Talbot Laura A, Gaines Jean M, Huynh Tu N, Metter E Jeffrey
Johns Hopkins University, School of Nursing, 525 North Wolfe Street, Rm. 445, Baltimore, MD 21205, USA.
J Am Geriatr Soc. 2003 Mar;51(3):387-92. doi: 10.1046/j.1532-5415.2003.51113.x.
To determine whether a home-based pedometer-driven walking program with arthritis self-management education (Walk +) would increase physical activity, muscle strength, and functional performance in older adults with osteoarthritis (OA) of the knee as opposed to arthritis self-management education alone (EDU).
A randomized two-by-three (group-by-time) design with participants assigned to Walk + (n = 17, mean age +/- standard deviation = 69.6 +/- 6.7) or EDU (n = 17, age = 70.8 +/- 4.7).
Community located in the Baltimore-Washington area.
Thirty-four community-dwelling adults, aged 60 and older with symptomatic knee OA and self-reported functional impairment.
Both groups received 12 hours of the Arthritis Self-Management program over 12 weeks and were followed for an additional 12 weeks. In addition, the Walk + group received individualized instruction in the use of a pedometer, with the goal of increasing their step count by 30% of their baseline step count.
The outcome measures were physical activity (daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac-R3D accelerometer), quadriceps femoris strength (isometric peak torque), and functional performance tasks (100-foot walk-turn-walk, timed stair climb, timed chair rise, and pain status).
Daily steps walked showed a significant group-by-time interaction (P =.04) after controlling for age. From baseline to completion of training, a 23% increase in daily steps occurred in the Walk + group and a 15% decrease in the EDU group. Although steps increased in the Walk + group, total activity vector magnitude was maintained, suggesting a more efficient gait. The Walk + group became quicker than the EDU group in the normal-pace walk-turn-walk (P =.04). An isometric strength gain of 21% postintervention was seen in the Walk + group, compared with a loss of 3.5% in the EDU group.
In older adults with symptomatic knee OA, Walk + appears to increase walking, with improvements in muscle strength and walking performance. The use of a home-based pedometer-driven program to increase physical activity, strength, and function in this population warrants further research.
确定基于家庭的计步器驱动步行计划联合关节炎自我管理教育（Walk +）是否能增加膝骨关节炎（OA）老年患者的身体活动、肌肉力量和功能表现，对比仅进行关节炎自我管理教育（EDU）的情况。
随机二乘三（组×时间）设计，参与者被分配至Walk +组（n = 17，平均年龄±标准差 = 69.6±6.7）或EDU组（n = 17，年龄 = 70.8±4.7）。
位于巴尔的摩 - 华盛顿地区的社区。
34名社区居住的成年人，年龄60岁及以上，有症状性膝OA且自我报告有功能障碍。
两组均在12周内接受12小时的关节炎自我管理计划，并额外随访12周。此外，Walk +组接受计步器使用的个性化指导，目标是将步数增加至基线步数的130%。
结局指标包括身体活动（通过计步器和Tritrac - R3D加速度计测量的每日步数和总活动向量大小）、股四头肌力量（等长峰值扭矩）以及功能表现任务（100英尺往返步行、定时爬楼梯、定时从椅子上起身和疼痛状态）。
在控制年龄后，每日步数显示出显著的组×时间交互作用（P = 0.04）。从基线到训练结束，Walk +组的每日步数增加了23%，而EDU组减少了15%。尽管Walk +组的步数增加，但总活动向量大小保持不变，表明步态更有效率。Walk +组在正常速度往返步行中比EDU组更快（P = 0.04）。干预后，Walk +组的等长力量增加了21%，而EDU组减少了3.5%。
在有症状性膝OA的老年患者中，Walk +似乎能增加步行量，同时改善肌肉力量和步行表现。使用基于家庭的计步器驱动计划来增加该人群的身体活动、力量和功能值得进一步研究。
