Karinkanta Saija, Kannus Pekka, Uusi-Rasi Kirsti, Heinonen Ari, Sievänen Harri
The UKK Institute for Health Promotion Research, Tampere 33501, Finland.
The UKK Institute for Health Promotion Research, Tampere 33501, Finland Medical School, University of Tampere, and Department of Orthopaedics and Trauma Surgery, Tampere University Hospital, Tampere, Finland.
Age Ageing. 2015 Sep;44(5):784-9. doi: 10.1093/ageing/afv064. Epub 2015 May 18.
previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures.
five-year health-care register-based follow-up study after a 1-year, four-arm RCT.
community-dwelling older women in Finland.
one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning.
participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR).
eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97).
home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies.
此前，一项随机对照运动干预研究（RCT）表明，抗阻与平衡跳跃联合训练（COMB）可改善身体机能和骨骼强度。这项随访研究的目的是评估这种运动干预在减少伤害性跌倒和骨折方面是否具有长期效果。
在一项为期1年的四臂RCT之后，基于医疗保健登记进行的五年随访研究。
芬兰社区居住的老年女性。
最初149名RCT参与者中的145名；开始时年龄为70 - 78岁的女性。
从计算机化患者登记系统收集参与者的医疗保健就诊信息。伤害性跌倒定义为受试者因跌倒而接触医疗保健专业人员或被送往医院的事件。通过Cox比例风险模型（风险比，HR）评估伤害性跌倒者的发生率，通过泊松回归评估伤害性跌倒和骨折的发生率（风险比，RR）。
随访期间发生了81次伤害性跌倒，包括26次骨折。与对照组相比，COMB组伤害性跌倒者的发生率低62%（HR 0.38，95%CI 0.17至0.85）。此外，COMB组的伤害性跌倒减少了51%（RR 0.49，95%CI 0.25至0.98），骨折减少了74%（RR 0.26，95%CI 0.07至0.97）。
参与为期12个月强化多成分运动训练的居家老年女性在干预后5年期间伤害性跌倒的发生率降低。骨折减少也很明显。这些长期效果需要在未来研究中得到证实。
