年人残疾的根本原因 (16)肥胖,特别是中度肥胖,与慢性疾病的风险增加有关,这些疾病与丧失功能间接相关。 众所周知,身体脂肪量及其分布是糖尿病、高血压、高脂症和其他心血管疾病的强烈预测因素。 (17)最近,腰围(作为中央肥胖症的替代衡量标准)也显示与老年人的丧失能力有关。 (18)此外,两性的比较表明,与老年男子相比,老年妇女的残疾程度往往较高,使她们面临更大的身体残疾风险。 (19)。 。 。

在那些保持能量平衡以管理体重的老年人中,能量摄入量和营养量的减少会导致营养缺乏。 这尤其危及最脆弱的老年人。 对于这些个体来说,抵抗训练可以是一种有效的方法,可以增加能量消耗,降低脂肪质量,保持精瘦的体积,即代谢活性组织. (20, 21)大量研究调查了家庭抵抗训练对老年人身体组成的影响。 然而,这似乎有利于减少年龄对身体组成的不利影响。 长期研究 (22) 说明家庭抗药性训练维持了由安稳、超重和患有二类糖尿病(60-80岁)的男女体能抗药性训练引起的体质减退。 另一项研究也证实了这一积极影响。 (23)骨矿密度低的妇女利用加权带、弹性带和哑铃从家庭抵抗训练中受益。 他们能够保持身体组成并减少与年龄有关的改变。

四聚体雌性肌的萎缩和弱点是膝关节炎的一个特征. 因此,能够加强这一肌肉群体的锻炼方案对于改善功能、减少疼痛和残疾至关重要。 41名55至75岁患骨质炎的病人的结果显示,在6周内每周3次接受有监督的家居抵抗训练,导致跨区增加(4.3%)4倍 (24)此外,为期12个月的抵抗训练,加上有监督的体操课和家庭课,导致三脚架斜拉索区增加(12.2%) (25). Triceps surae 收缩与脚踝病理学有关. 已经证明阿喀琉斯的垂体收缩能把浮雕脚压从脚跟转移到脚前 (26),而老年男子的板块弹性比年轻组别弱,相对于肌肉体积的最大自愿收缩力降低 (25)此外,一项利用体重加橡胶管对身体组成和健康的老年男女脂肪分布进行12周非仪器抗药性训练的研究显示,腰围、腹部前脂肪厚度和大腿脂肪厚度以及大腿肌肉厚度的提高都明显下降。 然而,体重、脂肪质量和无脂肪质量在12周之后没有变化 (27)。 。 。

骨质矿物密度

众所周知,骨折的风险与骨折的衰老密切相关。 (28)在70岁以上的男子中,骨质损失比60岁以下的男子迅速2至4倍。 有趣的是,女性骨折最多(5%)发生在更年期之后的头几年,此后每年仍为2%至3%,而男性为1%至2%。 (29)。 。 。

实践证明,锻炼对最大限度地提高峰值骨质和减少骨折至关重要。 (30)然而,任何类型的运动都不会导致骨质改善。 在这种情况下,与有氧训练对骨质的影响有关的结果仍然值得商榷。 抵抗训练经常用来加强老年人的骨质。 阻力训练提供的骨骼上的机械应力被确定为造成骨骼增生的因子 (29)。 。 。

若干研究 (23, 28, 31–33) 关于家庭抵抗训练对骨质矿物密度的影响,发现有争议。 在激素疗法中对老年妇女进行为期2年的随机、有控制的试验表明,上下体中等强度的家庭抗药性训练导致BMD得到改善。 BMD和Trochanter BMD的总胎体运动改善的幅度分别为下体运动组1.5%和2.4%,上体运动组1.8%和2.5%。 调查结果表明,对中等强度抗药性培训有系统反应,而不是针对具体地点的反应。 这项研究的结果表明,温和强度的家用抗药性训练颠倒了骨折过程,改善了股骨BMD. (23)此外,与线舞和脚印运动相结合的居家式蹲床锻炼方案减少了绝经期后老年妇女的骨骼损失。 (33)。 。 。

相反,在经过12个月的家居体力训练,加上有氧训练和与骨质疏松有关的脊椎硬化症老年妇女的伸展后,骨骼颈部和脊椎骨骨骼没有显著改善。(32)类似地,下肢的强度培训与社区老年妇女的平衡和影响培训协调起来,对骨矿密度没有重大影响 (28)此外,经过30个月监督的居家影响培训对BMD没有重大影响。 尽管如此,观察到了对曲霉骨矿物质含量的积极影响。 此外,锻炼降低了与秋季有关的骨折频率 (31)。 。 。

功能能力

从概念上讲,身体健康是独立开展日常生活中没有早期疲劳的基本活动所需的体能。 衰老过程往往减少体能因素(强度、耐力、灵活性和灵活性),使老年人在日常工作和正常运作方面面临困难。 (34)然而,与丧失行为能力和丧失依赖性有关的生理障碍,使用准确的锻炼干预,是有可能逆转的。 (35)。 。 。

大量研究显示,兵力有了显著提高 (22, 24, 25, 33, 36–48)余额 (33, 35, 41, 43, 47)流动 (40, 46),灵活 (43, 47),灵活性 (47),耐力 (43)心血管健身 (37, 47)生活质量 (32, 36, 40, 49)和身体能力 (28, 35, 37, 39, 44–46, 48–50) 有各种家庭抵抗培训方案。

绝大多数研究都注重实力,因为它对老年人至关重要。 虽然体力下降不是造成身体性能下降的唯一因素,但它仍然是维持身体能力的最重要决定因素之一。 身体能力下降增加了护理家庭安置的机会。 虽然已经表明,力量的提高可以促进老年男女自发的体育活动 (21)。 。 。

一项为期10周的研究试图阐明身体性能和残疾程度较低的加强和改善之间的联系,表明实力与行动技能、速度和下降效力有着重大的关系。 有趣的是,在那些受到更大损害的人中观察到强力对椅子上升的重大影响。 (46)其结果清楚地表明,实力对老年人的功能能力产生了巨大影响。

对72名70岁以上的社区居住男子进行最小监督的居家抵抗训练,再加上平衡锻炼和一般体育活动,完全安全,并促使他们参加培训(97%),身体表现得到改善 (35)然而,在患有慢性阻塞性肺病的人中,短期主要是在家进行的渐进抵抗运动方案导致膝盖伸展器的强度略有提高,而且遵守率相对较低。 44%的参与者无法完成练习 (42)这些调查结果突出表明,必须查明那些影响针对不同人群的家庭抵抗培训方案的有效性和坚持性的关键因素。

元和心血管标记

众所周知,老年人极易出现诸如血脂性贫血等新陈代谢异常,这很可能是由于营养不良、不活动或老龄化过程本身造成的。 然而,肥胖症、糖尿病和其他代谢性疾病导致糖尿病。 (51)这些风险因素加上高血压可能与心血管结构和功能的某些异常有关,如试管僵硬和内皮功能受损。 骨骼肌被称为代谢活性组织,也是休息代谢率的强烈决定因素. 因此,假定抗药性训练和随后肌肉质量的增量可减少多种心血管和代谢风险因素。 (52)。 。 。

元分析 (53) 指出抗药性培训提高了脂质特征。 此外,研究结果支持对患有二型糖尿病的老年患者进行抗体血糖控制培训的积极影响。 这里的问题是,当监督的演习培训被取消时,这些有利的改进是否仍然存在。 (22)此外,80%以上的糖尿病患者患有肥胖症。 事实表明,相当多的肥胖者对其外表感到不安,这可能导致参与社区活动的人数减少。 因此,家庭抗药性培训可以是跟踪和维持老年人专用标记的长期改进的自觉办法 (36)。 。 。

非糖尿病老年人利用体重和橡胶管锻炼进行家居抵抗训练,提高了脂质特征和血压。 经过12周的培训,HDL-C增加,Triglyceride减少,HbA1个C 观察到糖尿病血压(27)另一种在家中进行11次耐药演习的短期培训方案显示,老年人的HDL-C(60±1对62±1毫克/dl)和triglyceride(115±5对106±4毫克/dl)有显著改善。 然而,在总胆固醇、血浆葡萄糖、胰岛素或HbA方面没有明显变化。1个C (54)。 。 。

为期6个月的健身耐药训练,然后是家居式设置,并没有改变禁食的血糖,血清胰岛素和胰岛素敏感性. 此外,HbA减少1个C 在以体操为主的训练之后,没有适当地使用以家庭为基础的训练。 提交人认为,遵守率下降、锻炼体积和强度下降,可算作抑制性因素,不利于家庭训练提高甘油控制的效果。 (22)。 。 。

结论

虽然家庭抗药性培训对提高体能的诸多好处都有详细记载,但这种对老年人身体组成、骨质矿物质密度、新陈代谢概况和心血管风险因素的这种设定的有效性还需要进一步研究。 在多数情况下,老年人对家庭培训进行了良好的培训。 虽然许多老年人在家里受到限制,无法使用锻炼设施。 对他们来说,在家中的抵抗训练为改变他们的生活方式提供了迷人的选择。 集体而言,适当设计的家庭抗药性培训可以作为一种成本效益干预,减少甚至扭转与年龄有关的生理功能下降,改善身体和生理功能以及日常生活活动中的依赖性,减少与摔倒有关的骨折,并最终提高老年人的生活质量。

声明

作者贡献（CRediT）
所有作者对全部 14 项 CRediT 角色贡献均等（Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing）。
资助

Funding information was not reported in the published version of this article.

利益冲突
A conflict of interest statement was not reported in the published version of this article.
伦理批准
Ethics committee approval was not required for this article, as it is based on previously published literature and does not involve human participants, patient data or animals.
数据可用性
Data sharing is not applicable to this article as no new data were created or analysed in this study.

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Arazi H, Sharifi MI. Home-based Resistance Training Health Benefits for Older Adults: An Evidence-Based Approach to Enhancing the Physiological Functions. Ulutas Med J. 2017;3(4):65-71. doi:10.5455/umj.20170531035008

Arazi, H., & Sharifi, M. I. (2017). Home-based Resistance Training Health Benefits for Older Adults: An Evidence-Based Approach to Enhancing the Physiological Functions. The Ulutas Medical Journal, 3(4), 65–71. https://doi.org/10.5455/umj.20170531035008

Arazi, H. and Sharifi, M.I. (2017) 'Home-based Resistance Training Health Benefits for Older Adults: An Evidence-Based Approach to Enhancing the Physiological Functions', The Ulutas Medical Journal, 3(4), pp. 65–71. doi: 10.5455/umj.20170531035008.

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