運動處方研究進展_《中國循證醫學雜志》

作者：

步斌 ^1,2 , 侯樂榮 ^1,2 ,  周學蘭 ³ , 韓海軍 ² , 李良剛 ^1,2 , 張超慧 ² , Maria Singh ⁴

1. 成都體育學院運動醫學系（成都 610041）；2. 四川大學體育科學研究所，四川大學公眾健康與社會發展研究所（成都 610041）；3. 海南師范大學體育系（海口 571158）；4. Health Science College, University of Sydney;

關鍵詞：

運動處方運動康復療法機能評定運動實驗隨機對照試驗

DOI：

10.7507/1672-2531.20100597

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　本文試圖通過對近半個世紀以來運動處方的產生及其發展過程，以及各階段的特點進行分析和評價，為運動處方、運動康復療法和機能評定在我國的普及應用提供理論和實踐依據。
方法　采用計算機網絡文獻和資料收集法，對Medlin via Ovid、PubMed、Sport Discus、CINAHL、CAM、EMbase和EBM Cochrane Database of SR 7個數據庫進行檢索，檢索詞為exercise prescription、physical fitness、exercise therapy、fitness assessment、exercise test、randomized，檢索時間均從建庫至2008年6月。然后對其中的隨機和非隨機對照研究，以及資料較全者納入分析討論。
結果　共檢索到318篇文獻，但其中涉及運動處方和機能評定的隨機對照試驗（RCT）僅有7篇，系統評價和Meta分析各1篇。我們對其中資料較全又有代表性的93篇文獻進行了系統分析討論。結果顯示：最早的運動處方和機能評定研究可以追溯到1950年，其發展與運動康復療法的發展密不可分。二十世紀70年代是運動處方發展的初始期，首先是在身體活動與心血管健康方面提出了運動處方的概念，而后逐步提出了針對個體的運動處方，進而開始把運動處方與體能測試聯系在一起討論。二十世紀80年代運動處方開始進入了全面發展的階段，開始用體能測試指導運動處方，并使運動處方和機能評定進入實驗階段。二十世紀90年代運動處方開始與多種運動康復療法相結合，針對多種疾病進行干預和治療，并與多種體能訓練方法相結合指導訓練和康復，成為一種主要的非藥物治療手段。進入本世紀以后，運動處方和機能評定的研究得到了全面提高，開始出現非隨機對照試驗和RCT，一些先進的測試手段和分析方法開始應用于機能評定和運動處方的實施。
結論　運動處方的發展與運動康復療法和運動機能評定的發展是密不可分的，機能評定和體能測試是執行和實施運動處方的基礎。當今，運動處方已從單一的體育鍛煉方法提高到了針對多種疾病的非藥物治療手段。運動處方和機能評定的科學化已從觀察性研究、群體研究，開始進入了非隨機對照試驗和RCT。相對其它生物學科而言，運動處方的RCT研究相對滯后，如何使運動處方獲得最大的益處和最低的風險仍是值得研究的問題。

引用本文： 步斌,侯樂榮,周學蘭,韓海軍,李良剛,張超慧,Maria Singh. 運動處方研究進展. 中國循證醫學雜志, 2010, 10(12): 1359-1366. doi: 10.7507/1672-2531.20100597 復制

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1. Clarke HH. Application of measurement to health and physical education. 2nd ed. New York, N.Y.: Prentice-Hall. xvii, 1950: 493.
2. Fox SM 3rd, Naughton JP, Gorman PA. Physical activity and cardiovascular health. 3. The exercise prescription: frequency and type of activity. Mod Concepts Cardiovasc Dis, 1972, 41(6): 25-30.
3. Leeper RC, Hasbrook AH. Study of control force limits for female pilots. 1973. [cited; 30 p.]. Available from: http://purl.access.gpo.gov/GPO/LPS81369.
4. Jetté M. An exercise prescription program for use in conjunction with the Canadian home fitness test. Can J Public Health, 1975, 66(6): 461-464.
5. Astrand PO. Optimal function and health. Bibl Cardiol, 1976, (36): 11-18.
6. Lowenthal SL, McAllister RG. Program for cardiac patients: stress testing and training. Phys Ther, 1976, 56(10): 1117-1124.
7. Rosentswieg J. Exercise prescription for young women. Tex Med, 1977, 73(11): 76-77.
8. Fentem PH. Exercise: a prescription for health? Self-medication: the benefits of exercise. Br J Sports Med, 1978, 12(4): 223-226.
9. Shephard RJ. Exercise prescription--North American experience. Br J Sports Med, 1978, 12(4): 227-234.
10. Pollock ML. Exercise--a preventive prescription. J Sch Health, 1979, 49(4): 215-219.
11. Kligman EW, Pepin E. Prescribing physical activity for older patients. Geriatrics, 1992, 47(8): 33-4, 37-44, 47.
12. Ryan AJ. Physical fitness for physicians. Postgrad Med, 1980, 67(2): 199-202.
13. Smutok MA, Skrinar GS, Pandolf KB. Exercise intensity: subjective regulation by perceived exertion. Arch Phys Med Rehabil, 1980, 61(12): 569-574.
14. Dorossiev DL, Pertchev I. Methods of exercise testing and training prescription for cardiovascular diseases. Ann Clin Res, 1982, 14 Suppl 34: 111-117.
15. Jetté M, Mongeon J, Shephard RJ. Demonstration of a training response by the Canadian home fitness test. Eur J Appl Physiol Occup Physiol, 1982, 49(2): 143-150.
16. Milhorn HT Jr. Cardiovascular fitness. Am Fam Physician, 1982, 26(3): 163-169.
17. Cornish G. Personal exercise prescription. Cardiac rehabilitation and preventive medicine. Med J Aust, 1983, 1(4): 163-165.
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19. Shephard RJ, Lavallâee H. Ti zhi ping jia: yuan li, shi jian he ying yong. Beijing: Wen hua jiao yu chu ban she, 1983: 2, 5, 388.
20. Francis K. The use of the microcomputer in fitness assessment and exercise prescription for the older adult. J Clin Comput, 1984, 13(1): 4-15.
21. Shephard RJ. Tests of maximum oxygen intake. A critical review. Sports Med, 1984, 1(2):199-124.
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23. GDunn MM. uidelines for an effective personal fitness prescription. Nurse Pract, 1987, 12(9): 9-18, 23, 26.
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25. Rippe JM, Ward A, Porcari JP, et al. Walking for health and fitness. JAMA, 1988, 259(18): 2720-2724.
26. Vuori I. Exercise prescription in medical practice. Ann Clin Res, 1988, 20(1-2): 84-93.
27. Wolfe LA, Hall P, Webb KA, et al. Prescription of aerobic exercise during pregnancy. Sports Med, 1989, 8(5): 273-301.
28. American College of Sports Medicine position stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc, 1990, 22(2): 265-274.
29. Gordon NF, Scott CB, Wilkinson WJ, et al. Exercise and mild essential hypertension. Recommendations for adults. Sports Med, 1990, 10(6): 390-404.
30. Croce P, Gregg JR. Keeping fit when injured. Clin Sports Med, 1991, 10(1): 181-195.
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33. Heyward VH. Advanced fitness assessment & exercise prescription. 3rd ed. Champaign, IL: Human Kinetics, 1998: xii, 322.
34. Heyward VH. Advanced fitness assessment and exercise prescription. 5th ed. Champaign, IL: Human Kinetics, 2006: xiii, 425.
35. Blair SN, Kohl HW, Gordon NF, et al. How much physical activity is good for health? Annu Rev Public Health, 1992, 13: 99-126.
36. Jetté M, Quenneville J, Sidney K. Fitness testing and counselling in health promotion. Can J Sport Sci, 1992, 17(3): 194-198.
37. Fox SM 3rd, Naughton JP, Gorman PA. Physical activity and cardiovascular health. 3. The exercise prescription: frequency and type of activity. Mod Concepts Cardiovasc Dis, 1972, 41(6): 25-30.
38. Desharnais R, Jobin J, Côté C, et al. Aerobic exercise and the placebo effect: a controlled study. Psychosom Med, 1993, 55(2): 149-154.
39. Soukup JT, Kovaleski JE. A review of the effects of resistance training for individuals with diabetes mellitus. Diabetes Educ, 1993, 19(4): 307-312.
40. Webster L, Chen JG, Flores L, et al. Exercise countermeasure protocol management expert system. Comput Methods Programs Biomed, 1993, 39(3-4): 217-223.
41. Robertson AR, Johnson DA. Rehabilitation and development after childhood cancer: can the need for physical exercise be met? Pediatr Rehabil, 2002, 5(4): 235-240.
42. Convertino VA. Exercise as a countermeasure for physiological adaptation to prolonged spaceflight. Med Sci Sports Exerc, 1996, 28(8): 999-1014.
43. M Meyer T, Broocks A. Therapeutic impact of exercise on psychiatric diseases: guidelines for exercise testing and prescription. Sports Med, 2000, 30(4): 269-279.
44. Angyán L. Promoting physical activity in medical education. Mini-review. Acta Physiol Hung, 2004, 91(2): 157-166.
45. Maiorana A, O’Driscoll G, Cheetham C, et al. Combined aerobic and resistance exercise training improves functional capacity and strength in CHF. J Appl Physiol, 2000, 88(5): 1565-1570.
46. O’Grady M, Fletcher J, Ortiz S. Therapeutic and physical fitness exercise prescription for older adults with joint disease: an evidence-based approach. Rheum Dis Clin North Am, 2000, 26(3): 617-646.
47. Rush SR. Exercise prescription for the treatment of medical conditions. Curr Sports Med Rep, 2003, 2(3): 159-165.
48. Wallace JP, Raglin JS, Jastremski CA. Twelve month adherence of adults who joined a fitness program with a spouse vs without a spouse. J Sports Med Phys Fitness, 1995, 35(3): 206-213.
49. Dunbar CC, Kalinski MI, Robertson RJ. A new method for prescribing exercise: three-point ratings of perceived exertion. Percept Mot Skills, 1996, 82(1): 139-146.
50. Glenister D. Exercise and mental health: a review. J R Soc Health, 1996, 116(1): 7-13.
51. Bird SP, Tarpenning KM, Marino FE. Designing resistance training programmes to enhance muscular fitness: a review of the acute programme variables. Sports Med, 2005, 35(10): 841-851.
52. Dad’ová K, Radvanský J, Pelísková P, et al. Is prescription of physical activity a part of health care in civilization disorders? Results of questionnaire study in medical doctors. Cas Lek Cesk, 2007, 146(5): 503-507.
53. O’Brien K, Nixon S, Glazier RH, et al. Progressive resistive exercise interventions for adults living with HIV/AIDS. Cochrane Database Syst Rev, 2004, (4):CD004248.
54. Devillard X, Rimaud D, Roche F, et al. Effects of training programs for spinal cord injury. Ann Readapt Med Phys, 2007, 50(6): 490-498, 480-489.
55. Griffin JC. Client-centered exercise prescription. 2nd ed. Champaign, IL: Human Kinetics. 2006: xii, 339.
56. Jones KD, Adams D, Winters-Stone K, et al. A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988-2005). Health Qual Life Outcomes, 2006, 4: 67.
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