Northern Health, Melbourne, Victoria, Australia.
BMJ Open. 2013 Jun 20;3(6):e002569. doi: 10.1136/bmjopen-2013-002569.
To determine if a programme of progressive resistance exercise, mobilisation and orientation, in addition to usual care, was superior to usual care alone in the prevention of incident delirium in older hospitalised patients.
A randomised controlled trial.
The study was performed at a secondary referral hospital in Melbourne, Australia between May 2005 and December 2007.
648 consecutive medical inpatients aged 65 years or older who had been in hospital for less than 48 h and who did not have delirium.
Participants were randomly allocated to a twice-daily programme of progressive resistance exercise tailored to individual ability, mobilisation and orientation in addition to usual care or to usual care alone.
Delirium was measured using the Confusion Assessment Method at baseline and every 48 h until discharge. Secondary outcome measures were severity and duration of delirium, discharge destination and length of stay.
Delirium occurred in 4.9% (95% CI 2.3% to 7.3%) of the intervention group (15/305) and in 5.9% (20/339; 95% CI 3.8% to 9.2%) of the group receiving usual care. No difference was observed between groups (χ(2); p=0.5). The intervention had no effect on delirium duration, severity, discharge destination or length of stay.
A programme of progressive resistance exercise and orientation was not effective in reducing incident delirium in hospitalised elderly patients.
确定在常规护理基础上增加渐进式抗阻运动、活动和定向训练方案是否能预防老年住院患者发生新发谵妄。
随机对照试验。
2005 年 5 月至 2007 年 12 月期间，澳大利亚墨尔本的一家二级转诊医院进行了这项研究。
648 例连续入院的年龄≥65 岁、入院时间＜48 h 且无谵妄的住院患者。
参与者被随机分配至每日进行两次的渐进式抗阻运动方案，该方案根据个人能力进行调整，同时还进行活动和定向训练，作为附加干预；或仅接受常规护理。
使用意识模糊评估方法（CAM）在基线和每次 48 h 时评估谵妄情况，直至出院。次要结局指标为谵妄的严重程度和持续时间、出院去向和住院时间。
干预组（305 例中的 15 例，4.9%；95%CI，2.3%7.3%）和常规护理组（339 例中的 20 例，5.9%；95%CI，3.8%9.2%）分别有 4.9%和 5.9%的患者发生谵妄。两组间无差异（χ(2)；p=0.5）。干预对谵妄持续时间、严重程度、出院去向或住院时间均无影响。
对老年住院患者而言，渐进式抗阻运动和定向训练方案在预防新发谵妄方面无效。
