Department of Otolaryngology, Section of Hearing and Balance Research Unit, University of Tampere and University Hospital of Tampere, Finland.
Clin Interv Aging. 2013;8:1237-46. doi: 10.2147/CIA.S47690. Epub 2013 Sep 16.
To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting.
A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes.
Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL.
Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting.
评估肌肉力量或平衡康复是否能提高姿势稳定性和生活质量（QoL），以及在机构环境中居住的老年人中，自我管理训练是否可与指导训练相媲美。
一项随机、前瞻性干预研究纳入了 55 名老年患者。评估了三组干预措施：肌肉力量训练组、平衡和肌肉力量训练组以及自我管理训练组。每组均接受每周两次、每次 1 小时的 3 个月训练。在开始时、3 个月后和 6 个月后测量姿势稳定性。计算了时域依赖的身体摆动变量。评估了 3 年的跌倒率。使用 15D 工具评估一般健康相关生活质量（HRQoL）。姿势稳定性是主要结果，QoL 和跌倒为次要结果。
肌肉力量训练者能够进行训练，逐渐进行更剧烈的运动。在姿势描记术中，训练后尖峰摆动次数减少，踝关节力矩的稳定场增加，所有组的姿势稳定性均得到改善；特别是，体重信号的过零率和稳定图中低变异性发作的次数均得到改善。虽然在姿势描记术结果方面，不同训练组之间没有差异，但只有在指导训练组中，跌倒率才显著降低。生活质量的可变性很大一部分可以用姿势描记术的结果来解释（46%）。然而，训练的结果与生活质量的降低相关。
即使是中度或重度痴呆的居民也可以在物理治疗师的监督下在五人小组中进行锻炼。所有训练组均观察到姿势稳定性的改善，这表明即使是自我管理训练也可能有益。姿势描记术结果表明，通过减少身体摆动信号的振荡波动，训练改变了姿势策略。然而，只有指导训练才倾向于减少跌倒。短期训练干预计划可能会通过改变老年人的日常生活方式，使其变得更加活跃和疲惫，从而降低生活质量。
