Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+bone study
Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+bone study
复制标题
DOI：
10.1093/ageing/afv055
复制
发表时间：
2015-07-01
期刊：
影响因子：
6.7
通讯作者：
Brooke-Wavell, Katherine
中科院分区：
文献类型：
--
作者：
Duckham, Rachel L.;Masud, Tahir;Brooke-Wavell, Katherine
目的：评估家庭（奥塔哥运动计划，OEP）和团体（跌倒运动管理，FaME）跌倒预防运动计划相对于老年人常规护理的骨骼效果。方法：通过初级保健招募 65 岁以上的男性和女性。他们根据实践被随机分配至 OEP、FaME 或常规护理。在 24 周干预前后，测量了诺丁汉中心参与者的 BMD、骨矿物质含量 (BMC) 和结构特性。结果：参与者为 319 名男性和女性，平均年龄 (SD) 72(5) 岁。百分之九十二的参与者完成了试验。 OEP组每周完成58(43)分钟的家庭锻炼，而FaME组分别完成39(16)分钟和30(24)分钟/周的家庭锻炼。治疗组之间股骨颈 BMD 变化没有差异：相对于常规治疗组，OEP 和 FaME 的平均（95% CI）效应大小分别为 -0.003（-0.011,0.005）和 -0.002（-0.010,0.005）g cm(-2)； P = 0.44 和 0.53。其他骨骼部位的 BMD 或 BMC 或结构参数没有显着变化。结论：预防跌倒锻炼计划不会影响老年人的 BMD。为了增强骨骼强度，计划可能需要对骨骼施加更大压力或持续时间更长的锻炼。
Objective: to evaluate the skeletal effects of home (Otago Exercise Programme, OEP) and group (Falls Exercise Management, FaME) falls prevention exercise programmes relative to usual care in older people.Methods: men and women aged over 65 years were recruited through primary care. They were randomised by practice to OEP, FaME or usual care. BMD, bone mineral content (BMC) and structural properties were measured in Nottingham site participants before and after the 24-week intervention.Results: participants were 319 men and women, aged mean(SD) 72(5) years. Ninety-two percentage of participants completed the trial. The OEP group completed 58(43) min/week of home exercise, while the FaME group completed 39(16) and 30(24) min/week of group and home exercise, respectively. Femoral neck BMD changes did not differ between treatment arms: mean (95% CI) effect sizes in OEP and FaME relative to usual care arm were -0.003(-0.011,0.005) and -0.002(-0.010,0.005) g cm(-2), respectively; P = 0.44 and 0.53. There were no significant changes in BMD or BMC at other skeletal sites, or in structural parameters.Conclusions: falls prevention exercise programmes did not influence BMD in older people. To increase bone strength, programmes may require exercise that exerts higher strains on bone or longer duration.