Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls
Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls
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DOI：
10.1046/j.1532-5415.2001.49004.x
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发表时间：
2001-01-01
影响因子：
6.3
通讯作者：
Schlierf, G
中科院分区：
文献类型：
--
作者：
Hauer, K;Rost, B;Schlierf, G
目的：目的：探讨一种旨在改善有损伤性福尔斯史的老年患者的力量、灵活性和平衡能力，并减少其随后发生福尔斯的运动方案的安全性和有效性。设计：一项为期3个月的随机对照干预试验，并附加3个月的随访。地点：门诊老年康复中心。参与者：57名女性老年患者（平均年龄82 +/-4.8岁;范围75-90）入院接受急诊护理或住院康复，有复发或损伤性福尔斯史，包括急性跌倒相关骨折的患者。对照组患者参加安慰剂组每周3次，为期3个月。两组接受相同的理疗治疗每周2次，其中加强和平衡training were excluded.MEASUREMENTS：力量，功能能力，运动功能，心理参数，和下降率进行了评估，标准化的协议在开始（T1）和结束（T2）的干预。结果：研究组未发生与训练相关的医疗问题。45例患者（79%）在干预和随访期后完成了所有评估。两组的依从性均极佳（干预组85.4 ± 27.8% vs对照组84.2 ± 29.3%）。干预组患者的力量、功能性运动表现和平衡能力显著提高。与跌倒有关的行为和情绪限制明显减少。3个月随访期间持续改善，仅中度丢失。对于对照组的患者，在干预和随访期间没有记录到力量、功能表现或情绪状态的变化。跌倒的发生率减少了25%，干预组与对照组相比，无显着性（RR：0.753 CI：0.455-1.245）。结论：渐进式阻力训练和渐进式功能训练是安全有效的方法，增加力量和功能的表现，减少跌倒相关的行为和情绪的限制，在步行康复的体弱，高危老年患者的历史伤害性福尔斯。
OBJECTIVE: To determine the safety and efficacy of an exercise protocol designed to improve strength, mobility, and balance and to reduce subsequent falls in geriatric patients with a history of injurious falls.DESIGN: A randomized controlled 3-month intervention trial, with an additional 3-month follow-up.SETTING: Out-patient geriatric rehabilitation unit.PARTICIPANTS: Fifty-seven female geriatric patients (mean age 82 +/- 4.8 years; range 75-90) admitted to acute care or inpatient rehabilitation with a history of recurrent or injurious falls including patients with acute fall-related fracture.INTERVENTION: Ambulatory training of strength, functional performance, and balance 3 times per week for 3 months. Patients of the control group attended a placebo group 3 times a week for 3 months. Both groups received an identical physiotherapeutic treatment 2 times a week, in which strengthening and balance training were excluded.MEASUREMENTS: Strength, functional ability, motor function, psychological parameters, and fall rates were assessed by standardized protocols at the beginning (T1) and the end (T2) of intervention. Patients were followed up for 3 months after the intervention (T3).RESULTS: No training-related medical problems occurred in the study group. Forty-five patients (79%) completed all assessments after the intervention and follow-up period. Adherence was excellent in both groups (intervention 85.4 +/- 27.8% vs control 84.2 +/- 29.3%). The patients in the intervention group increased strength, functional motor performance, and balance significantly. Fall-related behavioral and emotional restrictions were reduced significantly. Improvements persisted during the 3-month follow-up with only moderate losses. For patients of the control group, no change in strength, functional performance, or emotional status could he documented during intervention and follow-up. Fall incidence was reduced nonsignificantly by 25% in the intervention group compared with the control group (RR:0.753 CI:0.455-1.245).CONCLUSIONS: Progressive resistance training and progressive functional training are safe and effective methods of increasing strength and functional performance and reducing fall-related behavioral and emotional restrictions during ambulant rehabilitation in frail, high-risk geriatric patients with a history of injurious falls.