Takai Itsushi
Department of Physical Therapy, Osaka Butsuryo College.
Nihon Ronen Igakkai Zasshi. 2010;47(3):220-5. doi: 10.3143/geriatrics.47.220.
Recent research suggests that the fear of falling may be a more serious problem than actual falling among frail elderly people. The purpose of this study was to investigate whether or not it is possible to influence the fear of falling among frail elderly people who previously had fallen, by balance exercises under attention tasks.
The subjects were 22 frail elderly people in nursing homes (3 men and 19 women, mean age 83.1+/-5.2 SD) who had fallen. Written informed consent was given for participation in the study. Subjects were divided into two groups at random: the balance exercise group (the control group) and the balance exercise during an attention task (the attention group). Balance exercise continued for 10 weeks, consisting of one 5 minute session, 3 times weekly. The control and intervention subjects were evaluated using the Fall Efficacy Scale (FES), Functional Reach Test (FRT), Timed Up & Go Test (TUGT) and walking speed, before the program, at the end of the trial, and 10 weeks after the program.
There was no change in walking speed in either group, and difference in TUGT of the control group was observed. We found improvement in FRT and TUGT of the attention group. The FES decreased in the attention group.
These findings indicate that balance exercise during an attention task can improve standing posture balance in frail elderly people who have fallen. These results also suggest that it is important to intervene in both motor function and attention function to decrease the fear of falling.
近期研究表明,在体弱的老年人中,害怕跌倒可能是一个比实际跌倒更严重的问题。本研究的目的是调查对于先前有过跌倒经历的体弱老年人,是否可以通过注意力任务下的平衡训练来影响其对跌倒的恐惧。
研究对象为22名养老院中的体弱老年人(3名男性和19名女性,平均年龄83.1±5.2标准差),他们都有过跌倒经历。研究已获得参与研究的书面知情同意书。受试者被随机分为两组:平衡训练组(对照组)和注意力任务下的平衡训练组(注意力组)。平衡训练持续10周,包括每次5分钟,每周3次。在训练前、试验结束时以及训练结束10周后,使用跌倒效能感量表(FES)、功能性伸展测试(FRT)、计时起立行走测试(TUGT)和步行速度对对照组和干预组受试者进行评估。
两组的步行速度均无变化,对照组的TUGT有差异。我们发现注意力组的FRT和TUGT有所改善。注意力组的FES下降。
这些发现表明,注意力任务下的平衡训练可以改善有过跌倒经历的体弱老年人的站立姿势平衡。这些结果还表明,干预运动功能和注意力功能对于降低跌倒恐惧很重要。