由于COVID-19封锁,肥胖老年人从健身房过渡到家庭阻力训练的经历和结果:一项随机对照试验的混合方法分析

IF 3.8 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Costas Glavas, Jakub Mesinovic, Anoohya Gandham, Mavil May Cervo, Carrie-Anne Ng, Peter R Ebeling, Elena S George, Robin M Daly, Belinda R Beck, Paul Jansons, David Scott
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引用次数: 0

摘要

背景:有监督的基于健身房的高强度阻力和冲击训练(HiRIT)可以增强身体功能和肌肉力量,但老年人可能面临坚持HiRIT的挑战,如有限的设施和缺乏交通工具,需要转向无监督的家庭锻炼。本研究的目的是探索在COVID-19封锁期间需要从有监督的健身房HiRIT过渡到无监督的家庭阻力训练(RT)和有氧训练(AT)的肥胖老年人的经验和观点。次要目的是比较12周后需要过渡到家庭锻炼(“HOME”)和能够继续在健身房锻炼(“GYM”)的参与者的身体组成和身体功能的变化。方法:在为期12周的运动和饮食减肥试验中,从以健身房为基础的HiRIT干预组招募了30名肥胖老年人(60-89岁)。由于COVID-19封锁,13名(43%)参与者被转移到HOME。HOME参与者被规定进行体重RT和AT锻炼,同时保持减肥干预。8名HOME参与者在干预后完成了半结构化访谈。定量结果包括运动坚持度、身体成分和身体功能与GYM参与者进行比较。结果:参与者对HOME项目的经验和看法包括各种因素,包括可及性、问责制、保持身体活动水平、动机、卫生保健专业人员的支持、对远程卫生视频会议的开放性、参与、缺乏设备、监督和有组织的例行程序。两组体重均显著降低(mean±SD;GYM: -4.4±0.4 kg, HOME: -6.2±1.2 kg),但与GYM相比,HOME表现出更大的脂肪量损失(平均差值:-3.1 kg, 95% CI: -6.0, -0.3),具有较大的效应量(d = 0.8)。结论:肥胖的老年人从有监督的健身房运动过渡到无监督的家庭运动,面临着支持和挑战的经历。虽然可及性和问责制增强了他们的参与度,但一些参与者面临与有限的设备和数字支持相关的困难,这强调了家庭锻炼干预措施有待改进的领域。在家锻炼可能对饮食减肥有效,但还需要进一步的研究来确定是否对身体机能有任何有益的影响。试验注册:澳大利亚新西兰临床试验注册中心(ANZCTR) ACTRN12618001146280;注册日期:12/07/2018。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experiences and outcomes of older adults with obesity transitioning from gym- to home-based resistance training due to COVID-19 lockdowns: a mixed-methods analysis of a RCT.

Background: Supervised gym-based high-intensity resistance and impact training (HiRIT) can enhance physical function and muscle strength, but older adults may face challenges affecting adherence to HiRIT, such limited access to facilities and lack of transportation, necessitating a shift towards unsupervised home-based exercise. The aim of this study was to explore experiences and perspectives of older adults with obesity who were required to transition from supervised gym-based HiRIT to unsupervised home-based resistance training (RT) and aerobic training (AT) during COVID-19 lockdowns. Secondary aims were to compare changes in body composition and physical function after 12 weeks between participants required to transition to home-based exercise ("HOME") and those who were able to continue gym-based exercise ("GYM").

Methods: Thirty older adults (60-89 years) with obesity were enrolled from the gym-based HiRIT intervention arm of a 12-week exercise and dietary weight loss trial. Thirteen (43%) participants were transitioned to HOME due to COVID-19 lockdowns. HOME participants were prescribed bodyweight RT and AT exercises, while maintaining the weight loss intervention. Eight HOME participants completed semi-structured interviews post-intervention. Quantitative outcomes including exercise adherence, body composition and physical function were compared to GYM participants.

Results: Participants' experiences and perspectives regarding the HOME program encompassed various elements including accessibility, accountability, maintaining physical activity levels, motivation, support from health care professionals, openness to telehealth videoconferencing for support, engagement, lack of equipment, supervision and a structured routine. Both groups had significant reductions in body mass (mean ± SD; GYM: -4.4 ± 0.4 kg, HOME: -6.2 ± 1.2 kg), but HOME demonstrated greater losses in fat mass (mean difference: -3.1 kg, 95% CI: -6.0, -0.3) compared with GYM represented by a large effect size (d = 0.8). Physical function outcomes improved only in GYM (all P < 0.05).

Conclusions: Older adults with obesity transitioning from supervised gym-based to unsupervised home-based exercise face both supportive and challenging experiences. While accessibility and accountability enhanced their engagement, some participants faced difficulties related to limited equipment and digital support, emphasising areas for improvement in home-based exercise interventions. Home-based exercise may be effective for supporting dietary weight loss, but further research is needed to determine if there are any beneficial effects on physical function.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001146280; date of registration: 12/07/2018.

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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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