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身体锻炼:对于慢性疼痛的老年患者,它有助于缓解疼痛和提高活动能力吗?

Physical exercise: does it help in relieving pain and increasing mobility among older adults with chronic pain?

机构信息

School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.

出版信息

J Clin Nurs. 2011 Mar;20(5-6):635-44. doi: 10.1111/j.1365-2702.2010.03548.x.

Abstract

AIM

To provide a physical exercise programme for older adults living in nursing homes.

BACKGROUND

Pain is common among older persons and for those already in long-term care and having difficulty in coping with pain will be at risk of further reducing their optimal independent function.

DESIGN

A quasi-experimental single group pretest-posttest design.

METHOD

Older persons from a nursing home were invited to join an eight-week physical exercise programme. Each session lasted an hour and sessions were conducted once a week by physiotherapist and nurses. Physical exercise programme consisted of stretching, strengthening, balancing, towel dancing and self-administered massage to various acupressure points. On completion of each session, older persons were given a pamphlet with pictures to illustrate the exercise of the day and they were encouraged to practise these exercises by themselves. Outcome measures including pain intensity, range of movement, activities of daily living and mobility were collected before and after the physical exercise programme.

RESULTS

There were 75 older adult participants (57 female and 18 male, mean age 85.14 SD 5.30). Seventy-three percent (n = 55) of them had pain in the previous three months and were referred as pain group, while 25% (n = 20) were no pain group. Pain scores of 4.89 (on a 10-point scale) indicated medium pain intensity before the intervention for the pain group; the location of pain was mainly in the knee, back and shoulder. On completion of the physical exercise programme, there was a significant decrease in pain intensity to 2.89 (SD 2.14) (p < 0.01). There was a significant increase in range of movement in the neck, shoulder, back, hip and knee rotation, flex and abduction (p < 0.01). Mobility level was significantly increased post intervention, yet activities of daily living remained unchanged.

CONCLUSIONS

The present study demonstrated the effectiveness of a physical exercise programme in relieving pain and enhancing functional mobility for older persons. Relevance to clinical practice.  It is important to educate older persons, especially those living in nursing homes, on the importance of engaging in regular physical exercise and maintaining mobility.

摘要

目的

为居住在养老院的老年人提供身体锻炼方案。

背景

疼痛在老年人中很常见,对于那些已经长期护理并难以应对疼痛的人,他们将面临进一步降低最佳独立功能的风险。

设计

准实验性单组前后测试设计。

方法

养老院的老年人受邀参加为期八周的身体锻炼计划。每次课程持续一小时,由物理治疗师和护士每周一次进行。身体锻炼计划包括伸展、增强力量、平衡、毛巾舞和自我按摩各个穴位。每次课程结束时,老年人会收到一本带有图片的小册子,说明当天的锻炼内容,并鼓励他们自己练习这些锻炼。在身体锻炼计划前后收集了疼痛强度、活动范围、日常生活活动和活动能力等结果测量。

结果

共有 75 名老年人参与(57 名女性和 18 名男性,平均年龄 85.14 ± 5.30 岁)。其中 73%(n = 55)在过去三个月中有疼痛,并被归类为疼痛组,而 25%(n = 20)为无痛组。疼痛组干预前疼痛强度评分为 4.89(10 分制),表示中度疼痛;疼痛部位主要在膝盖、背部和肩部。完成身体锻炼计划后,疼痛强度显著下降至 2.89(SD 2.14)(p < 0.01)。颈部、肩部、背部、臀部和膝盖旋转、弯曲和外展的活动范围均显著增加(p < 0.01)。干预后活动能力显著提高,但日常生活活动没有变化。

结论

本研究表明,身体锻炼计划可有效缓解老年人疼痛,提高其功能活动能力。与临床实践的相关性。教育老年人,特别是居住在养老院的老年人,定期进行身体锻炼和保持活动能力的重要性。

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