Clemson Lindy, Singh Maria Fiatarone, Bundy Anita, Cumming Robert G, Weissel Elvina, Munro Jo, Manollaras Kate, Black Deborah
Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
Aust Occup Ther J. 2010 Feb;57(1):42-50. doi: 10.1111/j.1440-1630.2009.00848.x.
Exercise as a falls prevention strategy is more complex with people at risk than with the general population. The Lifestyle approach to reducing Falls through Exercise (LiFE) involves embedding balance and lower limb strength training in habitual daily routines.
A total of 34 community-residing people aged ≥70 years were randomised either into the LiFE programme or into a no-intervention control group and followed up for six months. Inclusion criteria were two or more falls or an injurious fall in the past year.
There were 12 falls in the intervention group and 35 in the control group. Therelative risk (RR) analysis demonstrated a significant reduction in falls (RR = 0.23; 0.07-0.83). There were indications that dynamic balance (P = 0.04 at three months) and efficacy beliefs (P = 0.04 at six months) improved for the LiFE programme participants. In general, secondary physical and health status outcomes, which were hypothesised as potential mediators of fall risk, improved minimally and inconsistently.
LiFE was effective in reducing recurrent falls in this at-risk sample. However, there were minimal changes in secondary measures. The study was feasible in terms of recruitment, randomisation, blinding and data collection. A larger randomised trial is needed to investigate long-term efficacy, mechanisms of benefit and clinical significance of this new intervention.
作为一种预防跌倒的策略，运动对于高危人群而言比普通人群更为复杂。通过运动减少跌倒的生活方式方法（LiFE）包括将平衡和下肢力量训练融入日常习惯活动中。
共有34名年龄≥70岁的社区居民被随机分为LiFE项目组或无干预对照组，并随访6个月。纳入标准为在过去一年中发生过两次或更多次跌倒或一次致伤性跌倒。
干预组发生12次跌倒，对照组发生35次跌倒。相对风险（RR）分析表明跌倒次数显著减少（RR = 0.23；0.07 - 0.83）。有迹象表明，LiFE项目参与者的动态平衡（三个月时P = 0.04）和效能信念（六个月时P = 0.04）有所改善。总体而言，作为跌倒风险潜在中介因素的次要身体和健康状况指标改善甚微且不一致。
LiFE在降低该高危样本中的复发性跌倒方面有效。然而，次要指标变化极小。该研究在招募、随机分组、盲法和数据收集方面是可行的。需要进行更大规模的随机试验来研究这种新干预措施的长期疗效、获益机制和临床意义。
