Review von LIU und LATHAM. / Quelle: s.u.
Abstract
Background
Muscle
weakness in old age is associated with physical function decline.
Progressive resistance strength training (PRT) exercises are designed to
increase strength.
Objectives
To assess the effects of PRT on older people and identify adverse events.
Search methods
We
searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized
Register (to March 2007), the Cochrane Central Register of Controlled
Trials (
The Cochrane Library 2007, Issue 2),
MEDLINE (1966 to May 01, 2008), EMBASE (1980 to February 06 2007),
CINAHL (1982 to July 01 2007) and two other electronic databases. We
also searched reference lists of articles, reviewed conference abstracts
and contacted authors.
Selection criteria
Randomised controlled trials reporting physical outcomes of PRT for older people were included.
Data collection and analysis
Two review authors independently selected trials, assessed trial quality and extracted data. Data were pooled where appropriate.
Main results
One
hundred and twenty one trials with 6700 participants were included. In
most trials, PRT was performed two to three times per week and at a high
intensity. PRT resulted in a small but significant improvement in
physical ability (33 trials, 2172 participants; SMD 0.14, 95% CI 0.05 to
0.22). Functional limitation measures also showed improvements: e.g.
there was a modest improvement in gait speed (24 trials, 1179
participants, MD 0.08 m/s, 95% CI 0.04 to 0.12); and a moderate to large
effect for getting out of a chair (11 trials, 384 participants, SMD
-0.94, 95% CI -1.49 to -0.38). PRT had a large positive effect on muscle
strength (73 trials, 3059 participants, SMD 0.84, 95% CI 0.67 to 1.00).
Participants with osteoarthritis reported a reduction in pain following
PRT(6 trials, 503 participants, SMD -0.30, 95% CI -0.48 to -0.13).
There was no evidence from 10 other trials (587 participants) that PRT
had an effect on bodily pain.
Adverse events were poorly recorded but
adverse events related to musculoskeletal complaints, such as joint pain
and muscle soreness, were reported in many of the studies that
prospectively defined and monitored these events. Serious adverse events
were rare, and no serious events were reported to be directly related
to the exercise programme.
Authors' conclusions
This
review provides evidence that PRT is an effective intervention for
improving physical functioning in older people, including improving
strength and the performance of some simple and complex activities.
However, some caution is needed with transferring these exercises for
use with clinical populations because adverse events are not adequately
reported.
Plain language summary
Progressive resistance strength training for improving physical function in older adults
Older
people generally lose muscle strength as they age. This reduction in
muscle strength and associated weakness means that older people are more
likely to have problems carrying out their daily activities and to
fall.
Progressive resistance training (PRT) is a type of exercise where
participants exercise their muscles against some type of resistance that
is progressively increased as their strength improves. The exercise is
usually conducted two to three times a week at moderate to high
intensity by using exercise machines, free weights, or elastic
bands.This review sets out to examine if PRT can help to improve
physical function and muscle strength in older people.
Evidence
from 121 randomised controlled trials (6,700 participants) shows that
older people who exercise their muscles against a force or resistance
become stronger. They also improve their performance of simple
activities such as walking, climbing steps, or standing up from a chair
more quickly. The improvement in activities such as getting out of a
chair or stair climbing is generally greater than walking speed.
Moreover, these strength training exercises also improved older people's
physical abilities, including more complex daily activities such as
bathing or preparing a meal. PRT also reduced pain in people with
osteoarthritis. There was insufficient evidence to comment on the risks
of PRT or long term effects.
Quelle: The Cochrane Library /
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002759.pub2/abstract
Reprint / pdf / online im internet - Zugriff vom 06.10.2012:
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