Multi-target stepping program in combination with a standardized multi-component exercise program can prevent falls in community-dwelling older adults : A randomized controlled trial
Multi-target stepping program in combination with a standardized multi-component exercise program can prevent falls in community-dwelling older adults : A randomized controlled trial
复制标题
多目标步进计划与标准化多成分运动计划相结合可以预防社区老年人跌倒：一项随机对照试验
DOI：
10.1111/jgs.12453
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发表时间：
2013
期刊：
影响因子：
6.3
通讯作者：
Aoyama T
中科院分区：
文献类型：
--
作者：
Yamada M;Higuchi T;Nishiguchi S;Yoshimura K;Kajiwara Y;Aoyama T
目的研究每周两次的多目标步进（MTS）任务结合多组分锻炼计划对步进准确性、凝视行为、跌倒危险因素和跌倒率的影响。设计：随机对照试验。参与者：居住在日本社区的65岁及以上的成年人（N = 264）被随机分为MTS组（N = 132）和对照组（N = 132）。干预：为期24周的以社区为基础的MTS计划，每周两次，并结合标准化的多组分锻炼计划。测量在干预结束后12个月的随访期间，跌倒和跌倒相关骨折的数量，行走准确性，进行MTS测试时的凝视行为，以及与跌倒风险评估相关的四项临床测试(Timed up and Go （TUG)，功能延伸（FR）， 10米步行和五椅站立（5CS））的结果进行测量。结果随访12个月，MTS组有13例（11.6%）和对照组有39例（33.0%）出现下降（发病率比0.35,95%可信区间(CI) = 0.19 ~ 0.66）。在12个月的随访期间，MTS组的3名参与者和对照组的13名参与者发生了跌倒相关骨折（相对风险= 0.22,95% CI = 0.06-0.80）。干预后，MTS组的一部分参与者在MTS测试中的行走准确性和凝视行为方面有了显著的改善，MTS组的所有参与者在执行TUG和10米行走方面都有了显著的改善（P< 0.001）。在复杂的环境中，将MTS测试与多组分运动项目相结合的参与者在步进准确性、注视行为和身体表现方面有更大的改善。考虑到随访评估中较低的跌倒率，这些改进可能有助于预防社区居住的老年人跌倒。
ObjectivesTo investigate the effects of a twice‐weekly multitarget stepping (MTS) task combined with a multicomponent exercise program on stepping accuracy, gaze behavior, fall risk factors, and fall rates.DesignRandomized controlled trial.SettingCommunity.ParticipantsCommunity‐dwelling adults aged 65 and older in Japan (N = 264) were randomized into an MTS group (n = 132) and a control group (n = 132).InterventionTwenty‐four weeks of a twice‐weekly community‐based MTS program in combination with a standardized multicomponent exercise program.MeasurementsNumber of falls and fall‐related fractures during a 12‐month follow‐up period after completion of the intervention, stepping accuracy, gaze behavior while performing the MTS test, and results of four clinical tests relevant to assessment of risk of falls (Timed Up and Go (TUG), functional reach (FR), 10‐m walking, and Five Chair Stand (5CS)) were measured.ResultsThirteen participants (11.6%) in the MTS group and 39 (33.0%) in the control group fell during the 12‐month follow‐up period (incidence rate ratio = 0.35, 95% confidence interval (CI) = 0.19–0.66). Three participants in the MTS group and 13 in the control group experienced fall‐related fractures during the 12‐month follow‐up period (relative risk = 0.22, 95% CI = 0.06–0.80). After the intervention, a subset of participants in the MTS group had significantly greater improvement in stepping accuracy and gaze behavior during the MTS test, and all participants in the MTS group had significantly greater improvement in performing the TUG and 10‐m walking (P< .001).ConclusionParticipants who performed MTS tests combined with a multicomponent exercise program showed greater improvements in stepping accuracy, gaze behavior, and physical performance in a virtually complex environment. Considering the less‐frequent fall rate in the follow‐up assessment, these improvements could contribute to preventing falls in community‐dwelling older adults.