The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial
The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial
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DOI：
10.1111/j.1532-5415.2004.52411.x
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发表时间：
2004-09-01
影响因子：
6.3
通讯作者：
Taylor, K
中科院分区：
文献类型：
--
作者：
Clemson, L;Cumming, RG;Taylor, K
目的：为了测试Stepping On，一个使用小组学习环境的多方面社区项目，是否能有效减少在家生活的高危人群的福尔斯。设计：一项随机试验，受试者随访14个月。设置：干预措施在社区场所进行，随访家庭访视。参与者：310名70岁及以上的社区居民，他们在过去12个月内曾跌倒或担心跌倒。干预：踩踏计划旨在提高跌倒自我效能，鼓励行为改变，减少福尔斯。该计划的关键方面是改善下肢平衡和力量，改善家庭和社区环境和行为安全，鼓励定期视力筛查，适应低视力，并鼓励药物审查。每周进行两小时的治疗，持续7周，并进行后续的职业治疗家庭访视。测量：主要结果测量是福尔斯，使用每个参与者邮寄的月历确定。结果：干预组的福尔斯减少了31%（相对危险度（RR）=0.69，95%置信区间（CI）=0.50-0.96; P= 0.025）。这是一个具有临床意义的结果，证明了Stepping On计划对社区居住的老年人有效。亚组的二次分析显示，它是特别有效的男性（n=80; RR=0.32，95%CI =0.17-0.59）。结论：本研究的结果重新关注的想法，认知行为学习在一个小群体的环境，可以减少福尔斯。Stepping On提供了一个成功的防摔选项。
Objectives: To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home.Design: A randomized trial with subjects followed for 14 months.Setting: The interventions were conducted in community venues, with a follow-up home visit.Participants: Three hundred ten community residents aged 70 and older who had had a fall in the previous 12 months or were concerned about falling.Intervention: The Stepping On program aims to improve fall self-efficacy, encourage behavioral change, and reduce falls. Key aspects of the program are improving lower-limb balance and strength, improving home and community environmental and behavioral safety, encouraging regular visual screening, making adaptations to low vision, and encouraging medication review. Two-hour sessions were conducted weekly for 7 weeks, with a follow-up occupational therapy home visit.Measusrements: The primary outcome measure was falls, ascertained using a monthly calendar mailed by each participant.Results: The intervention group experienced a 31% reduction in falls (relative risk (RR)=0.69, 95% confidence interval (CI)=0.50-0.96; P=.025). This was a clinically meaningful result demonstrating that the Stepping On program was effective for community-residing elderly people. Secondary analysis of subgroups showed that it was particularly effective for men (n=80; RR=0.32, 95% CI=0.17-0.59).Conclusion: The results of this study renew attention to the idea that cognitive-behavioral learning in a small-group environment can reduce falls. Stepping On offers a successful fall-prevention option.