基于SFT的衰弱老年人运动剂量—效应模型及干预策略研究

Frail significantly increases the incidence of disability and mortality in the elderly, so the realization of healthy aging for them is an important issue in the field of health management at present. Physical activity is one of the most effective interventions to slow frail. Previous studies of the project team shows that, the morbidity rate of frail in the elderly was 36.8%. And by intervening with exercises and nutrition, the skeletal muscle and physical strength of the elderly were improved, but the corresponding relationship between exercise intensity, exercise volume and effect is still not clear. Therefore, how to exercise scientifically and effectively, and how to locate the amount and intensity of exercise for the frail elderly are very important issues that need to be solved urgently. This current study designed a reasonable exercise dose intervention method, to explore the effects of exercise volume and intensity on muscle quality, physical fitness ，activity ability and sleep of the frail elderly, and to explain which exercise factor is more conducive to improving outcomes of frail elderly. The study aim to draw the response curves of exercise dose and effect indexes, construct and validate the exercise dose-effect model for the frail elderly, determine the propagable threshold of exercise dose for the frail elderly, and to evaluate the applicability of Senior Fitness Test in the exercise effect for the frail elderly. Meanwhile the current study aim to provide evidence for physical activity for in the frail elderly and provide research basis for formulating sports health policy for the elderly.

衰弱显著增加老年人失能发生率和死亡率，衰弱老年人实现健康老龄化是当前健康管理领域的重大课题。运动锻炼是延缓衰弱最有效的干预方式之一。项目组前期研究显示，我国老年人衰弱的患病率为36.8%，通过运动和营养干预，可明显增强衰弱老年人的骨骼肌，提高身体力量，但运动强度、运动量与效应的相对应关系并不明确。因此，衰弱老年人如何科学、有效地运动，运动量和强度如何定位，是一个目前亟需解决的重要问题。本研究通过设计合理的运动剂量干预方法，探讨量和强度对衰弱老年人肌肉质量、体适能、活动及睡眠的影响，解释哪种运动因素更有利于结局的改善，绘制运动剂量与各效应指标的反应曲线，构建并验证衰弱老年人运动剂量—效应模型，确定值得推广的衰弱老年人运动剂量的阈值，评价体适能测试(Senior Fitness Test, SFT)在衰弱老年人运动效应指标的适用性，为老年人的运动干预提供证据，为制定老年人运动健康政策提供研究基础。

衰弱显著增加老年人失能发生率和死亡率，运动锻炼是延缓衰弱最有效的干预方式之一。但运动强度、运动量与健康效应的相对应关系并不明确。因此，衰弱老年人如何科学、有效地运动，运动量和运动强度如何定位，是一个目前亟需解决的重要问题。本研究首先通过meta分析，显示抗阻力运动可以显著改善衰弱老年人的肌肉力量、肌肉耐力及身体功能，高强度抗阻力运动比低强度抗阻力运动效果更明显。本研究通过设计不同组别的运动量和运动强度的运动干预，结果发现下肢抗阻训练可作为安全有效的训练方案应用于衰弱前期老年人的康复锻炼，循序渐进达到增加下肢肌肉力量的作用。可穿戴设备应用于老年人健康状况的监测，可科学准确地评估运动锻炼的效果。不同运动剂量干预对衰弱老年人健康影响效果不同，运动量和运动强度都有利于肌力、体适能、睡眠指标的改善，但是强度是影响上述健康指标的主要因素。通过绘制运动剂量与各效应指标的反应曲线，明确抗阻训练与衰弱老年人的肌力和体适能存在剂量效应关系。中等或以上运动强度、中等或以上运动量的运动训练可为衰弱老年人肌力和体适能的改善带来较大效益，同时小强度及小运动量的训练也可产生积极的健康效应，体现在对心理健康和降低疾病风险的积极效应方面。基于本研究结果，探索移动健康（Mobile-Health）运动管理关键技术的应用，对中国老年人群延缓衰老、维护健康功能、促进健康老龄化具有重要的现实意义，同时具有良好的转化前景和经济适用性。