Department of Physical Therapy, Touro College, Bay Shore, New York, USA.
J Geriatr Phys Ther. 2010 Apr-Jun;33(2):85-91.
The purpose of this pilot study was to evaluate the effects of a home-based standing exercise and balance training program on balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults.
A quasi-experimental single group pre- to posttest design was utilized in 14 subjects, 9 male and 5 female, aged 71 to 85 years receiving home care. Measurements included the Falls Efficacy Scale (FES), Performance Oriented Mobility Assessment (POMA), and the One-Leg Stance Test (OLST) administered prior to and following 4 weeks of exercise and balance training. Participants trained twice per day, 5 days per week for 4 weeks, and maintained exercise logs.
Pre- to posttest differences on the FES, POMA, and OLST were analyzed with the Wilcoxon signed rank test and the 2-tailed paired t test, respectively, with statistical significance set at .05. Analysis demonstrated significant improvements on the FES, POMA, and OLST following 4-weeks of standing exercise and balance training. Based on entrance and exit interviews, 6 of the 14 participants had a history of falls in the 6 months prior to the study, while only 2 participants reported having a single, minor fall by discharge.
The results of the present pilot study demonstrated significant improvement in balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults following participation in a home-based exercise and balance training program. However, definitive conclusions need to await validation from more rigorously designed studies before the present training program can be confidently recommended to physical therapists engaged in home care practice.
本初步研究旨在评估基于家庭的站立运动和平衡训练方案对身体虚弱、能走动的社区居住的老年患者平衡信心、平衡表现和步态的影响。
在 14 名接受家庭护理的年龄在 71 岁至 85 岁的男性 9 名和女性 5 名参与者中，采用准实验性单组前后测试设计。测量包括在接受为期 4 周的运动和平衡训练前后进行的跌倒效能量表（FES）、活动能力取向的移动评估（POMA）和单腿站立测试（OLST）。参与者每天训练 2 次，每周 5 天，持续 4 周，并保持运动记录。
分别使用 Wilcoxon 符号秩检验和双侧配对 t 检验对 FES、POMA 和 OLST 的前后测试差异进行分析，统计显著性设置为.05。分析表明，经过 4 周的站立运动和平衡训练后，FES、POMA 和 OLST 均有显著改善。根据进入和退出访谈，14 名参与者中有 6 名在研究前 6 个月有跌倒史，而只有 2 名参与者在出院时报告有一次轻微的跌倒。
本初步研究结果表明，身体虚弱、能走动的社区居住的老年患者在参加基于家庭的运动和平衡训练方案后，平衡信心、平衡表现和步态均有显著改善。然而，在目前的训练方案能够自信地推荐给从事家庭护理实践的物理治疗师之前，还需要更严格设计的研究来验证，才能得出明确的结论。
