Rosendahl Erik, Lindelöf Nina, Littbrand Håkan, Yifter-Lindgren Elinor, Lundin-Olsson Lillemor, Håglin Lena, Gustafson Yngve, Nyberg Lars
Department of Community Medicine and Rehabilitation, Umeå University, Sweden.
Aust J Physiother. 2006;52(2):105-13. doi: 10.1016/s0004-9514(06)70045-9.
The aims of this randomised controlled trial were to determine if a high-intensity functional exercise program improves balance, gait ability, and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training. One hundred and ninety-one older persons dependent in activities of daily living, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ? 10 participated. They were randomised to a high-intensity functional exercise program or a control activity, which included 29 sessions over 3 months, as well as to protein-enriched energy supplement or placebo. Berg Balance Scale, self-paced and maximum gait speed, and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA, using the intention-to-treat principle. At three months, the exercise group had improved significantly in self-paced gait speed compared with the control group (mean difference 0.04 m/s, p = 0.02). At six months, there were significant improvements favouring the exercise group for Berg Balance Scale (1.9 points, p = 0.05), self-paced gait speed (0.05 m/s, p = 0.009), and lower-limb strength (10.8 kg, p = 0.03). No interaction effects were seen between the exercise and nutrition interventions. In conclusion, a high-intensity functional exercise program has positive long-term effects in balance, gait ability, and lower-limb strength for older persons dependent in activities of daily living. An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training.
这项随机对照试验的目的是确定高强度功能锻炼计划是否能改善日常生活活动依赖的老年人的平衡能力、步态能力和下肢力量，以及锻炼后立即摄入富含蛋白质的能量补充剂是否能增强训练效果。191名日常生活活动依赖、居住在养老机构且简易精神状态检查表（MMSE）评分≥10分的老年人参与了研究。他们被随机分为高强度功能锻炼计划组或对照活动组（包括3个月内进行29次训练），以及富含蛋白质的能量补充剂组或安慰剂组。在3个月和6个月时对伯格平衡量表、自定步速和最大步态速度以及下肢力量的1次重复最大值进行随访，并采用意向性分析原则通过2×2析因协方差分析进行分析。3个月时，与对照组相比，锻炼组的自定步速步态速度有显著改善（平均差异0.04 m/s，p = 0.02）。6个月时，锻炼组在伯格平衡量表（1.9分，p = 0.05）、自定步速步态速度（0.05 m/s，p = 0.009）和下肢力量（10.8 kg，p = 0.03）方面有显著改善。锻炼和营养干预之间未观察到交互作用。总之，高强度功能锻炼计划对日常生活活动依赖的老年人的平衡能力、步态能力和下肢力量有积极的长期影响。锻炼后立即摄入富含蛋白质的能量补充剂似乎不会增强训练效果。
