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跌倒和骨折在参加和未参加预防老年人跌倒的锻炼计划的参与者中的比较:一项 1 年随访研究。

Falls and fractures in participants and excluded non-participants of a fall prevention exercise program for elderly women with a history of falls: 1-year follow-up study.

机构信息

Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo.

出版信息

Geriatr Gerontol Int. 2014 Apr;14(2):285-92. doi: 10.1111/ggi.12095. Epub 2013 May 19.

Abstract

AIM

To evaluate the effectiveness of a strength and balance enhancing exercise intervention as a means of preventing falls in community-dwelling elderly Japanese women with a history of falls, while comparing functional fitness, fall and fracture rate in excluded subjects.

METHODS

A 1-year follow-up trial was carried out on 105 participants over the age of 70 years, who were randomly assigned to the exercise or education group, and also on 91 women excluded based on the exclusion criteria. The exercise group attended a 60-min exercise class twice a week for 3 months. Falls, injuries, fractures, and functional fitness assessments were measured at baseline, post-intervention and 1-year follow up.

RESULTS

During the follow up, fall rates were 19.6% in the exercise group, 40.4% in the education group and 40.8% in excluded subjects (χ(2)  = 7.069, P = 0.029). Compared with the exercise group, the odds ratio (OR) for falls was greater in the education group (OR 2.78, 95% confidence interval (CI) 1.17-6.96) and excluded participants (OR 2.83, 95%CI 1.25-6.80). The OR for fractures was over fourfold greater in excluded participants (OR 4.30, 95% CI 1.02-9.70) than the exercise group.

CONCLUSIONS

The exercise intervention for participants with fall history effectively decreased incidences of falls and fractures. However, fall and fracture rates in excluded people were high. Further research focusing on feasible countermeasures for falls in excluded people who are at high risk of fractures is required.

摘要

目的

评估一项增强力量和平衡的运动干预措施对有跌倒史的日本社区居住老年女性预防跌倒的有效性,同时比较排除对象的功能适应性、跌倒和骨折发生率。

方法

对 105 名 70 岁以上的参与者进行了为期 1 年的随访试验,他们被随机分配到运动组或教育组,同时还对 91 名根据排除标准被排除的女性进行了随访。运动组参加了为期 3 个月、每周两次、每次 60 分钟的运动课程。在基线、干预后和 1 年随访时测量跌倒、损伤、骨折和功能适应性评估。

结果

在随访期间,运动组的跌倒率为 19.6%,教育组为 40.4%,排除组为 40.8%(χ²=7.069,P=0.029)。与运动组相比,教育组(OR 2.78,95%CI 1.17-6.96)和排除组(OR 2.83,95%CI 1.25-6.80)的跌倒风险更高。排除组的骨折风险比运动组高出四倍多(OR 4.30,95%CI 1.02-9.70)。

结论

针对有跌倒史的参与者的运动干预措施有效降低了跌倒和骨折的发生率。然而,排除组的跌倒和骨折发生率较高。需要进一步研究针对高骨折风险的排除者的可行跌倒预防对策。

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