运动干预对2型糖尿病老年患者步行功能影响的Meta分析

doi:10.16460/j.issn1008-9969.2020.11.040

摘要/Abstract

摘要： 目的系统评价运动干预对2型糖尿病老年患者的步行功能的影响。方法计算机检索数据库PubMed、Web of Science、Cochrane Library、EMbase、CBM、中国知网、万方、维普,自建库至2019年7月1日,数据库中有关运动干预对2型糖尿病老年患者步行功能影响的随机对照试验,并追朔纳入研究的参考文献。按照纳入排除标准、提取资料并评价纳入研究的方法学质量后,采用RevMan5.3软件进行Meta分析。结果最终共纳入8篇文献,合计549例研究对象。Meta分析结果显示：运动能够减少2型糖尿病老年患者起立行走计时测试的时间,提高步行功能[MD=-1.63,95%CI（-1.83, -1.44）,P<0.01];运动干预能够提高2型糖尿病老年患者6 min步行的长度,提高步行耐力和速度[MD=68.72,95%CI（39.98, 97.45）,P<0.01],运动干预能够提高2型糖尿病老年患者2 min原地踏步的步数,提高下肢活动能力[MD=23.34,95%CI（19.28, 27.40）,P<0.01],运动干预能够提高2型糖尿病老年患者30 s座椅站立的次数,提高下肢力量[MD=3.69,95%CI（2.84, 4.55）,P<0.01]。结论运动干预可以改善2型糖尿病老年患者的步行功能。

关键词: 老年, 2型糖尿病, 运动干预, 步行功能, Meta分析

Abstract: Objective To systematically evaluate the effect of exercise on walking function of elderly patients with type 2 diabetes. Methods We search databases including PubMed, Web of Science, Cochrane Library, EMbase, CBM, CNKI, Wanfang and Weipu from the inception to July 1, 2019 for RCTs on the effect of exercise on walking function of elderly patients with type 2 diabetes. Meta analysis was performed using RevMan 5.3 software. Results Eight articles were finally included, with a total of 549 subjects. Meta-analysis results showed that exercise can shorten the time of standing walking time test and improve walking function [MD=-1.63, 95%CI(-1.83, -1.44), P<0.01] and can improve the length of 6-minute walk, walking endurance and speed [MD=68.72, 95%CI(39.98, 97.45), P<0.01]. Exercise can increase the number of steps of 2 minutes in situ, improve lower extremity mobility [MD=23.34, 95%CI(19.28, 27.40), P<0.01], increase the number of 30 s seat standing and improve lower limb strength [MD=3.69, 95%CI(2.84, 4.55), P<0.01]. Conclusion Exercise can improve walking function of elderly patients with type 2 diabetes.

Key words: elderly, type 2 diabetes, exercise, walking function, Meta-analysis

中图分类号:

刘敏, 刘安诺, 吴德全, 高宇, 陈国红, 朱桂月, 张萌, 马雯, 丁翠路. 运动干预对2型糖尿病老年患者步行功能影响的Meta分析[J]. 护理学报, 2020, 27(11): 40-45.

LIU Min, LIU An-nuo, WU De-quan, GAO Yu, CHEN Guo-hong, ZHU Gui-yue, ZHANG Meng, MA Wen, DING Cui-lu. Effect of Exercise on Walking Function of Elderly Type 2 Diabetic Patients：A Meta-analysis[J]. Journal of Nursing, 2020, 27(11): 40-45.

参考文献

[1] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J]. 中国实用内科杂志, 2018, 38(4):34-86.DOI:10.3760/cma.j.issn.1674-5809.2018.01.003.
[2] Sarodnik C, Bours SPG, Schaper NC,et al.The Risks of Sarcopenia, Falls and Fractures in Patients with Type 2 Diabetes Mellitus[J].Maturitas,2018(109):70-77.DOI:10.1016/j.maturitas.2017.12.011.
[3] Trierweiler H, Kisielewicz G, Hoffmann Jonasson T, et al.Sarcopenia: A Chronic Complication of Type 2 Diabetes Mellitus[J]. Diabetol Metab Syndr, 2018, 10(1):25. DOI:10.1186/s13098-018-0326-5.
[4] 段富贵. 下肢肌力/体重与老年人行走能力的相关性[J].中国老年学杂志,2018, 38(16):110-111.
[5] 谭恺,王军力,王玉龙.低风险老年人步行锻炼与跌倒关系的Meta分析[J].体育科学研究,2019,23(3):63-70.DOI:10.19715/j.tiyukexueyanjiu.2019.03.013.
[6] 李立,陈玉娟,翟凤鸣,等. 老年人不同运动形式下足底压力分布特征研究进展[J].中国老年学杂志,2011,31(16):3210-3212.DOI:10.3969/j.issn.1005-9202.2011.16.104.
[7] 吕俊. 70~79岁老年人体质测评指标的筛选[D].成都:成都体育学院,2018.
[8] 康丽. 计时起立-行走测试在老年人跌倒预测与风险评估中的应用价值[D].天津:天津医科大学,2017.
[9] Higgins JPT, Thomas J,Chandler J,et al.Cochrane Handbook for Systematic Reviews of Interventions[M]. 2nd Edition. Chichester (UK): John Wiley & Sons,2019.
[10] Xiao CM.Effects of Tai Chi Ball on Balance and Physical Function in Older Adults with Type 2 Diabetes Mellitus[J].J Am Geriatr Soc,2015,63(1):176-177.DOI:10.1111/jgs.13207.
[11] 裴丽. 快速健步走运动对老年2型糖尿病患者身体活动能力的影响[J].社区医学杂志,2016,14(23):66-68.
[12] Park SY.Effects on Training and Detraining on Physical Function, Control of Diabetes and Anthropometrics in Type 2 Diabetes; A Randomized Controlled Trial[J]. Physiother Theory Pract,2015,31(2):83-88.DOI:10.3109/09593985.2014.958265.
[13] Gallé F,Di Onofrio V,Miele A,et al.Effects of a Community-based Exercise and Motivational Intervention on Physical Fitness of Subjects with Type 2 Diabetes[J]. Eur J Public Health 2019,29(2):281-286.DOI:10.1093/eurpub/cky140.
[14] del Pozo-Cruz B, Alfonso-Rosa RM,del Pozo-Cruz J,et al.Effects of a 12-wk Whole-body Vibration Based Intervention to Improve Type 2 Diabetes[J]. Maturitas,2014,77(1):52-58.DOI:10.1016/j.maturitas.2013.09.005.
[15] Hsieh PL,Tseng CH,Tseng YJ.Resistance Training Improves Muscle Function and Cardiometabolic Risks But Not Quality of Life in Older People with Type 2 Diabetes Mellitus: A Randomized Controlled Trial[J]. J Geriatr Phys Ther, 2018,41(2):65-76.DOI:10.1519/JPT.0000000000000107.
[16] 谭思洁,张棣,李伟. 康复运动对老年2型糖尿病患者身体活动能力的影响[J]. 中国康复医学杂志, 2009(8):719-722.DOI:10.3969/j.issn.1001-1242.2009.08.015.
[17] Tsang T, Orr R,Lam P,et al.Health Benefits of Tai Chi for Older Patients with Type 2 Diabetes: The “Move It for Diabetes Study”-A Randomized Controlled Trial[J].Clin Interv Aging,2007,2(3):429-439.
[18] 杨帆,罗予,温子豪. 老年人步态及运动干预手段研究进展[J].当代体育科技,2017,7(25):201-202.DOI:10.16655/j.cnki.2095-2813.2017.25.201.
[19] 董宏,孟良,王荣辉.体育锻炼对中老年人群骨密度影响的Meta分析[J].北京体育大学学报,2016,39(3):58-65.
[20] Tabit CE,Chung WB,Hamburg NM.Endothelial Dysfunction in Diabetes Mellitus: Molecular Mechanisms and Clinical Implications[J].Rev Endocr Metab Disord,2010,11(1):61-74.DOI:10.1007/s11154-010-9134-4.
[21] Al-Shreef FM, Al-Jiffri OH.Bone Metabolism and Hand Grip Strength Response to Aerobic Versus Resistance Exercise Training in Non-insulin Dependent Diabetic Patients[J].Afr Health Sci,2015,15(3):896-901. DOI:10.4314/ahs.v15i3.25.
[22] 梁敏,王海牛,黄鹏,等.抗阻动对2型糖尿病糖脂代谢异常患者干预效果的系统综述和Meta分析[J].中国组织工程研究,2019,23(35):5718-5726.
[23] 袁爱国,刘辉文,雷雨.2型糖尿病有氧运动疗法的最新研究进展[J].中国康复医学杂志,2016,31(6):702-706.DOI:10.3969/j.issn.1001-1242.2016.06.021.
[24] 沈意娜,赵芳,周立新,等.对2型糖尿病患者运动相关临床实践指南的评价研究[J].中国护理管理,2018,18(6):755-761.DOI:10.3969/j.issn.1672-1756.2018.06.008.
[25] 马明,林强,秦洪云.六分钟步行试验与摄氧量的相关性研究[J].中国组织工程研究与临床康复,2009,13(50):9909-9912.DOI:10.3969/j.issn.1673-8225.2009.50.022.
[26] Stanaway FF, Gnjidic D, Blyth FM, et al.How Fast Does the Grim Reaper Walk? Receiver Operating Characteristics Curve Analysis in Healthy Men Aged 70 and Over[J]. BMJ,2011(343):d7679. DOI:10.1136/bmj.d7679.
[27] Sivaramakrishnan D, Fitzsimons C,Kelly P,et al.The Effects of Yoga Compared to Active and Inactive Controls on Physical Function and Health Related Quality of Life in Older Adults- systematic Review and Meta-analysis of Randomised Controlled Trials[J].Int J Behav Nutr Phys Act 2019,16(1):33.DOI:10.1186/s12966-019-0789-2.
[28] 张兆龙,覃林.基于跌倒效能系统评价Otago家庭运动预防老年人日常跌倒损伤的效果[J]. 中国康复医学杂志,2018, 33(2):200-205.DOI:10.3969/j.issn.1001-1242.2018.02.015.
[29] 沈小雨,章代亮,付慧,等.运动处方对老年2型糖尿病患者影响的研究进展[J].中国老年学杂志,2018,38(5):1270-1272.DOI:10.3969/j.issn.1005-9202.2018.05.095.
[30] 许可彩,于卫华.老年人功能性体适能的影响因素研究进展[J].护理学报, 2019, 26(13):34-37.DOI:10.16460/j.issn1008-9969.2019.13.034.
[31] Hill KD, Hunter SW, Batchelor FA, et al.Individualized Home-based Exercise Programs for Older People to Reduce Falls and Improve Physical Performance: A Systematic Review and Meta-analysis[J].Maturitas,2015,82(1):72-84.DOI:10.1016/j.maturitas.2015.04.005.
[32] Chapman A, Meyer C, Renehan E, et al.Exercise Interventions for the Improvement of Falls-related Outcomes Among Older Adults with Diabetes Mellitus: A Systematic Review and Meta-analyses[J]. J Diabetes Complications,2017,31(3):631-645.DOI:10.1016/j.jdiacomp.2016.09.015.
[33] Gomes MJ,Martinez PF,Pagan LU,et al.Skeletal Muscle Aging: Influence of Oxidative Stress and Physical Exercise[J].Oncotarget, 2017, 8(12):20428-20440.DOI:10.18632/oncotarget.14670.
[34] 李俊. 有氧运动对2型糖尿病大鼠血管炎症及SIRT1/NF-κB信号通路的影响[J].北京体育大学学报, 2018,41(5):57-63.

相关文章 15

[1]	焦雪萍, 王志稳, 韩舒羽. ICU老年患者躁动行为的干预研究进展[J]. 护理学报, 2025, 32(3): 38-42.
[2]	杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12.
[3]	陈玉英, 王海彦, 陈思颖, 杨雪娟. 老年人自立支援照护模式的照护技巧及启示[J]. 护理学报, 2025, 32(2): 31-36.
[4]	夏碧芸, 陈瑜, 吴彦妍, 胡雁. 降低经桡动脉冠状动脉介入术后老年患者桡动脉闭塞发生的循证实践[J]. 护理学报, 2025, 32(2): 37-43.
[5]	刘硕怡, 熊莉娟, 李凌, 王玉梅, 何嘉, 李鑫, 袁淑蕾, 郭雪琴, 王暘婧, 张慧娟. 老年住院患者衰弱预防及管理临床实践指南的质量评价及内容分析[J]. 护理学报, 2025, 32(2): 50-55.
[6]	闫亚铃, 乐美妮, 姚桃琴, 王雪莲, 姜建玲, 辛艺. 老年胃肠肿瘤患者围手术期衰弱管理方案的构建[J]. 护理学报, 2025, 32(2): 74-78.
[7]	谭丘羽, 邓一芯, 冀婉倩, 王冬华. 农村老年人自我刻板化与主观记忆抱怨在自我感知老化与痴呆恐惧间的链式中介效应[J]. 护理学报, 2025, 32(1): 56-61.
[8]	李雯欣, 涂惠, 张娜, 陈祎慧, 谢丽丽, 于浪琴. 运动干预改善心血管病患者运动恐惧的研究进展[J]. 护理学报, 2024, 31(9): 24-27.
[9]	叶香, 黎楷, 黄敏, 张倩, 李际敏, 刘荣珍, 孟敏, 朱少玉, 谢翠华. 对成年2型糖尿病患者基于移动APP+家属共管血糖的研究[J]. 护理学报, 2024, 31(9): 60-65.
[10]	丁心舒, 孙乐菲, 高伟, 鲁琦, 闫畅, 刘德山. 矛盾年龄歧视量表在社区老年人中的信效度检验[J]. 护理学报, 2024, 31(7): 12-16.
[11]	姚晨晨, 陈娟, 杨雷. 老年衰弱患者基于埃德蒙顿衰弱量表评估分层抗阻运动的效果观察[J]. 护理学报, 2024, 31(7): 73-78.
[12]	薛荣, 张开利, 陈保云, 马荣慧, 张雨欣. 中老年脑卒中患者多维衰弱发展轨迹及其影响因素研究[J]. 护理学报, 2024, 31(6): 6-12.
[13]	邓悦, 胡宇帆, 王冉, 张远星, 王芳, 袁萍, 陈璐. 老年患者接受远程医疗护理体验与需求质性研究的Meta整合[J]. 护理学报, 2024, 31(5): 50-55.
[14]	王薇, 周演铃, 薛文萍, 张淋淋, 林书球. 老年髋部骨折患者衰弱评估工具的范围综述[J]. 护理学报, 2024, 31(4): 42-47.
[15]	祁水林, 林桦, 邓锐颖, 李荣杰, 李若雨, 王凤廷. 老年皮肤瘙痒症患者非药物管理的最佳证据总结[J]. 护理学报, 2024, 31(3): 46-50.

Metrics

Viewed

Full text

Abstract

Cited

Shared