Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly-a cluster-randomized controlled trial
Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly-a cluster-randomized controlled trial
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DOI：
10.1007/s00198-014-2693-6
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发表时间：
2014-06-01
影响因子：
4
通讯作者：
Cheung, W. H.
中科院分区：
文献类型：
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作者：
Leung, K. S.;Li, C. Y.;Cheung, W. H.
本研究是一项前瞻性随机分组对照临床试验，涉及710名老年受试者，旨在研究低幅度高频振动（LMHFV）对跌倒和骨折率、肌肉性能和骨质量的长期影响。结果表明，低分子肝素钙能有效地降低老年人跌倒发生率，提高老年人的肌力，福尔斯是老年人脆性骨折的直接原因。LMHFV已被证明可以改善肌肉功能和骨骼质量。为探讨低分子肝素钙（LMHFV）预防社区老年人跌倒和骨折的疗效，对710例60岁以上绝经后女性进行随机分组对照研究。共有364名参与者每天接受20分钟LMHFV（35 Hz，0.3 g），每周5天，持续18个月; 346名参与者作为对照。跌倒或骨折发生率作为主要结局。此外，在0、9和18个月时进行了股四头肌肌力、平衡能力、骨矿物质密度（BMD）和生活质量（QoL）评估。振动组的平均依从性为66.0%，振动组334名受试者中有18.6%报告跌倒或骨折发生率，而对照组327名受试者中有28.7%报告跌倒或骨折发生率（校正HR = 0.56，p = 0.001）。振动组和对照组的骨折率分别为1.1%和2.3%（p = 0.171）。在反应时、运动速度、平衡能力评估的最大偏移以及股四头肌肌力方面均发现显著改善（p < 0.001）。BMD的总体变化无显著性差异。LMHFV能有效预防长者跌倒，并能改善长者的肌肉力量及平衡能力。我们建议在社区中使用它作为有效的跌倒预防计划，并减少相关伤害。
This study is a prospective cluster-randomized controlled clinical trial involving 710 elderly subjects to investigate the long-term effects of low-magnitude high-frequency vibration (LMHFV) on fall and fracture rates, muscle performance, and bone quality. The results confirmed that LMHFV is effective in reducing fall incidence and enhancing muscle performance in the elderly.Falls are direct causes of fragility fracture in the elderly. LMHFV has been shown to improve muscle function and bone quality. This study is to investigate the efficacy of LMHFV in preventing fall and fractures among the elderly in the community.A cluster-randomized controlled trial was conducted with 710 postmenopausal females over 60 years. A total of 364 participants received daily 20 min LMHFV (35 Hz, 0.3 g), 5 days/week for 18 months; 346 participants served as control. Fall or fracture rate was taken as the primary outcome. Also, quadriceps muscle strength, balancing abilities, bone mineral density (BMD), and quality of life (QoL) assessments were done at 0, 9, and 18 months.With an average of 66.0 % compliance in the vibration group, 18.6 % of 334 vibration group subjects reported fall or fracture incidences compared with 28.7 % of 327 in the control (adjusted HR = 0.56, p = 0.001). The fracture rate of vibration and control groups were 1.1 and 2.3 % respectively (p = 0.171). Significant improvements were found in reaction time, movement velocity, and maximum excursion of balancing ability assessment, and also the quadriceps muscle strength (p < 0.001). No significant differences were found in the overall change of BMD. Minimal adverse effects were documented.LMHFV is effective in fall prevention with improved muscle strength and balancing ability in the elderly. We recommend its use in the community as an effective fall prevention program and to decrease related injuries.