Saravanakumar Padmapriya, Higgins Isabel Johanna, van der Riet Pamela Jane, Marquez Jodie, Sibbritt David
Faculty of Health, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia.
Contemp Nurse. 2014;48(1):76-87. doi: 10.1080/10376178.2014.11081929. Epub 2014 Jul 23.
Falls amongst older people is a global public health concern. Whilst falling is not a typical feature of ageing, older people are more likely to fall. Fall injuries amongst older people are a leading cause of death and disability. Many older people do not do regular exercise so that they lose muscle tone, strength, and flexibility which affect balance and predispose them to falls. The management of falls in residential care settings is a major concern with strategies for prevention and monitoring a focus in this setting. Yoga and tai chi have shown potential to improve balance and prevent falls in older adults. They also have potential to improve pain and quality of life. The aim of this study was to determine the feasibility of conducting a three-arm randomised controlled trial (RCT) with frail older people in a residential care setting to test the hypothesis that a 14-week modified tai chi or yoga programme is more effective than usual care activity in improving balance function, quality of life, pain experience and in reducing number of falls. There were no statistically significant differences between the three groups in the occurrence of falls. Yoga demonstrated a slight decrease in fall incidence; quality of life improved for the tai chi group. Only the yoga group experienced a reduction in average pain scores though not statistically significant. The findings of the study suggest it is possible to safely implement modified yoga and tai chi in a residential care setting and evaluate this using RCT design. They show positive changes to balance, pain and quality of life and a high level of interest through attendance amongst the older participants. The results support offering tai chi and yoga to older people who are frail and dependent with physical and cognitive limitations.
老年人跌倒问题是一个全球性的公共卫生问题。虽然跌倒并非衰老的典型特征，但老年人更容易跌倒。老年人跌倒受伤是导致死亡和残疾的主要原因。许多老年人不经常锻炼，因此肌肉张力、力量和灵活性下降，这会影响平衡并使他们容易跌倒。在住宿护理机构中，跌倒的管理是一个主要问题，预防和监测策略是该机构关注的重点。瑜伽和太极拳已显示出改善老年人平衡和预防跌倒的潜力。它们还有改善疼痛和生活质量的潜力。本研究的目的是确定在住宿护理机构中对体弱老年人进行三臂随机对照试验（RCT）的可行性，以检验以下假设：为期14周的改良太极拳或瑜伽课程在改善平衡功能、生活质量、疼痛体验以及减少跌倒次数方面比常规护理活动更有效。三组在跌倒发生率上没有统计学上的显著差异。瑜伽组的跌倒发生率略有下降；太极拳组的生活质量有所改善。只有瑜伽组的平均疼痛评分有所降低，尽管在统计学上不显著。该研究结果表明，在住宿护理机构中安全实施改良瑜伽和太极拳并使用随机对照试验设计进行评估是可行的。它们显示出在平衡、疼痛和生活质量方面的积极变化，并且老年参与者的出勤率很高，表现出浓厚的兴趣。研究结果支持为身体和认知有局限的体弱和依赖他人的老年人提供太极拳和瑜伽课程。
