Valley View Centre Long Term Care Residential Facility for People with Intellectual Disabilities, Moose Jaw, Saskatchewan, Canada.
J Intellect Disabil Res. 2014 May;58(5):485-92. doi: 10.1111/jir.12045. Epub 2013 Apr 19.
Persons with intellectual disabilities (ID) constitute a special-needs population at high risk of falling. This is the first study to evaluate whether obstacle course training can improve mobility and prevent falls in this population.
The intervention was implemented as part of an institution-wide health care improvement plan aimed at reducing falls at a residential facility for people with ID. It comprised an annual screening of each resident for his or her individual fall risk. Subsequently, the group of ambulatory persons with a moderate to high fall risk (n = 39) were offered 10-session obstacle course training to improve their balance and gait abilities. Mobility was assessed pre-intervention, mid-term and post-intervention with the Performance Oriented Mobility Assessment (POMA), the Timed Up and Go (TUG) and the 10-meter walking test. The number of falls was compared between the year before and after intervention.
The number of falls decreased by 82% (P < 0.001). POMA scores significantly improved from pre-intervention to mid-term (mean difference ± SD, 1.8 ± 2.9, P = 0.001), from mid-term to post-intervention (2.0 ± 2.9, P < 0.001), and from pre-intervention to post-intervention (3.8 ± 4.3, P < 0.001). Participants completed the 10-meter walking test faster at the post-intervention compared with the pre-intervention assessment (difference ± SD, 2.1 ± 5.1 s, P = 0.022). TUG scores did not improve significantly.
The present study provides preliminary evidence for the effectiveness of obstacle course training in improving mobility and preventing falls in people with ID. As falls are a significant health concern in this population, further research is advocated to provide conclusive evidence for the suggested beneficial effects of exercise interventions.
智力障碍（ID）患者属于高跌倒风险的特殊人群。本研究首次评估了障碍课程训练是否能改善该人群的移动能力并预防跌倒。
该干预措施是作为一项旨在减少 ID 居住者跌倒的机构范围医疗保健改善计划的一部分实施的。它包括对每个居民进行年度个体跌倒风险筛查。随后，对具有中度至高度跌倒风险的可移动者（n=39）进行了 10 节障碍课程训练，以提高他们的平衡和步态能力。在干预前、中期和后期使用动作表现评估（POMA）、计时起立行走测试（TUG）和 10 米步行测试评估移动能力。将干预前后的跌倒次数进行了比较。
跌倒次数减少了 82%（P<0.001）。POMA 评分从中期到后期显著提高（平均差异±SD，1.8±2.9，P=0.001），从中期到后期（2.0±2.9，P<0.001），以及从干预前到干预后（3.8±4.3，P<0.001）。与干预前评估相比，参与者在干预后完成 10 米步行测试的速度更快（差异±SD，2.1±5.1s，P=0.022）。TUG 评分无显著提高。
本研究初步证明了障碍课程训练在改善 ID 患者的移动能力和预防跌倒方面的有效性。由于跌倒对该人群是一个重大健康问题，因此提倡进一步研究，以提供对运动干预有益效果的确凿证据。
