108 年 國立臺灣大學物理治療系碩士班《英文科學論文閱讀測驗》

請簡要描述研究背景及研究問題。

【題組共用題幹】
請閱讀該文獻的內容並回答問題1-4。(摘錄自Am J Clin Nutr. 2017 Oct; 106(4):1078-1091.)

Background: Overweight and obese older people face a high risk of muscle loss and impaired physical function, which may
contribute to sarcopenic obesity. Resistance exercise training (RET) has a beneficial effect on muscle protein synthesis and can
be augmented by protein supplementation (PS). However, whether body weight affects the augmentation of muscular and
functional performance in response to PS in older people undergoing RET remains unclear. Maintaining muscle strength and
preventing sarcopenia are crucial for enabling obese elderly people to successfully survive multiple comorbidities and helping
them meet their physical demands.

Objective: This study was conducted to identify the effects of PS on the body composition and physical function of older people
undergoing RET by using a systematic review and meta-analysis.

請問此篇研究的方法是如何進行?

【題組共用題幹】
請閱讀該文獻的內容並回答問題1-4。(摘錄自Am J Clin Nutr. 2017 Oct; 106(4):1078-1091.)

Background: Overweight and obese older people face a high risk of muscle loss and impaired physical function, which may
contribute to sarcopenic obesity. Resistance exercise training (RET) has a beneficial effect on muscle protein synthesis and can
be augmented by protein supplementation (PS). However, whether body weight affects the augmentation of muscular and
functional performance in response to PS in older people undergoing RET remains unclear. Maintaining muscle strength and
preventing sarcopenia are crucial for enabling obese elderly people to successfully survive multiple comorbidities and helping
them meet their physical demands.

Objective: This study was conducted to identify the effects of PS on the body composition and physical function of older people
undergoing RET by using a systematic review and meta-analysis.

Design: We performed a comprehensive search of online databases to identify randomized controlled trials (RCTs) reporting the
efficacy of PS for lean mass gain, strength gain, and physical mobility improvements in older people undergoing RET. The
present study followed the guidelines recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis
Protocols. Online sources were used to perform a comprehensive electronic search. Articles were obtained from online databases
PubMed, EMBASE, the Cochrane Library Database, the Physiotherapy Evidence Database (PEDro), and Google Scholar.
Secondary sources included papers cited by articles retrieved from the aforementioned sources and articles published in journals
inaccessible from the aforementioned databases. We used the following search terms: "older/aging/aged/elderly/seniors." We
used the following search terms to find intervention studies: "progressive resistance training, resistance exercise, strength
training, weight training, and/or weight lifting," and "protein/amino acid/nutrient supplement."

請重點整理此篇研究的重要結果。

【題組共用題幹】
請閱讀該文獻的內容並回答問題1-4。(摘錄自Am J Clin Nutr. 2017 Oct; 106(4):1078-1091.)

Background: Overweight and obese older people face a high risk of muscle loss and impaired physical function, which may
contribute to sarcopenic obesity. Resistance exercise training (RET) has a beneficial effect on muscle protein synthesis and can
be augmented by protein supplementation (PS). However, whether body weight affects the augmentation of muscular and
functional performance in response to PS in older people undergoing RET remains unclear. Maintaining muscle strength and
preventing sarcopenia are crucial for enabling obese elderly people to successfully survive multiple comorbidities and helping
them meet their physical demands.

Objective: This study was conducted to identify the effects of PS on the body composition and physical function of older people
undergoing RET by using a systematic review and meta-analysis.

Design: We performed a comprehensive search of online databases to identify randomized controlled trials (RCTs) reporting the
efficacy of PS for lean mass gain, strength gain, and physical mobility improvements in older people undergoing RET. The
present study followed the guidelines recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis
Protocols. Online sources were used to perform a comprehensive electronic search. Articles were obtained from online databases
PubMed, EMBASE, the Cochrane Library Database, the Physiotherapy Evidence Database (PEDro), and Google Scholar.
Secondary sources included papers cited by articles retrieved from the aforementioned sources and articles published in journals
inaccessible from the aforementioned databases. We used the following search terms: "older/aging/aged/elderly/seniors." We
used the following search terms to find intervention studies: "progressive resistance training, resistance exercise, strength
training, weight training, and/or weight lifting," and "protein/amino acid/nutrient supplement."

Results: We included 17 RCTs; the overall mean ± SD age and body mass index (BMI; in kg/m2) in these RCTs were 73.4 ±
8.1 y and 29.7 ± 5.5, respectively. The participants had substantially greater lean mass and leg strength gains when PS and RET
were used than with RET alone, with the standard mean differences (SMDs) being 0.58 (95% CI: 0.32, 0.84) and 0.69 (95% CI:
0.39, 0,98), respectively. The subgroup of studies with a mean BMI ≥30 exhibited substantially greater lean mass (SMD: 0.53;
95% CI: 0.19, 0.87) and leg strength (SMD: 0.88; 95% CI: 0.42, 1.34) gains in response to PS. The subgroup of studies with a
mean BMI <30 also exhibited relevant gains in response to PS.

請為此篇研究的結果,寫一段結論。

【題組共用題幹】
請閱讀該文獻的內容並回答問題1-4。(摘錄自Am J Clin Nutr. 2017 Oct; 106(4):1078-1091.)

Background: Overweight and obese older people face a high risk of muscle loss and impaired physical function, which may
contribute to sarcopenic obesity. Resistance exercise training (RET) has a beneficial effect on muscle protein synthesis and can
be augmented by protein supplementation (PS). However, whether body weight affects the augmentation of muscular and
functional performance in response to PS in older people undergoing RET remains unclear. Maintaining muscle strength and
preventing sarcopenia are crucial for enabling obese elderly people to successfully survive multiple comorbidities and helping
them meet their physical demands.

Objective: This study was conducted to identify the effects of PS on the body composition and physical function of older people
undergoing RET by using a systematic review and meta-analysis.

Design: We performed a comprehensive search of online databases to identify randomized controlled trials (RCTs) reporting the
efficacy of PS for lean mass gain, strength gain, and physical mobility improvements in older people undergoing RET. The
present study followed the guidelines recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis
Protocols. Online sources were used to perform a comprehensive electronic search. Articles were obtained from online databases
PubMed, EMBASE, the Cochrane Library Database, the Physiotherapy Evidence Database (PEDro), and Google Scholar.
Secondary sources included papers cited by articles retrieved from the aforementioned sources and articles published in journals
inaccessible from the aforementioned databases. We used the following search terms: "older/aging/aged/elderly/seniors." We
used the following search terms to find intervention studies: "progressive resistance training, resistance exercise, strength
training, weight training, and/or weight lifting," and "protein/amino acid/nutrient supplement."

Results: We included 17 RCTs; the overall mean ± SD age and body mass index (BMI; in kg/m2) in these RCTs were 73.4 ±
8.1 y and 29.7 ± 5.5, respectively. The participants had substantially greater lean mass and leg strength gains when PS and RET
were used than with RET alone, with the standard mean differences (SMDs) being 0.58 (95% CI: 0.32, 0.84) and 0.69 (95% CI:
0.39, 0,98), respectively. The subgroup of studies with a mean BMI ≥30 exhibited substantially greater lean mass (SMD: 0.53;
95% CI: 0.19, 0.87) and leg strength (SMD: 0.88; 95% CI: 0.42, 1.34) gains in response to PS. The subgroup of studies with a
mean BMI <30 also exhibited relevant gains in response to PS.

1. 請為此摘要下一個英文與中文標題。(10%)
2. 依本篇內容,其主要的結果參數(primary outcome measure)應為何?(5%)
3. 本研究的新穎之處為何?對臨床有何重要性?(10%)

【題組共用題幹】
請閱讀該文獻內容並回答問題。(摘錄自JAMDA. 2018; 19(4): 361-369)

Abstract
Falls prevention is an international priority, and residents of long-term aged care fall approximately 3 times more often than
community dwellers. There is a relative scarcity of published trials in this setting. Our objective was to undertake a randomized
controlled trial to test the effect of published best practice exercise in long-term residential aged care. The trial was designed to
determine if combined high level balance and moderate intensity progressive resistance training (the Sunbeam Program) is
effective in reducing the rate of falls in residents of aged care facilities. A cluster randomized controlled trial of 16 residential
aged care facilities and 221 participants was conducted. The broad inclusion criterion was permanent residents of aged care.
Exclusions were diagnosed terminal illness, no medical clearance, permanent bed- or wheelchair-bound status, advanced
Parkinson's disease, or insufficient cognition to participate in group exercise. Assessments were taken at baseline, after
intervention, and at 12 months. Randomization was performed by computer-generated sequence to receive either the Sunbeam
program or usual care. A cluster refers to an aged care facility. The program consisted of individually prescribed progressive
resistance training plus balance exercise performed in a group setting for 50 hours over a 25-week period, followed by a
maintenance period for 6 months. The primary outcome measure was
Secondary outcomes included physical performance (Short Physical Performance Battery), quality of life (36-item Short-Form
Health Survey), functional mobility (University of Alabama Life Space Assessment), fear of falling (Falls Efficacy Scale
International), and cognition (Addenbrooke's Cognitive Evaluation-revised). The rate of falls was reduced by 55% in the exercise
group (incidence rate ratio = 0.45, 95% confidence interval 0.17-0.74); an improvement was also seen in physical performance
(P = .02). There were no serious adverse events.
The Sunbeam Program significantly reduced the rate of falls and improved physical performance in residents of aged care. This
finding is important as prior work in this setting has returned inconsistent outcomes, resulting in best practice guidelines being
cautious about recommending exercise in this setting. This work provides an opportunity to improve clinical practice and health
outcomes for long-term care residents.

1. 本研究的介入方式有哪幾種?介入如何執行?(10%)
2. 請依圖表解釋此研究結果。(15%)

【題組共用題幹】
請閱讀該文獻內容並以中文回答問題。(摘錄自Stroke. 2018; 49:2990-2998.)

Methods
Participants were recruited from the community stroke patient groups via convenience sampling. Inclusion criteria consisted
of: a diagnosis of stroke; ≥6 months after stroke onset; ≥50 years of age; community dwelling; medically stable; having balance
deficits (a Mini-Balance Evaluation System Test score ≤25); ability to follow 3-step commands; and able to walk at least 10 m
without manual assistance. Exclusion criteria involved: having neurological conditions other than stroke; not community-
dwelling before the stroke event; significant receptive or expressive aphasia; substantial cognitive impairment (Montreal
Cognitive Assessment score <21); and other serious illnesses that precluded participation in the study. A researcher with
background in rehabilitation was responsible for screening and enrolling the participants.
Dual- and single-task training were explored to determine whether a specific training approach was superior in decreasing
dual-task interference. Although single-task training is typically implemented during conventional rehabilitation, it may not
address decreasing fall risk in attention-demanding environments. The dual-task training also has the potential to improve the
ability to allocate attentional resources when a dual-task situation is encountered. The upper-limb exercise group served as an
active control group, enabling us to determine whether the observed improvement in the dual-or single-task group was a function
of maturation or repeated testing. Each group received their respective training (three 60-minute sessions per week) for 8
weeks. Each training session was supervised by 2 instructors with physical therapy background, with an instructor to participant
ratio of 2:4. All training sessions took place in an exercise room located in the university. The timing of the exercise sessions for
each group was dependent on the availability of the participants, space, and equipment. Nevertheless, the training sessions for the
3 groups were conducted at different times of the day or on different days so that participants would not be exposed to observing
other treatments.
Demographic information was obtained during a baseline interview. The Oxfordshire Stroke Classification tool was used to
classify stroke subtypes. Participants completed the Geriatric Depression Scale (short form) and the Chedoke-McMaster Stroke
Assessment, and the Stroop Color-Word test. They were also asked whether they had experienced any falls in the past year. A fall
is defined as inadvertently coming to rest on the ground or other lower level with or without loss of consciousness and other than
as the consequence of sudden onset of paralysis, epileptic seizure, excess alcohol intake or overwhelming external force. The
outcomes detailed below were measured in a university research laboratory within 1 week before intervention initiation, within 1
week after the intervention, and 8 weeks after the intervention by blinded researchers.

Results
A
%DTE in walking time
35
30 25 20 15 10 5
Forward walking +
verbal fluency
*
Baseline
Post-intervention
Follow-up
C 40
30
Forward walking +
verbal fluency
20
10
0
-10
-20
Dual-task Single-task Control
Dual-task Single-task Control
-30
B
%DTE in walking time
35
30 25 20 15 10 5
Forward walking +
Serial 3 subtractions
*
Baseline
Post-intervention
Follow-up
D
40
30
Forward walking +
Serial 3 subtractions
20
10
0
-10
-20
Dual-task Single-task Control
Dual-task Single-task Control
-30
%DTE: percent dual-task effect
CRR: correct response rate

• p<0.05

1. 本研究的介入方式有哪幾種?介入如何執行?(10%)
2. 請依圖表解釋此研究結果。(15%)

【題組共用題幹】
請閱讀該文獻內容並以中文回答問題。(摘錄自Stroke. 2018; 49:2990-2998.)

Methods
Participants were recruited from the community stroke patient groups via convenience sampling. Inclusion criteria consisted
of: a diagnosis of stroke; ≥6 months after stroke onset; ≥50 years of age; community dwelling; medically stable; having balance
deficits (a Mini-Balance Evaluation System Test score ≤25); ability to follow 3-step commands; and able to walk at least 10 m
without manual assistance. Exclusion criteria involved: having neurological conditions other than stroke; not community-
dwelling before the stroke event; significant receptive or expressive aphasia; substantial cognitive impairment (Montreal
Cognitive Assessment score <21); and other serious illnesses that precluded participation in the study. A researcher with
background in rehabilitation was responsible for screening and enrolling the participants.
Dual- and single-task training were explored to determine whether a specific training approach was superior in decreasing
dual-task interference. Although single-task training is typically implemented during conventional rehabilitation, it may not
address decreasing fall risk in attention-demanding environments. The dual-task training also has the potential to improve the
ability to allocate attentional resources when a dual-task situation is encountered. The upper-limb exercise group served as an
active control group, enabling us to determine whether the observed improvement in the dual-or single-task group was a function
of maturation or repeated testing. Each group received their respective training (three 60-minute sessions per week) for 8
weeks. Each training session was supervised by 2 instructors with physical therapy background, with an instructor to participant
ratio of 2:4. All training sessions took place in an exercise room located in the university. The timing of the exercise sessions for
each group was dependent on the availability of the participants, space, and equipment. Nevertheless, the training sessions for the
3 groups were conducted at different times of the day or on different days so that participants would not be exposed to observing
other treatments.
Demographic information was obtained during a baseline interview. The Oxfordshire Stroke Classification tool was used to
classify stroke subtypes. Participants completed the Geriatric Depression Scale (short form) and the Chedoke-McMaster Stroke
Assessment, and the Stroop Color-Word test. They were also asked whether they had experienced any falls in the past year. A fall
is defined as inadvertently coming to rest on the ground or other lower level with or without loss of consciousness and other than
as the consequence of sudden onset of paralysis, epileptic seizure, excess alcohol intake or overwhelming external force. The
outcomes detailed below were measured in a university research laboratory within 1 week before intervention initiation, within 1
week after the intervention, and 8 weeks after the intervention by blinded researchers.

Results
A
%DTE in walking time
35
30 25 20 15 10 5
Forward walking +
verbal fluency
*
Baseline
Post-intervention
Follow-up
C 40
30
Forward walking +
verbal fluency
20
10
0
-10
-20
Dual-task Single-task Control
Dual-task Single-task Control
-30
B
%DTE in walking time
35
30 25 20 15 10 5
Forward walking +
Serial 3 subtractions
*
Baseline
Post-intervention
Follow-up
D
40
30
Forward walking +
Serial 3 subtractions
20
10
0
-10
-20
Dual-task Single-task Control
Dual-task Single-task Control
-30
%DTE: percent dual-task effect
CRR: correct response rate

• p<0.05