Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania 19039, USA.
J Am Geriatr Soc. 2010 Oct;58(10):1911-7. doi: 10.1111/j.1532-5415.2010.03076.x.
To compare the effectiveness of a short-term leg-strengthening exercise program with that of attentional control on improving strength, walking abilities, and function 1 year after hip fracture.
Randomized controlled pilot study.
Patients' homes.
Community-dwelling older adults (n=26) 6 months after hip fracture at baseline.
Exercise and control participants received interventions from physical therapists twice a week for 10 weeks. The exercise group received high-intensity leg-strengthening exercises. The control group received transcutaneous electrical nerve stimulation and mental imagery.
Isometric force production of lower extremity muscles, usual and fast gait speed, 6-minute walk (6-MW) distance, modified Physical Performance Test (mPPT), and Medical Outcomes Study 36-item Short Form Survey (SF-36) physical function.
The primary endpoint was 1 year after fracture. Isometric force production (P=.006), usual (P=.02) and fast (P=.03) gait speed, 6-MW distance (P=.005), and mPPT score (P<.001) were improved 1 year after fracture with exercise. Effect sizes were 0.79 for strength, 0.81 for mPPT score, 0.56 for gait speed, 0.49 for 6-MW, and 0.30 for SF-36 score. More patients in the exercise group made meaningful changes in gait speed and 6-MW distance than control patients (chi-square P=.004).
A 10-week home-based progressive resistance exercise program was sufficient to achieve moderate to large effects on physical performance and quality of life and may offer an alternative intervention mode for patients with hip fracture who are unable to leave home by 6 months after the fracture. The effects were maintained at 3 months after completion of the training program.
比较短期腿部强化锻炼方案与注意力控制对改善髋部骨折后 1 年的力量、步行能力和功能的效果。
随机对照初步研究。
患者家中。
髋部骨折后 6 个月的社区居住的老年人（n=26）。
运动组和对照组每周接受物理治疗师两次干预，持续 10 周。运动组接受高强度腿部强化锻炼。对照组接受经皮神经电刺激和心理意象。
下肢肌肉等长力量、常速和快速步行速度、6 分钟步行（6-MW）距离、改良物理性能测试（mPPT）和医疗结局研究 36 项简明健康调查问卷（SF-36）的身体功能。
主要终点是骨折后 1 年。骨折后 1 年，等长力量（P=.006）、常速（P=.02）和快速（P=.03）步行速度、6-MW 距离（P=.005）和 mPPT 评分（P<.001）均得到改善。力量的效应大小为 0.79，mPPT 评分的效应大小为 0.81，步行速度的效应大小为 0.56，6-MW 的效应大小为 0.49，SF-36 评分的效应大小为 0.30。运动组中有更多的患者在步行速度和 6-MW 距离方面出现有意义的变化，而对照组患者则较少（卡方 P=.004）。
10 周的家庭渐进式抗阻锻炼方案足以对身体表现和生活质量产生中度至较大的影响，对于髋部骨折后 6 个月内无法离家的患者来说，可能提供一种替代的干预模式。在训练计划完成后 3 个月仍能保持效果。
