Delivery and Outcomes of a Yearlong Home Exercise Program After Hip Fracture A Randomized Controlled Trial
Delivery and Outcomes of a Yearlong Home Exercise Program After Hip Fracture A Randomized Controlled Trial
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DOI：
10.1001/archinternmed.2011.15
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发表时间：
2011-02-28
影响因子：
--
通讯作者：
Magaziner, Jay
中科院分区：
文献类型：
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作者：
Orwig, Denise L.;Hochberg, Marc;Magaziner, Jay
背景：髋部骨折影响全球160多万人，并导致身体成分、功能和力量发生重大变化。常规护理（UC）并没有成功地恢复大多数患者的功能，先前的研究还没有确定一个有效的恢复方案。我们的目的是确定UC后开始的为期一年的家庭锻炼计划是否可以用于老年髋部骨折患者并改善预后。方法：对180名65岁及以上的社区女性髋部骨折患者进行随机对照试验，随机分为干预组（n=91）和UC组（n=89）。从1998年11月到2004年9月，从巴尔的摩地区的3家医院招募了骨折后15天内的患者。在骨折后2、6和12个月进行随访评估。运动加计划由运动教练管理，包括监督和独立进行的有氧和阻力运动，并增加强度。主要观察指标包括对侧股骨颈骨密度。其他结果包括使用耶鲁体育活动量表进行体育活动所花费的时间和消耗的千卡，肌肉量和力量，脂肪量，日常生活活动以及身体和心理功能。通过骨折后2至12个月的结果轨迹差异来评估干预对每个结果的影响。结果：超过80%的参与者接受了培训师的访问，其中大多数人接受了超过四分之三（79%）的协议访问。干预组报告在随访期间花在运动活动上的时间更长
Background: Hip fracture affects more than 1.6 million persons worldwide and causes substantial changes in body composition, function, and strength. Usual care (UC) has not successfully restored function to most patients, and prior research has not identified an effective restorative program. Our objective was to determine whether a yearlong home-based exercise program initiated following UC could be administered to older patients with hip fracture and improve outcomes.Methods: A randomized controlled trial of 180 community dwelling female patients with hip fracture, 65 years and older, randomly assigned to intervention (n=91) or UC(n=89). Patients were recruited within 15 days of fracture from 3 Baltimore-area hospitals from November 1998 through September 2004. Follow-up assessments were conducted at 2, 6, and 12 months after fracture. The Exercise Plus Program was administered by exercise trainers that included supervised and independently performed aerobic and resistive exercises with increasing intensity. Main outcome measures included bone mineral density of the contralateral femoral neck. Other outcomes included time spent and kilocalories expended in physical activity using the Yale Physical Activity Scale, muscle mass and strength, fat mass, activities of daily living, and physical and psychosocial functioning. The effect of intervention for each outcome was estimated by the difference in outcome trajectories 2 to 12 months after fracture.Results: More than 80% of participants received trainer visits, with the majority receiving more than 3 quarters (79%) of protocol visits. The intervention group reported more time spent in exercise activity during follow-up (P