Halvarsson Alexandra, Dohrn Ing-Mari, Ståhle Agneta
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Sweden Department of Physical Therapy, Karolinska University Hospital, Sweden
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Sweden.
Clin Rehabil. 2015 May;29(5):417-25. doi: 10.1177/0269215514546770. Epub 2014 Sep 8.
To give the rationale and evidence for and a detailed description of a rehabilitation programme of proven effectiveness in improving balance in older adults.
Based on the knowledge that balance loss usually occurs in situations when attention is divided, especially when being older, and that balance control relies on the interaction of several physiological systems, we have developed a specific and progressive balance training programme with dual- and multi-task exercises for older adults.
Balance demanding exercises, specific to the various components of balance control and to situations in daily life, were performed in sitting, standing and walking at three different levels of progression (basic, moderate and advanced) of increasing difficulty and complexity. The training was performed in 45-minutes group sessions, with 6-10 participants in each group, three times per week during 12 weeks, with two or three physiotherapists present.
This balance training programme strengthens self-efficacy in balance control leading to improved fall-related self-efficacy, reduced fear of falling, increased walking speed, and improved physical function. Participants found the programme motivating, valuable, fun, and enjoyable, which was reflected in a high attendance rate.
为一项经证实能有效改善老年人平衡能力的康复计划提供理论依据、证据及详细描述。
基于这样的认识，即平衡能力丧失通常发生在注意力分散的情况下，尤其是在老年人中，且平衡控制依赖于多个生理系统的相互作用，我们为老年人制定了一项特定的、循序渐进的平衡训练计划，其中包括双重任务和多任务练习。
针对平衡控制的各个组成部分以及日常生活中的各种情况，进行了对平衡能力要求较高的练习，练习在坐姿、站姿和行走状态下进行，分为三个不同的进阶水平（基础、中等和高级），难度和复杂度逐渐增加。训练以45分钟的小组课程形式进行，每组6至10名参与者，每周三次，共持续12周，每次有两到三名物理治疗师在场。
这项平衡训练计划增强了平衡控制方面的自我效能感，从而提高了与跌倒相关的自我效能感，减少了对跌倒的恐惧，提高了步行速度，并改善了身体功能。参与者认为该计划具有激励性、有价值、有趣且令人愉悦，这反映在高出席率上。
