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

研究I：研究I的目的是调查城市社区老年妇女尿失禁的患病率和特征。研究对象为957名年龄在70岁及以上的女性。尿失禁患病率为43.5%(416/957)。尿失禁患者的自我健康状况较差，目前服用三种或三种以上药物的受试者比例较高，害怕摔倒，有心脏病和分娩史的比例明显较高(p&lt；0.05)。此外，尿失禁组年龄较大，在正常步行速度、最大步行速度和睁眼单腿站立时间方面的成绩明显较差(p&lt；0.05)。研究II：研究II的目的是评估盆底肌(PFM)和功能锻炼在减少社区居住的日本老年女性尿失禁患者尿漏方面的有效性。147名70岁及以上的社区居住妇女报告每月一次或多次尿漏。获得知情同意后，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)旨在增强PFM和功能健身的锻炼说明，每次60分钟，每周两次，为期3个月。与对照组相比，干预组内收肌力(F=6.364，p=0.013)和最大步行速度(F=4.843，p=0.030)均有明显改善。锻炼3个月后，干预组有43.1%的受试者为可控性，对照组有14.1%的受试者为可控性(Z=3.817，p&lt；0.001)。这些结果表明，多维运动在改善社区老年妇女的功能适能和治疗应激性尿失禁方面是有效的。

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.