Minimising disability and falls in older people through a post-hospital individualised exercise program.

这项研究旨在实施和评估改善平衡功能活动(FABB)计划，这是一项量身定做的锻炼计划，旨在最大限度地减少最近住院的老年人的残疾和跌倒。将进行一项随机对照试验，以确定该计划在最大限度地减少残疾和摔倒、改善平衡、肌肉力量、反应时间、生活质量和摔倒恐惧方面的成功。此外，还将建立采用和遵守锻炼计划以及该计划的成本效益的预测因素。我们将在两家大型教学医院之一的老年护理和康复病房住院后的头六个月内招募350名老年人。被随机分配到干预组的参与者将被要求完成一项个性化的家庭锻炼计划，每周三次。此外，他们还可以选择每月接受物理治疗家访或参加运动课程。这些每周的运动课程将由物理治疗师进行，由6-8人组成。控制组将收到一本关于预防跌倒的教育手册，并将有机会在一年的控制期结束后以自筹资金的方式参加该计划。干预后的组间比较将使用适当的统计技术，包括回归模型。其他分析将建立计划采用和遵守以及成本效益(运动组与对照组相比，防止每次下降的增量成本)的预测因子。这项研究系统地解决了一个日益重要的卫生保健问题，因此有可能大大提高澳大利亚和国际上老年人的健康。

This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of and adherence to the exercise program and the cost effectiveness of the program will be established. We will recruit 350 older people in the first six months after an in-patient stay in aged care and rehabilitation wards at one of two large teaching hospitals. Participants randomised to the intervention group will be asked to complete an individualised home exercise program three times a week. In addition, they will be offered a choice between receiving monthly physiotherapy home visits or attending exercise classes. These weekly exercise classes will be conducted by physiotherapists and will be made up of 6-8 people. The control group will receive an education booklet about falls prevention and will be given the opportunity to join the program on a self-funding basis after their one-year control period is complete. Post-intervention between-group comparisons will be made using appropriate statistical techniques including regression models. Additional analyses will establish predictors for program adoption and adherence and cost-effectiveness (the incremental cost per fall prevented in the exercise group compared with the control group). This study addresses an increasingly important health care problem in a systematic manner and thus has the potential to substantially enhance the health of older people in Australia and internationally.