Sarcopenia interventions in long-term care facilities targeting sedentary behaviour and physical inactivity: A systematic review.

IF 8.9 1区 医学
Yihan Mo,Linghui Chen,Yuxin Zhou,Anna Bone,Matthew Maddocks,Catherine J Evans
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引用次数: 0

Abstract

BACKGROUND Sedentary behaviour and physical inactivity are independent risk factors for sarcopenia for long-term care facility residents. Understanding the components, mechanisms and context of interventions that target change in these risk factors can help optimize sarcopenia management approaches. This study aimed to identify, appraise and synthesize the interventions targeting sedentary behaviour and physical inactivity, construct a Theory of Change logic model, inform complex sarcopenia intervention development and identify areas for improvement. METHODS Eight electronic databases, including Embase and Web of Science, were searched for eligible interventional studies from inception until February 2024. Narrative synthesis was used. The Theory of Change was applied to develop a logic model presenting the synthesized results. A Cochrane risk of bias assessment tool was used for quality appraisal. RESULTS The study included 21 articles involving 1014 participants, with mean ages ranging from 72.5 to 90.4 years. The proportion of female participants ranged from 8.0% to 100.0%. The applied sarcopenia diagnosis criteria varied, including those of the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People. The overall risk of bias in the included studies was moderate. Interventions primarily targeted physical inactivity, with resistance training being the most common intervention type. The reporting of intervention adherence was insufficient (only 11 out of 21 included studies provided adherence reports), and adherence overall and by intervention type was not possible to discern due to inconsistent criteria for high adherence across these studies. Four categories of intervention input were identified: educational resources; exercise equipment and accessories; monitoring and tailoring tools; and motivational strategies. Intervention activities fell into five categories: determining the intervention plan; educating; tailoring; organizing, supervising, assisting and motivating; and monitoring. While sarcopenia-related indicators were commonly used as desired outcomes, intermediate outcomes (i.e., sedentary time and physical activity level) and other long-term outcomes (i.e., economic outcomes) were less considered. Contextual factors affecting intervention use included participant characteristics (i.e., medical condition and education level) and intervention provider characteristics (i.e., trustworthiness). CONCLUSIONS The findings led to the development of a novel logic model detailing essential components for interventions aimed at managing sarcopenia in long-term care facilities, with a focus on addressing sedentary behaviour and physical inactivity. Future sarcopenia interventions in long-term care facilities should fully attend to sedentary behaviour, enhance adherence to interventions through improved education, monitoring, tailoring and motivation and establish an agreed standard set of outcome measures.
针对长期护理设施中的久坐行为和缺乏运动的 "肌肉疏松症 "干预措施:系统回顾。
背景对于长期护理机构的住户来说,久坐不动和缺乏运动是导致肌肉疏松症的独立风险因素。了解针对改变这些风险因素的干预措施的组成部分、机制和背景,有助于优化肌肉疏松症的管理方法。本研究旨在识别、评估和综合针对久坐行为和缺乏运动的干预措施,构建一个 "变化理论 "逻辑模型,为复杂的肌肉疏松症干预措施的开发提供信息,并确定需要改进的领域。方法检索了八个电子数据库,包括 Embase 和 Web of Science,以查找从开始到 2024 年 2 月期间符合条件的干预研究。采用叙事综合法。运用 "变革理论 "建立了一个逻辑模型,展示了综合结果。研究共纳入 21 篇文章,涉及 1014 名参与者,平均年龄为 72.5 岁至 90.4 岁。女性参与者的比例从 8.0% 到 100.0% 不等。应用的肌肉疏松症诊断标准各不相同,包括亚洲肌肉疏松症工作组和欧洲老年人肌肉疏松症工作组的标准。纳入研究的总体偏倚风险为中等。干预措施主要针对缺乏运动的人群,阻力训练是最常见的干预类型。对干预措施依从性的报告不足(21 项纳入研究中仅有 11 项提供了依从性报告),由于这些研究对高依从性的标准不一致,因此无法对整体依从性和干预类型的依从性进行判别。研究确定了四类干预投入:教育资源、运动设备和附件、监测和定制工具以及激励策略。干预活动分为五类:确定干预计划;教育;量身定制;组织、监督、协助和激励;以及监测。虽然与肌肉疏松症相关的指标通常被用作预期结果,但中间结果(即久坐时间和体力活动水平)和其他长期结果(即经济结果)则较少被考虑。影响干预措施使用的环境因素包括参与者的特征(即医疗条件和教育水平)和干预措施提供者的特征(即可信度)。结论:研究结果促成了一个新颖的逻辑模型,详细说明了旨在管理长期护理设施中肌肉疏松症的干预措施的基本组成部分,重点是解决久坐行为和缺乏运动的问题。未来在长期护理机构中开展的肌肉疏松症干预措施应充分关注久坐行为,通过改进教育、监测、量身定制和激励措施来提高干预措施的依从性,并建立一套一致认可的标准结果衡量标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine
自引率
12.40%
发文量
0
期刊介绍: The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
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