Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial
Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial
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DOI：
10.1016/j.apmr.2006.04.005
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发表时间：
2006-07-01
影响因子：
4.3
通讯作者：
van Wieringen, Piet C.
中科院分区：
文献类型：
--
作者：
Faber, Marjan J.;Bosscher, Ruud J.;van Wieringen, Piet C.
目的：确定中等强度的团体运动项目对老年人跌倒、功能表现和残疾的影响；并研究虚弱对这些效应的影响。设计：为期20周的多中心随机对照试验，随访52周。环境：15个养老院。参与者：278名男性和女性（平均年龄+/-标准差85 +/- 6y）。干预措施：两个锻炼项目被随机分配到15个家庭。第一个项目是功能性步行（FW），包括与日常活动相关的锻炼。在第二个项目中，平衡（IB），练习的灵感来自太极拳的原理。在每个家庭中，参与者被随机分配到干预组或对照组。对照组的参与者被要求不要改变他们通常的活动模式。干预组遵循一项为期20周的锻炼计划，前4周每周1次会议，其余几周每周2次会议。主要结果测量：跌倒、以表现为导向的活动能力评估（POMA）、身体表现评分和格罗宁根活动限制量表（GARS）（测量自我报告的残疾）。结果：FW组跌倒发生率（3.3次/年）高于113组（2.4次/年）和对照组（2.5次/年），但差异无统计学意义。在被分类为虚弱的参与者亚组中，运动组中成为跌倒者的风险显著增加（风险比[HR]=2.95； 95%可信区间[CI]， 1.64-5.32）。对于被归类为体弱前的参与者，成为跌倒者的风险降低了：这种影响在11周的训练后变得显著（HR= 0.39 - 95% CI, 0.18 - 0.88）。两个运动组的参与者在他们的POMA和身体表现得分上都有了小而显著的改善。在FW组中，GARS评分也是如此。事后分析显示，只有身体虚弱的参与者改善了他们的POMA和身体表现得分。结论：预防跌倒的中等强度团体运动项目对体弱前期的跌倒和身体表现有积极影响，但对体弱老年人没有积极影响。
Objectives: To determine the effects of moderate intensity group-exercise programs on falls, functional performance, and disability in older adults; and to investigate the influence of frailty on these effects.Design: A 20-week, multicenter randomized controlled trial, with 52-week follow-up.Setting: Fifteen homes for the elderly.Participants: Two hundred seventy-eight men and women (mean age +/- standard deviation, 85 +/- 6y). Interventions: Two exercise programs were randomly distributed across 15 homes. The first program, functional walking (FW), consisted of exercises related to daily mobility activities. In the second program, in balance (IB), exercises were inspired by the principles of Tai Chi. Within each home participants were randomly assigned to an intervention or a control group. Participants in the control groups were asked not to change their usual pattern of activities. The intervention groups followed a 20-week exercise program with I meeting a week during the first 4 weeks and 2 meetings a week during the remaining weeks.Main Outcome Measures: Falls, Performance Oriented Mobility Assessment (POMA), physical performance score, and the Groningen Activity Restriction Scale (GARS) (measuring self-reported disability). Results: Fall incidence rate was higher in the FW group (3.3 falls/y) compared with the 113 (2.4 falls/y) and control (2.5 falls/y) groups, but this difference was not statistically significant. The risk of becoming a faller in the exercise groups increased significantly in the subgroup of participants who were classified as being frail (hazard ratio [HR]=2.95; 95% confidence interval [CI], 1.64-5.32). For participants who were classified as being pre-frail, the risk of becoming a faller decreased: this effect became significant after 11 weeks of training (HR=.39- 95% CI,.18-.88). Participants in both exercise groups showed a small, but significant improvement in their POMA and physical performance scores. In the FW group, this held true for the GARS score as well. Post hoc analyses revealed that only the pre-frail participants improved their POMA and physical performance scores.Conclusions: Fall-preventive moderate intensity group-exercise programs have positive effects on falling and physical performance in pre-frail, but not in frail elderly.