Nursing rehabilitation and exercise strategies in the nursing home
Nursing rehabilitation and exercise strategies in the nursing home
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DOI：
10.1093/gerona/54.10.m494
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发表时间：
1999-10-01
影响因子：
5.1
通讯作者：
Doyle, N
中科院分区：
文献类型：
--
作者：
Morris, JN;Fiatarone, M;Doyle, N
背景本研究的目的是评估如何重量训练或护理为基础的康复护理计划在养老院的影响居民的日常生活活动能力（ADL）和目标测试的身体性能。本研究涉及一项准实验对照，对10个月期间的功能状态进行纵向比较，其中基线状态通过基于功能状态、认知状态和年龄的加权程序进行调整。来自六个住宿护理疗养院设施的所有居民都有资格，除了那些有晚期预后，预计停留时间少于90天，或有健康并发症，禁止接触。根据患者的特征，将这些家庭分成三组：每组中的两名成员被随机指定为实验地点，第三名成员成为对照地点。468例受试者的基线数据可用，392例受试者的随访数据可用。来自最小数据集的ADL自我表现指标，包括早期丧失ADL、运动和晚期丧失ADL的指标;一些客观功能测试（包括平衡、力量和耐力的指标）;以及通过老年抑郁量表测量的情绪状态，结果。两个实验组的平均ADL值下降的速度明显低于对照组。在更具体的测量中，功能下降也较低：运动，早期损失ADL和晚期损失ADL。通过这两种干预措施，设施能够实施基础广泛的干预措施，导致ADL下降率显著降低。一个设施范围内的护理康复计划可以发挥有用的作用，扭转功能下降，帮助居民保持他们参与广泛的ADL活动。
Background. The purpose of this study was to evaluate how weight training or nursing-based rehabilitative care programs in nursing homes impact on resident performance of Activities of Daily Living (ADL) and objectives tests of physical performance.Methods. This study involved a quasi-experimental control, longitudinal comparison of functional status over a 10-month period, where baseline status was adjusted through a weighting procedure based on functional status, cognitive status, and age. All residents from six residential care nursing home facilities were eligible except those with a terminal prognosis, a projected stay of less than 90 days, or with health complications that prohibited contact. Homes were placed into matched triplets based on patient characteristics: two members of each triplet were randomly designated to be experimental sites, the third became the control site. Baseline data were available for 468 subjects, follow-up for 392. ADL self-performance measures derived from the Minimum Data Set, including indicators of early loss ADL, locomotion, and late loss ADL; a number of objective functional tests (including measures of balance, power, and endurance); and mood state as measured by the Geriatric Depression Scale,Results. Mean ADL values in the two experimental groups declined at a significantly lower rate than did rates for the controls. Functional decline was also lower in more specific measures: locomotion, early loss ADL, and late loss ADL.Conclusions. With both interventions, facilities were able to implement a broad-based intervention that resulted in a significant reduction in ADL decline rates. A facility-wide nursing rehabilitation program can play a useful role in reversing functional decline, helping residents to maintain their involvement in a broad spectrum of ADL activities.