Physical Therapy and Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
J Geriatr Phys Ther. 2013 Jan-Mar;36(1):3-12. doi: 10.1519/JPT.0b013e3182550ea5.
To determine if persons older than 65 years receiving a combination of physical therapy, occupational therapy, speech, or nursing interventions in their home demonstrated changes in gait/balance function after an episode of home care services.
Charts from 11 667 persons who were at risk for falling and who were participating in an exercise program in the home were included.
Data were retrieved from the Outcome and Assessment Information Set, Version B, and the computerized database of physical therapist-collected outcome data. Recorded physical therapist-data may have included a neuropathic pain rating, the Berg Balance Scale (BBS), the Performance Oriented Measurement Assessment (POMA), the Dynamic Gait Index (DGI), and the modified Clinical Test of Sensory Integration and Balance (mCTSIB).
Data were extracted by an honest broker and were analyzed. Mean (SD) change in each performance test and the percentage of participants in the total sample and in the 9 age/health condition strata that exceeded the minimum detectable change (MDC) for each gait/balance measure were described. The value of MDC95 describes the amount of true change in participant status beyond measurement error with 95% certainty.
The gait/balance measures demonstrated MDCs ranging between 68% and 91% for the study sample. Mean (SD) of improvement on the BBS was 12 (8) points, with 88% of all participants exceeding the BBS MDC95 value of 5 points. Mean (SD) of improvement in gait/balance performance as measured by the POMA was 8 (4) points, with 91% of all participants exceeding the POMA MDC95 value of 3 points. Among all patients, mean (SD) of improvement on the DGI was 7 (4) points with 91% of all participants exceeding the DGI MDC95 value of 2 points by discharge. At admission, the median number of mCTSIB conditions that could be completed was 1 and the median number of completed conditions on the mCTSIB increased to 3 at discharge, with 81% of all participants demonstrating improvement.
On the basis of established criteria, participants seemed to make clinically meaningful gains after the home care episode of care.
为了确定在居家护理服务后，65 岁以上接受物理治疗、职业治疗、言语治疗或护理干预综合治疗的人群，其步态/平衡功能是否有变化。
本研究纳入了 11667 名有跌倒风险并在家中参加运动计划的患者图表。
从 Outcome and Assessment Information Set，Version B 以及物理治疗师收集的结果数据的计算机数据库中检索数据。记录的物理治疗师数据可能包括神经病理性疼痛评分、伯格平衡量表（Berg Balance Scale，BBS）、动作定向测量评估（Performance Oriented Measurement Assessment，POMA）、动态步态指数（Dynamic Gait Index，DGI）和改良临床感觉整合与平衡测试（modified Clinical Test of Sensory Integration and Balance，mCTSIB）。
由诚实中间人提取数据并进行分析。描述了每个测试的平均（标准差）变化，以及总样本和 9 个年龄/健康状况分层中，超过步态/平衡测量每项最小可检测变化（Minimum Detectable Change，MDC）的参与者比例。MDC95 的值描述了参与者状态的真实变化量，超过了 95%的测量误差。
步态/平衡测量的 MDC 值在研究样本中为 68%至 91%。BBS 的平均（标准差）改善值为 12（8）分，所有参与者中有 88%超过 BBS 的 MDC95 值 5 分。以 POMA 测量的步态/平衡表现的平均（标准差）改善值为 8（4）分，所有参与者中有 91%超过 POMA 的 MDC95 值 3 分。在所有患者中，DGI 的平均（标准差）改善值为 7（4）分，所有患者中有 91%在出院时超过 DGI 的 MDC95 值 2 分。入院时，mCTSIB 可完成的条件中位数为 1，出院时 mCTSIB 可完成的条件中位数增加到 3，所有患者中有 81%显示出改善。
根据既定标准，参与者在居家护理服务后似乎取得了有临床意义的改善。
