Minimising disability and falls in older people through a post-hospital exercise program: a protocol for a randomised controlled trial and economic evaluation.
Minimising disability and falls in older people through a post-hospital exercise program: a protocol for a randomised controlled trial and economic evaluation.
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DOI：
10.1186/1471-2318-9-8
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发表时间：
2009-02-26
期刊：
影响因子：
4.1
通讯作者：
Cumming, Robert G
中科院分区：
文献类型：
--
作者：
Sherrington, Catherine;Lord, Stephen R;Cumming, Robert G
背景：残疾和福尔斯在最近住院的老年人中特别常见。有证据表明，残疾的严重程度和跌倒率可以通过精心设计的运动干预来降低。然而，运动对住院的老年人有这些好处的可能性还没有确定。这项随机对照试验将调查最近住院的人中，以家庭为基础的运动计划对残疾和福尔斯的影响。从健康和社区服务提供者的角度来看，锻炼计划的成本效益将被建立。此外，预测坚持锻炼programs.METHODS和设计：350最近住院的老年人将参加这项研究。参与者将没有运动的医学禁忌症，并且将在认知和身体上能够完成评估和运动计划。主要结果测量将是与移动性相关的残疾（用12个月的问卷和短期身体表现组合测量）和福尔斯（用12个月的日历测量）。次要指标将是跌倒风险测试，移动性、力量和灵活性的其他指标，生活质量，跌倒相关的自我效能，卫生系统和社区服务联系，他人的帮助，日常任务的困难，体力活动水平和不良事件。出院后，完成所有医院相关治疗，参与者将被随机分配到干预组或常规护理对照组。对于干预组，将建立个性化的家庭锻炼计划，并在物理治疗师的10次家庭访视期间进行。参与者将被要求在家里锻炼，每周6次，为期12个月的studyperiod.Discussion：这项研究将确定这种运动干预对流动性相关的残疾和福尔斯在老年人谁一直在医院以及成本效益和预测因素的坚持程序的影响。因此，结果将有直接的影响，为这个高风险的老年人群体的干预措施的设计和实施。试验注册：本研究的协议是注册与澳大利亚新西兰临床试验注册ACTRN12607000563460。
BACKGROUND: Disability and falls are particularly common among older people who have recently been hospitalised. There is evidence that disability severity and fall rates can be reduced by well-designed exercise interventions. However, the potential for exercise to have these benefits in older people who have spent time in hospital has not been established.This randomised controlled trial will investigate the effects of a home-based exercise program on disability and falls among people who have had recent hospital stays. The cost-effectiveness of the exercise program from the health and community service provider's perspective will be established. In addition, predictors for adherence with the exercise program will be determined.METHODS AND DESIGN: Three hundred and fifty older people who have recently had hospital stays will participate in the study. Participants will have no medical contraindications to exercise and will be cognitively and physically able to complete the assessments and exercise program.The primary outcome measures will be mobility-related disability (measured with 12 monthly questionnaires and the Short Physical Performance Battery) and falls (measured with 12 monthly calendars). Secondary measures will be tests of risk of falling, additional measures of mobility, strength and flexibility, quality of life, fall-related self efficacy, health-system and community-service contact, assistance from others, difficulty with daily tasks, physical activity levels and adverse events.After discharge from hospital and completion of all hospital-related treatments, participants will be randomly allocated to an intervention group or usual-care control group. For the intervention group, an individualised home exercise program will be established and progressed during ten home visits from a physiotherapist. Participants will be asked to exercise at home up to 6 times per week for the 12-month study period.DISCUSSION: The study will determine the impact of this exercise intervention on mobility-related disability and falls in older people who have been in hospital as well as cost-effectiveness and predictors of adherence to the program. Thus, the results will have direct implications for the design and implementation of interventions for this high-risk group of older people.TRIAL REGISTRATION: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ACTRN12607000563460.