Are Changes in Leg Power Responsible for Clinically Meaningful Improvements in Mobility in Older Adults?
Are Changes in Leg Power Responsible for Clinically Meaningful Improvements in Mobility in Older Adults?
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DOI：
10.1111/j.1532-5415.2010.03155.x
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发表时间：
2010-12-01
影响因子：
6.3
通讯作者：
Leveille, Suzanne G.
中科院分区：
文献类型：
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作者：
Bean, Jonathan F.;Kiely, Dan K.;Leveille, Suzanne G.
从康复中通常针对的生理属性中，以确定那些变化导致临床有意义的差异（CMD）在移动性outcome. ProGNSecondary分析的数据收集的随机对照试验的运动使用的二元结果，通过记录一个大CMD（短身体性能电池（SPPB）=1个单位;步态速度（GS）=0.1米/秒）。参与者：社区居住的活动受限的老年人（n=116），参加为期16周的两种运动模式的随机对照试验。和运动耐量试验最大阶段的心率压积。结果包括GS和SPPB。腿部力量和腿部力量使用计算机化的气动力量训练设备测量，并分别以瓦特和牛顿记录。参与者中68%为女性，平均年龄为75.2岁，平均5.5岁，基线平均SPPB评分为8.7。在控制了年龄、部位、分组和基线结果值后，腿部力量是SPPB中唯一与大CMD显著相关的属性（比值比（OR）=1.48，95%置信区间（CI）=1.09-2.02）和GS（OR=1.31，95%CI =1.01-1.70）.结论独立于力量的下肢力量的改善似乎对SPPB和GS的临床有意义的改善做出了重要贡献。
OBJECTIVESFrom among physiological attributes commonly targeted in rehabilitation, to identify those in which changes led to clinically meaningful differences (CMDs) in mobility outcomes.DESIGNSecondary analysis of data collected for a randomized controlled trial of exercise using binary outcomes defined by recording a large CMD (Short Physical Performance Battery (SPPB)=1 unit; gait speed (GS)=0.1 m/s). Iterative models were performed to evaluate possible confounding between physiological variables and relevant covariates.SETTINGOutpatient rehabilitation centers.PARTICIPANTSCommunity-dwelling mobility-limited older adults (n=116) participating in a 16-week randomized controlled trial of two modes of exercise.MEASUREMENTSPhysiological measures included leg power, leg strength, balance as measured according to the Performance-Oriented Mobility Assessment (POMA), and rate pressure product at the maximal stage of an exercise tolerance test. Outcomes included GS and SPPB. Leg power and leg strength were measured using computerized pneumatic strength training equipment and recorded in Watts and Newtons, respectively.RESULTSParticipants were 68% female, had a mean age of 75.2, a mean of 5.5 chronic conditions, and a baseline mean SPPB score of 8.7. After controlling for age, site, group assignment, and baseline outcome values, leg power was the only attribute in which changes were significantly associated with a large CMD in SPPB (odds ratio (OR)=1.48, 95% confidence interval (CI)=1.09-2.02) and GS (OR=1.31, 95% CI=1.01-1.70).CONCLUSIONImprovements in leg power, independent of strength, appear to make an important contribution to clinically meaningful improvements in SPPB and GS.