| Objectives:Nowadays,aging of population has become an important social problem among countries all over the world,especially for developing countries,the procession of aging is closely related to economic development.In China,the number of the old adult population has increased dramatically,meanwhile health is the basic demand of people's life,so how to actively improve the physical and mental health of the elderly and to promote the extension of healthy life expectancy have become a key issue that needs to be solved.According to the report released by WHO,there are more than 300,000 people dying of falling injury every year in the world,and more than half of them are over 60 years older.In our country,40 million elderly people fall down every year,and falling has become the leading killer of people over 60 years older.Falling is a serious threat to the health of the elderly,in addition to causing death among the elderly,it can also lead to a great deal of disability.Falling increases the burden of medical services and health costs,and affects the mental health.For example,the fear after falling down may reduce the physical activity of the elderly,then decline the quality of life.Issued by the State Council in 2016,"The program" of "Healthy China 2030" focuses on key issues such as health risk factors controlling and the fitness servicing of elderly.Therefore,how to effectively prevent the elderly from falling and improve the healthy living standard of the elderly are particularly important,and they have great social and economic value.Epidemiological studies suggest that the main risk factors for falling in the elderly group are muscle weak,decrease in physical activity,cognitive impairment,and so on.At the same time,exercise has a good health effect on the muscle function and physical activity of the elderly.Under the background of "Exercise is Medicine",taking exercise intervention as a means of health promotion has attracted more and more attention.Randomized controlled trials confirmed that reasonable exercise could effectively improve the muscle function and physical activity of the elderly.Elastic band has the advantages of cheap price,easy to use,simple and safe operation.So using elastic band to carry out progressive resistance training may have positive significance for the body component,strength and physical performance of the elderly.The purpose of this study was,by feasibility trail and a randomized controlled trial,to observe the effects of progressive resistance training with elastic band on the body component,strength and physical performance of elderly.Methods:1 Literature StudyBased on datebase of CNKI,WOS,PUBMED,and so on,by using tools of scientific knowledge map software(CiteSpace V)to visualize the research hotspots and trend.2 Trial StudyThis thesis included two studies: a feasibility study(Study one)and randomized controlled trial(Study two)of training program.(1)Study on the feasibility of intervention program: A validation study was conducted to initially test the feasibility,which used a single group repeated-measures design.It recruited 14 healthy elderly people(79.14±6.99 yrs)in the community to take part in a resistance training with elastic band for 4 weeks(3 times a week,each time 60min).The intervention mainly includes 8 movements(squat,hip abduction,knee extension,chest up,seated row,elbow flexion,shoulder abduction,plantar flexion).The exercise intensity was medium,2 groups for each action,8-12 times for each group.All outcome measures were undertaken at baseline and post-intervention,including physical performance,physical condition,sleep quality and quality of life.(2)Randomized controlled trials: A 12-week randomized controlled trial(RCT).Ninety-five elderly persons were randomly divided into two groups:47 persons in Intervention group(PRTG,73.45±7.45yrs),48 persons in control group(CG,71.47±6.1yrs).CG subjects maintain their original lifestyle,and PRTG subjects undergo 12-weeks progressive resistance training with elastic band.Exercise schedule was based on study 1,adding a lower limb exercise(hip extension),the sequence of actions was:squat,hip abduction,hip extension,knee extension,chest up,seated row,elbow flexion,shoulder abduction,plantar flexion.The exercise intensity was gradual,from low to medium to high intensity,2 groups for each action,8-12 times for each group.All outcome measures were undertaken at baseline and post-inter,concluding Body Component as Lean Mass,Fat Mass;Isokinetic muscle strength of hip,knee and ankle for peak torque,average power and endurance ratio of hip joint 90°/s,knee joint 90°/s,and ankle joint 180°/s;and physical performance for Reaction time,10 m timed walk,Functional reach test(FR),Timed Up & Go test(TUG),Berg balance scale(BBS),WIN-POD balance system test.Results:(1)The results of feasibility study showed that: During the 4-week resistance training with elastic band,all subjects expressed satisfaction(100%)with the intervention plan.There was no adverse event.After intervention,the physical condition,physical performance and sleep quality of the participants were significantly improved.Such as left hand grip strength,reaction time,10 m timed walking,FR and sleep quality(P<0.05).(2)Study 2: In a 12-week randomized controlled trial,participants in PRTG had an average attendance of 32 sessions(88.9%).All data are based on the intentionality analysis principle,and the results are as follows:1)Body component: Compared with CG,after 12-week training intervention,the subjects with PRTG improved significantly in LM,and the degree of change was significantly difference between groups(P=0.031).There was no significant difference in LM test results in CG participants.There was no significant change in FM in PRTG subjects.2)Isokinetic muscle strength: After 12-week intervention,compared with CG,PRTG subjects significantly increased in peak torque of 90°/s flexor of hip joint,peak torque of 90°/s flexor of knee joint,180°/s extensor endurance ratio of ankle joint,180°/s flexor endurance ratio of ankle joint(P<0.05).The average power of the 180°/s extensor in the ankle joint of the PRTG participants was significantly higher than the baseline level(t=-4.656,P<0.001).3)Physical performance: After 12-week training intervention,compared to CG,PRTG subjects were significantly improved in Reacting time,TUG,FR(P=0.022,P=0.014,P=0.005);The degree of improvement about average sway speed of X(Y)axis,average deviation of X(Y)axis in PRTG subjects who are under single(double)foot standing and eyes closing situation is better than those of CG subjects(P=0.034,P<0.001,P<0.001).And BBS score,average sway deviation of Y(X)axis in PRTG subjects who are under bipedal foot standing and eyes(open)closing situation were significantly better than those of the subjects at baseline level(P<0.05).Conclusions:Findings form the thesis had showed that a 12-week progressive resistance training with elastic bands could improve body component of the elderly,especially the lean mass.And it was also effective for promoting Isokinetic muscle strength of the lower extremity joints.In addition,the intervention program has a certain effect on the benefits of physical performance.During the implementation of the intervention,all participants showed a high degree of compliance and satisfaction with the training arrangements,and no adverse event occurred.Therefore,progressive resistance training with elastic bands may be used as an effective method to prevent the elderly from falling down.This study is only a preliminary research of the effect,biological,psychological indicators and long-term follow-up study should be designed to explore the internal mechanism and observe the sustainability of the effects. |
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