Gill Dawn P, Zou G Y, Jones Gareth R, Speechley Mark
Graduate Program in Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Gerontology. 2008;54(2):106-15. doi: 10.1159/000116113. Epub 2008 Feb 6.
Physical activity (PA) and exercise have numerous beneficial effects in older adults. The effect of sustaining an injury from a fall on subsequent PA levels has received little research attention, even though about a quarter of older adults who fall sustain a serious injury. Even less is known about the effect of injurious falls on different PA categorizations.
To examine the role of injurious falls on subsequent household and recreational PA levels in older community-dwelling males who were all Canadian veterans of World War II and the Korean War.
Data from a fall risk-factor modification trial were used for the present study. Falls and related injuries were ascertained prospectively using fall calendars. A brief, valid and reliable PA interview for older adults (Phone-FITT) measured household and recreational PA approximately 1 year later. Covariates were measured as part of the screening questionnaire administered at the start of the study. Multiple linear regression models were computed using household and recreational PA as dependent variables.
The present study included 200 males with a mean age 81 years (SD = 3.8). Half of the participants fell at least once and about one third reported at least one injury resulting from a fall. Multivariable analyses indicated that household PA scores were 3.1 points lower (95% CI = -5.8 to -0.3, p = 0.03) and recreational PA scores were 3.4 points higher (95% CI = 0.1 to 6.7, p = 0.04) among persons who had one or more falls leading to injury compared to those who did not fall or had one or more falls without injury. Analyses were adjusted for age, baseline PA, self-rated health, foot problems, balance problems, inability to stand without using armrests, vision and memory.
Categorization of PA type (household vs. recreational) suggests distinct differences in PA response following an injurious fall. Use of an overall PA measure would obscure this finding. Following further research, the results from this study may help in the design of preventive strategies to maximize physical activity in those who have sustained an injurious fall.
身体活动（PA）和锻炼对老年人有诸多益处。尽管约四分之一的跌倒老年人会遭受重伤，但跌倒导致受伤对后续PA水平的影响却很少受到研究关注。关于伤害性跌倒对不同PA分类的影响，人们了解得更少。
探讨伤害性跌倒对二战和朝鲜战争加拿大退伍军人中社区居住老年男性后续家庭和娱乐性PA水平的作用。
本研究使用了一项跌倒风险因素修正试验的数据。通过跌倒日历前瞻性地确定跌倒及相关损伤情况。大约1年后，使用一份针对老年人简短、有效且可靠的PA访谈（电话FITT）来测量家庭和娱乐性PA。作为研究开始时所管理筛查问卷的一部分，对协变量进行了测量。使用家庭和娱乐性PA作为因变量计算多元线性回归模型。
本研究纳入了200名平均年龄81岁（标准差 = 3.8）的男性。一半参与者至少跌倒过一次，约三分之一报告至少有一次跌倒导致的损伤。多变量分析表明，与未跌倒或跌倒但未受伤的人相比，有一次或多次跌倒导致受伤的人家庭PA得分低3.1分（95%可信区间 = -5.8至 -0.3，p = 0.03），娱乐性PA得分高3.4分（95%可信区间 = 0.1至6.7，p = 0.04）。分析对年龄、基线PA、自我评定健康状况、足部问题、平衡问题、不使用扶手无法站立、视力和记忆力进行了校正。
PA类型（家庭与娱乐）的分类表明伤害性跌倒后PA反应存在明显差异。使用总体PA测量会掩盖这一发现。经过进一步研究，本研究结果可能有助于设计预防策略，以最大限度地提高遭受伤害性跌倒者的身体活动水平。
