The effectiveness of digital technology-based Otago Exercise Program on balance ability, muscle strength and fall efficacy in the elderly: a systematic review and meta-analysis.
IF 3.5 2区 医学Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
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引用次数: 0
Abstract
Objective: To explore the impact of the digital implementation of the Otago Exercise Program (OEP) on balance ability (static and dynamic), muscle strength, and fall efficacy in elderly people; and analyze different potential influencing factors in subgroups to find the most suitable training plan.
Methods: EBSCO, PubMed, Web of Science, and China Knowledge Network databases (core) were searched up to August 1, 2023. Experimental studies of implementing OEP based on digital technology to improve outcomes related to falls in the elderly were included. Bias risks were assessed using the Cochrane collaboration tool. Meta-analysis was performed to assess the pooled effect of balance ability (static and dynamic), muscle strength, and fall efficacy using a random effects model. Subgroup analyses were conducted to examine the potential modifying effects of different factors (e.g., training period, frequency, duration, age).
Results: Twelve articles were included from the literature, including 10 randomized controlled trials, one single-group quasi-experimental study, and one case report. Digital technologies used in the studies were categorized into three types: (1) online interventions (Zoom, WeChat), (2) recorded videos (via computers, TVs, DVDs), and (3) wearable technologies (motion sensors, augmented reality systems). The implementation of OEP based on digital technology showed significantly improved on static balance (SMD = 0.86, 95% CI 0.35-1.37), dynamic balance (SMD = 1.07, 95% CI 0.90-1.24), muscular strength (SMD = 0.43, 95% CI 0.17-0.69), and fall efficacy (SMD=-0.70, 95% CI -0.98, -0.41); Subgroup analysis by period '≥12 weeks', frequency '≥3 times/week', and duration '≤45 minutes per session', respectively, showed significant improvements on static balance (SMD = 0.73, 95% CI 0.21-1.25; SMD = 0.86, 95% CI 0.35-1.37; SMD = 1.10, 95% CI 0.31-1.89), dynamic balance (SMD = 1.08, 95% CI 0.88-1.28; SMD = 1.01, 95% CI 0.93-1.27; SMD = 1.07, 95% CI 0.89-1.25), muscle strength (SMD = 0.43, 95% CI 0.10-0.75; SMD = 0.54, 95% CI 0.30-0.77; SMD = 0.53, 95% CI 0.19-0.87), and fall efficacy (SMD=-0.75, 95% CI -1.39, -0.11; SMD=-0.70, 95% CI -0.98, -0.41; SMD=-0.74, 95% CI -1.10, -0.39).
Conclusions: OEP implemented through digital technology effectively enhances static and dynamic balance, muscle strength, and self-efficacy in older adults. A training regimen of 12 weeks or more, with sessions occurring three or more times per week for 30 to 45 min, appears to be an effective approach for improving these outcomes based on the available evidence from the included studies. Future research should prioritize specific digital technologies and target populations, employing high-quality research designs to further explore these interventions, and consider new technologies such as wearables, to assess changes in fall prevalence.
目的:探讨数字化实施奥塔哥运动计划(OEP)对老年人平衡能力(静态和动态)、肌力和跌倒疗效的影响;并对不同的潜在影响因素进行分组分析,找出最适合的训练方案。方法:检索至2023年8月1日的EBSCO、PubMed、Web of Science和中国知识网核心数据库。包括基于数字技术实施OEP以改善老年人跌倒相关结果的实验研究。使用Cochrane协作工具评估偏倚风险。采用随机效应模型进行meta分析,评估平衡能力(静态和动态)、肌肉力量和跌倒疗效的综合效应。进行亚组分析,考察不同因素(如训练时间、频率、持续时间、年龄)的潜在修正效应。结果:共纳入文献12篇,其中随机对照试验10篇,单组准实验研究1篇,病例报告1篇。研究中使用的数字技术分为三类:(1)在线干预(Zoom, b微信),(2)录制视频(通过电脑,电视,dvd)和(3)可穿戴技术(运动传感器,增强现实系统)。基于数字技术的OEP实施在静态平衡(SMD= 0.86, 95% CI 0.35-1.37)、动态平衡(SMD= 1.07, 95% CI 0.90-1.24)、肌肉力量(SMD= 0.43, 95% CI 0.17-0.69)和跌倒效能(SMD=-0.70, 95% CI -0.98, -0.41)方面均有显著改善;按时间≥12周、频率≥3次/周和持续时间≤45分钟进行亚组分析,显示静态平衡有显著改善(SMD = 0.73, 95% CI 0.21-1.25;Smd = 0.86, 95% ci 0.35-1.37;SMD = 1.10, 95% CI 0.31-1.89),动态平衡(SMD = 1.08, 95% CI 0.88-1.28;Smd = 1.01, 95% ci 0.93-1.27;SMD = 1.07, 95% CI 0.89-1.25),肌力(SMD = 0.43, 95% CI 0.10-0.75;Smd = 0.54, 95% ci 0.30-0.77;SMD= 0.53, 95% CI 0.19-0.87)和跌倒疗效(SMD=-0.75, 95% CI -1.39, -0.11;Smd =-0.70, 95% ci -0.98, -0.41;Smd =-0.74, 95% ci -1.10, -0.39)。结论:通过数字技术实施的OEP有效地提高了老年人的静态和动态平衡、肌肉力量和自我效能感。根据纳入研究的现有证据,12周或更长时间的训练方案,每周进行3次或更多次,每次30至45分钟,似乎是改善这些结果的有效方法。未来的研究应优先考虑特定的数字技术和目标人群,采用高质量的研究设计来进一步探索这些干预措施,并考虑可穿戴设备等新技术来评估跌倒患病率的变化。
期刊介绍:
BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.