A development of overall health promotion exercise program for the prevention of dependence in community-dwelling frail elderly

研究一：研究一的目的是调查尿失禁的患病率和城市社区老年妇女尿失禁的特点。研究对象是957名年龄在70岁及以上的女性。尿失禁发生率为43.5%（416/957）。尿失禁组自评健康状况较差；目前服用三种或三种以上药物的受试者比例很高，并且害怕摔倒；有心脏病史和分娩的比例显著增高（p<0.05）。尿失禁组年龄偏大，在正常行走速度、最大行走速度、单腿睁眼站立时间等指标上差异有统计学意义（p<0.05）。研究II：研究II的目的是评估盆底肌（PFM）和功能健身运动在减少日本社区老年妇女尿失禁尿漏中的有效性。147名70岁及以上的社区妇女报告每月有一次或多次尿漏。在征得知情同意后，74人随机分为干预组，73人随机分为对照组。干预组参加了东京都老年学研究所（TMIG）的运动指导，旨在提高PFM和功能健康，每次60分钟，每周两次，持续3个月。干预组内收肌力量（F=6.364, p=0.013）、最大步行速度（F=4.843, p=0.030）较对照组有更大且显著的改善。运动3个月后，43.1%的干预组和14.1%的对照组报告为大陆（Z=3.817, p<0.001）。这些结果表明，多维度运动对改善社区老年妇女的功能健康和治疗应激性尿失速是有效的。

Research I : The purpose of research I was to investigated the prevalence of urinary incontinence and the characteristics of urban community-dwelling elderly women with urinary incontinence. The subjects were 957 women aged 70 years and older. The prevalence of urinary incontinence was 43.5% (416/957). The group possessing urinary incontinence had poor self-rated health; had a high percentage of subjects currently taking three or more medications and had fear of falling; and had a significantly (p<0.05) higher rate of a history of heart disease and delivery. In addition, the group with urinary incontinence were older, and had significantly (p<0.05) poorer results in usual walking speed, maximum walking speed, and one leg standing time with eyes opened.Research II : The purpose of research II was to evaluate the effectiveness of a pelvic floor muscle (PFM) and functional fitness exercises in reducing urine leakage in community-dwelling Japanese elderly women with urinary incontinence. One hundred forty-seven community-dwelling women aged 70 and older who reported urine leakage with one or more times per month. After obtaining informed consent, 74 persons were randomized to intervention group and 73 to control group. The intervention group attended a Tokyo Metropolitan Institute of Gerontology (TMIG) exercise instructions aimed at enhancing PFM and functional fitness for 60 minutes per session, twice a week for 3-month. The intervention group showed greater and significant improvement in adductor muscle strength (F=6.364, p=0.013), and maximum walking speed (F=4.843, p=0.030) compared to control group. After the 3-month exercise, 43.1% of the intervention group and 14.1% of the control group reported to be continent (Z=3.817, p<0.001). These results demonstrated that a multidimensional exercise was effective in the improvement of functional fitness and treatment of stress UI in community-dwelling elderly women.