Trombetti Andrea, Hars Mélany, Herrmann François R, Kressig Reto W, Ferrari Serge, Rizzoli René
Division of Bone Diseases, Department of Rehabilitation and Geriatrics, University Hospitals and Faculty of Medicine of Geneva, 1211 Geneva 14, Switzerland.
Arch Intern Med. 2011 Mar 28;171(6):525-33. doi: 10.1001/archinternmed.2010.446. Epub 2010 Nov 22.
Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals.
We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk.
At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P < .002) under dual-task condition in the intervention group, compared with the delayed intervention control group. Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later.
In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.
跌倒主要发生在行走或执行并发任务时。我们确定了基于音乐的多任务锻炼计划是否能改善老年人的步态和平衡,并降低跌倒风险。
我们进行了一项为期12个月的随机对照试验,纳入了134名65岁以上、跌倒风险增加的社区居住个体。他们被随机分配到干预组(n = 66)或延迟干预对照组(n = 68),延迟干预对照组计划在6个月后开始该计划。干预措施是一项为期6个月、按照钢琴音乐节奏进行的多任务锻炼计划。双任务条件下从基线到6个月时步态变异性的变化是主要终点。次要结局包括平衡、功能表现和跌倒风险的变化。
在6个月时,与延迟干预对照组相比,干预组在双任务条件下的步长变异性降低(调整后平均差异,-1.4%;P <.002)。与对照组相比,平衡和功能测试有所改善。干预组的跌倒次数较少(发病率比,0.46;95%置信区间,0.27 - 0.79),跌倒风险较低(相对风险,0.61;95%置信区间,0.39 - 0.96)。在第二个6个月的干预期内,延迟干预对照组也出现了类似变化。干预对步态变异性产生的益处持续了6个月。
在跌倒风险增加的社区居住老年人中,一项为期6个月的基于音乐的多任务锻炼计划改善了双任务条件下的步态,改善了平衡,并降低了跌倒率和跌倒风险。试验注册 clinicaltrials.gov标识符:NCT01107288。