Obstacle course training can improve mobility and prevent falls in people with intellectual disabilities
Obstacle course training can improve mobility and prevent falls in people with intellectual disabilities
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DOI：
10.1111/jir.12045
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发表时间：
2014-05-01
影响因子：
3.6
通讯作者：
Weerdesteyn, V.
中科院分区：
文献类型：
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作者：
Van Hanegem, E.;Enkelaar, L.;Weerdesteyn, V.
背景智障人士（ID）是跌倒高风险的特殊需求人群。这是第一项评估障碍训练是否可以改善该人群的活动能力并防止跌倒的研究。方法该干预措施是作为全机构医疗保健改善计划的一部分实施的，旨在减少智障人士居住设施中的跌倒情况。它包括每年对每位居民进行一次跌倒风险筛查。随后，对具有中度至高度跌倒风险的行走人群（n = 39）进行了 10 节障碍课程训练，以提高他们的平衡和步态能力。通过以表现为导向的活动能力评估 (POMA)、定时起身行走 (TUG) 和 10 米步行测试来评估干预前、中期和干预后的活动能力。比较干预前后一年的跌倒次数。结果跌倒次数减少了82%（P < 0.001）。 POMA评分从干预前到中期显着改善（平均差+/- SD，1.8 +/- 2.9，P = 0.001），从中期到干预后（2.0 +/- 2.9，P < 0.001），从干预前到干预后（3.8 +/- 4.3，P < 0.001）显着改善。与干预前的评估相比，参与者在干预后更快地完成了 10 米步行测试（差异 +/- SD，2.1 +/- 5.1 秒，P = 0.022）。 TUG 分数没有显着提高。结论本研究为障碍训练在改善智障人士活动能力和预防跌倒方面的有效性提供了初步证据。由于跌倒是该人群的一个重大健康问题，因此建议开展进一步研究，为运动干预措施的有益效果提供确凿的证据。
BackgroundPersons with intellectual disabilities (ID) constitute a special-needs population at high risk of falling. This is the first study to evaluate whether obstacle course training can improve mobility and prevent falls in this population.MethodsThe intervention was implemented as part of an institution-wide health care improvement plan aimed at reducing falls at a residential facility for people with ID. It comprised an annual screening of each resident for his or her individual fall risk. Subsequently, the group of ambulatory persons with a moderate to high fall risk (n = 39) were offered 10-session obstacle course training to improve their balance and gait abilities. Mobility was assessed pre-intervention, mid-term and post-intervention with the Performance Oriented Mobility Assessment (POMA), the Timed Up and Go (TUG) and the 10-meter walking test. The number of falls was compared between the year before and after intervention.ResultsThe number of falls decreased by 82% (P < 0.001). POMA scores significantly improved from pre-intervention to mid-term (mean difference +/- SD, 1.8 +/- 2.9, P = 0.001), from mid-term to post-intervention (2.0 +/- 2.9, P < 0.001), and from pre-intervention to post-intervention (3.8 +/- 4.3, P < 0.001). Participants completed the 10-meter walking test faster at the post-intervention compared with the pre-intervention assessment (difference +/- SD, 2.1 +/- 5.1 s, P = 0.022). TUG scores did not improve significantly.ConclusionsThe present study provides preliminary evidence for the effectiveness of obstacle course training in improving mobility and preventing falls in people with ID. As falls are a significant health concern in this population, further research is advocated to provide conclusive evidence for the suggested beneficial effects of exercise interventions.