虚弱高齢者の運動：系統的レビュー

虚弱（Frailty）高齢者に対する運動療法の効果をみた系統的レビューを紹介します。

Katharine CM Nash: The effects of exercise on strength and physical performance in frail older people: a systematic review. Reviews in Clinical Gerontology, Available on CJO 2012 doi:10.1017/S0959259812000111

下記HPで全文見れるかもしれません。
http://journals.cambridge.org/download.php?file=%2F56498_5A1F2208C1D17A09F4880976D26EF37F_journals__RCG_S0959259812000111a.pdf&code=48f5e6800244b5bd417e3dfa463249ff&cover=Y

13論文の系統的レビューとなっています。結果として、Frailty（虚弱）の定義、介入、アウトカム、結果に違いはありますが、運動や身体活動プログラム（特に中等度の負荷で複数の要素のプログラム）は安全で筋力と機能を改善させていました。ただし、複数の併存疾患を有する高度の虚弱高齢者は除いてです。

複数の併存疾患を有する高度の虚弱高齢者は、低栄養を合併しているために、運動療法のみでは改善が難しいという可能性があります。この場合、高度の虚弱高齢者や障害者では、運動療法単独ではなく栄養療法を併用したリハ栄養のほうが、より効果を出せるかもしれません。

Summary
The proportion of older people becoming frail will increase with the expanding older population. Apart from poor health, frailty is associated with loss of strength and functional dependency. Building on previous work in this area, this review investigates the effectiveness, sustainability and adverse effects of exercise interventions on muscle strength and physical performance in frail older people. Randomized controlled trials reporting physical outcomes in frail older people were identified from seven electronic databases. Thirteen trials involving 1652 participants met the inclusion criteria. There was wide heterogeneity in degree of frailty, types of intervention, outcome measures and results. However, evidence from this review suggests that exercise and some physical activity programmes, particularly moderate intensity and multi-component programmes, are safe and can improve strength and function in the majority of frail older people except highly frail individuals with multiple co-morbidities. There was limited evidence on transferability of improvements into everyday life, and sustainability could not be determined.