California State University, Northridge, Department of Physical Therapy, 18111 Nordhoff Street, Northridge, CA 91330-8411, USA.
J Geriatr Phys Ther. 2009;32(3):125-33. doi: 10.1519/00139143-200932030-00008.
The purpose of this randomized controlled trial was to measure the effectiveness of A Matter of Balance, a small-group based balance program, on muscle strength, gait, balance, and fall risk among older community-dwelling adults at risk for falls. A secondary aim was to measure the effects of the program on actual fall rates over the 3-month study.
Twenty-three older adults were randomly assigned to either an experimental group that participated in a 12-week small-group based balance program or a control group. Subjects were assessed at baseline and following an intervention using the following outcome measures: lower extremity manual muscle testing (MMT) and range of motion; gait analysis on the GAITRite system; balance parameters on the SMART EquiTest, the Timed Up and Go test, the Berg Balance Scale, and incidence of falls.
A repeated measures ANOVA revealed that there was a significant interaction between groups over time in the Berg Balance Scale scores, P < or = .05. The experimental group improved over time (48.1 to 52.9/56, respectively), whereas the control group decreased in performance (49.1 to 47.8/56, respectively), P < or = .05. The mean number of falls was significantly less in the experimental group during the intervention compared with the control group (0.09 and 0.50, respectively), P < or = .05.
A community-based multifactorial intervention including individualized fall risk assessment, exercise, and home assessment appears to safely and effectively reduce the number of falls, resulting in significant improvements in functional balance ability and decreased fall risk.
本随机对照试验旨在测量基于小组的平衡计划(A Matter of Balance)对有跌倒风险的老年社区居住成年人的肌肉力量、步态、平衡和跌倒风险的有效性。次要目的是测量该计划在 3 个月研究期间对实际跌倒率的影响。
23 名老年人被随机分配到实验组(参加为期 12 周的小组基础平衡计划)或对照组。在基线和干预后,使用以下结果测量来评估受试者:下肢手动肌肉测试(MMT)和运动范围;GAITRite 系统上的步态分析;SMART EquiTest、计时起立行走测试、伯格平衡量表上的平衡参数和跌倒发生率。
重复测量方差分析显示,在 Berg 平衡量表评分方面,组间存在显著的时间交互作用,P < or =.05。实验组随时间推移而改善(分别为 48.1 至 52.9/56),而对照组的表现则下降(分别为 49.1 至 47.8/56),P < or =.05。实验组在干预期间的平均跌倒次数明显少于对照组(分别为 0.09 和 0.50),P < or =.05。
基于社区的多因素干预措施,包括个体化跌倒风险评估、运动和家庭评估,似乎可以安全有效地减少跌倒次数,从而显著改善功能平衡能力并降低跌倒风险。