臺灣博碩士論文加值系統

背景與目標：肌少症是因年齡增加導致的肌肉質量減少、肌肉力量衰退與身體活動功能限制的疾病。若特別針對肌少症的三項診斷指標：肌肉質量、肌力與身體活動功能表現，目前仍缺乏各種運動療效之間的比較文獻。本篇研究的目的即採用系統性回顧與網絡統合分析，比較阻力訓練、耐力訓練與全身震動系統於治療老年人肌少症之成效。
方法：收集並分析阻力訓練、耐力訓練與全身震動系統的隨機對照試驗，摘錄其中訓練前與訓練後之肌肉質量、肌力與身體活動功能之數據，對象為六十歲以上的老人。以廣義線性混合模型進行網絡統合分析，並以直接證據與間接證據呈現混合治療型比較之結果。
結果：共收錄31篇隨機對照試驗，1405名六十歲以上老人被收錄(年齡介於60歲與92歲)。肌力在阻力訓練組與無運動介入組之間達到顯著差異，經由阻力訓練後的肌力較無運動組別增加12.8公斤 (95% 信賴區間 8.54 至 17.0公斤)。身體活動功能則在阻力訓練組與無運動介入組、全身震動系統與無運動介入組達到顯著差異[平均值分別是2.63次 (95% 信賴區間 1.34 至 3.93次) 與2.07次 (95% 信賴區間 0.49至3.65次)]。但肌肉質量在各組的直接比較或間接比較皆無顯著差異。
結論：若使用肌少症的診斷指標來評估老人的運動效益，阻力訓練可顯著增加老人的肌力與身體活動功能，而全身震動系統可顯著改善老人的身體活動功能。但研究結果卻顯示三種運動介入方式無法顯著增加肌肉質量。

Background and Objectives: Sarcopenia is an age-related loss of muscle mass, muscle strength, and physical performance. Few studies have examined the relative benefits of resistance training, endurance training, and whole-body vibration through the simultaneous consideration of three diagnostic criteria: muscle mass, muscle strength, and physical performance. The purpose of this systemic review and network meta-analysis was to analyze the effects of resistance training, endurance training, and whole-body vibration on changes in muscle mass, muscle strength, and physical performance through the evaluation of lean body mass, leg extension strength, and chair-stand tests in elderly people.
Methods: We combined evidence from all randomized controlled trials comparing resistance training, endurance training, and whole-body vibration with usual care among adults aged at least 60 years. The effects of exercises and usual care on muscle mass, muscle strength, and physical performance were examined. We performed a mixed treatment comparison by using generalized linear mixed models for the network meta-analysis.
Results: Thirty-one randomized controlled trials involving 1405 participants were included (age range, 60–92 years). Muscle strength enhancement was greater for resistance training compared with usual care [12.8 (95% CI 8.54 to 17.0)]. Physical performance enhancement was greater for resistance training compared with usual care, and whole-body vibration was greater compared with usual care [2.63 (95% CI 1.34 to 3.93), and 2.07 (95% CI 0.49 to 3.65)]. No significant difference was observed regarding changes in lean body mass.
Conclusion: Resistance training is beneficial for elderly people with outcome indicators of sarcopenia; specifically, it enhances muscle strength and physical performance. Resistance training and whole-body vibration were the two most effective exercise interventions in terms of physical performance. However, no statistically significant results were observed for resistance training, endurance training, and whole-body vibration concerning increases in muscle mass.

口試委員會審定書 II
誌謝 III
中文摘要 IV
英文摘要 VI
CHAPTER 1 INTRODUCTION 1
1.1 Sarcopenia 1
1.1.1 Definition, prevalence and causes of sarcopenia 1
1.1.2 Consequences of sarcopenia 3
1.1.3 Interventions of sarcopenia 4
1.2 Resistance training 5
1.3 Endurance training 6
1.4 Whole body vibration 7
1.5 Review of three exercises 9
1.5.1 Resistance training 9
1.5.2 Endurance training 10
1.5.3 Whole body vibration 11
CHAPTER 2 STUDY GAP 13
CHAPTER 3 MATERIALS AND METHODS 14
3.1 Identification of studies 14
3.2 Selection of sample studies 14
3.3 Data extraction and bias assessment 16
3.4 Data synthesis and analysis 17
3.4.1 Relative treatment effects 17
3.4.2 Methods for direct and indirect comparisons 18
3.4.3 Relative treatment ranking 19
3.4.4 Statistical heterogeneity and inconsistency 20
CHAPTER 4 RESULTS 21
4.1 Muscle mass: Lean body mass 23
4.2 Muscle strength: Leg extension strength 24
4.3 Physical performance: chair-stand test 25
4.4 Publication bias 26
4.5 Statistical heterogeneity and Inconsistency 27
CHAPTER 5 DISCUSSION 28
5.1 Comparison with previous studies 28
5.1.1 Muscle mass 28
5.1.2 Muscle strength 29
5.1.3 Physical performance 30
5.2 Preservation of muscle mass and improvement of muscle strength 31
5.3 Improvement of muscle strength and physical performance 31
5.4 Improvement of muscle strength in the elderly with heart disease 32
5.5 Estimation the benefits of endurance training on physical performance 33
5.6 Public health issue and clinical implication 34
5.7 Strength and limitation 35
5.8 Direction of future research 35
CHAPTER 6 CONCLUSION 37
CHAPTER 7 REFERENCES 38

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