Liu-Ambrose Teresa, Khan Karim M, Eng Janice J, Janssen Patti A, Lord Stephen R, McKay Heather A
Bone Health Research Group, British Columbia Women's Hospital and Health Center Osteoporosis Program and Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
J Am Geriatr Soc. 2004 May;52(5):657-65. doi: 10.1111/j.1532-5415.2004.52200.x.
To compare the effectiveness of group resistance and agility-training programs in reducing fall risk in community-dwelling older women with low bone mass.
A randomized, controlled, single-blind 25-week prospective study with assessments at baseline, midpoint, and trial completion.
Community center.
Community-dwelling women aged 75 to 85 with low bone mass.
Participants were randomly assigned to one of three groups: resistance training (n=32), agility training (n=34), and stretching (sham) exercises (n=32). The exercise classes for each study arm were held twice weekly.
The primary outcome measure was fall risk (derived from weighted scores from tests of postural sway, reaction time, strength, proprioception, and vision), as measured using a Physiological Profile Assessment (PPA). Secondary outcome measures were ankle dorsiflexion strength, foot reaction time, and Community Balance and Mobility Scale score.
Attendance at the exercise sessions for all three groups was excellent: resistance training (85.4%), agility training (87.3%), and stretching program (78.8%). At the end of the trial, PPA fall-risk scores were reduced by 57.3% and 47.5% in the resistance and agility-training groups, respectively, but by only 20.2% in the stretching group. In the resistance and agility groups, the reduction in fall risk was mediated primarily by improved postural stability, where sway was reduced by 30.6% and 29.2%, respectively. There were no significant differences between the groups for the secondary outcomes measures. Within the resistance-training group, reductions in sway were significantly associated with improved strength, as assessed using increased squat load used in the exercise sessions.
These findings support the implementation of community-based resistance and agility-training programs to reduce fall risk in older women with low bone mass. Such programs may have particular public health benefits because it has been shown that this group is at increased risk of falling and sustaining fall-related fractures.
比较团体抗阻训练和敏捷性训练项目在降低社区居住的低骨量老年女性跌倒风险方面的效果。
一项随机、对照、单盲的25周前瞻性研究，在基线、中点和试验结束时进行评估。
社区中心。
年龄在75至85岁之间的社区居住低骨量女性。
参与者被随机分配到三组中的一组：抗阻训练组（n = 32）、敏捷性训练组（n = 34）和伸展（假）运动组（n = 32）。每个研究组的运动课程每周进行两次。
主要结局指标是跌倒风险（由姿势摆动、反应时间、力量、本体感觉和视力测试的加权分数得出），使用生理特征评估（PPA）进行测量。次要结局指标是踝背屈力量、足部反应时间和社区平衡与移动量表得分。
所有三组的运动课程出勤率都很高：抗阻训练组为85.4%，敏捷性训练组为87.3%，伸展运动组为78.8%。在试验结束时，抗阻训练组和敏捷性训练组的PPA跌倒风险评分分别降低了57.3%和47.5%，而伸展运动组仅降低了20.2%。在抗阻训练组和敏捷性训练组中，跌倒风险的降低主要是通过改善姿势稳定性实现的，其中摆动分别减少了30.6%和29.2%。次要结局指标在各组之间没有显著差异。在抗阻训练组中，摆动的减少与力量的改善显著相关，这是通过运动课程中增加的深蹲负荷来评估的。
这些发现支持实施基于社区的抗阻训练和敏捷性训练项目，以降低低骨量老年女性的跌倒风险。这类项目可能具有特殊的公共卫生益处，因为已经表明这一群体跌倒以及遭受与跌倒相关骨折的风险增加。
