Stevens-Lapsley Jennifer E, Loyd Brian J, Falvey Jason R, Figiel Greg J, Kittelson Andrew J, Cumbler Ethan U, Mangione Kathleen K
Physical Therapy Program, University of Colorado, Aurora, CO, USA
Physical Therapy Program, University of Colorado, Aurora, CO, USA.
Clin Rehabil. 2016 Aug;30(8):776-85. doi: 10.1177/0269215515603219. Epub 2015 Sep 3.
To determine whether a progressive multicomponent physical therapy intervention in the home setting can improve functional mobility for deconditioned older adults following acute hospitalization.
Randomized controlled trial.
Patient homes in the Denver, CO, metropolitan area.
A total of 22 homebound older adults age 65 and older (mean ± SD; 85.4 ±7.83); 12 were randomized to intervention group and 10 to the control group.
The progressive multicomponent intervention consisted of home-based progressive strength, mobility and activities of daily living training. The control group consisted of usual care rehabilitation.
A 4-meter walking speed, modified Physical Performance Test, Short Physical Performance Battery, 6-minute walk test.
At the 60-day time point, the progressive multicomponent intervention group had significantly greater improvements in walking speed (mean change: 0.36 m/s vs. 0.14 m/s, p = 0.04), modified physical performance test (mean change: 6.18 vs. 0.98, p = 0.02) and Short Physical Performance Battery scores (mean change: 2.94 vs. 0.38, p = 0.02) compared with the usual care group. The progressive multicomponent intervention group also had a trend towards significant improvement in the 6-minute walk test at 60 days (mean change: 119.65 m vs. 19.28 m; p = 0.07). No adverse events associated with intervention were recorded.
The progressive multicomponent intervention improved patient functional mobility following acute hospitalization more than usual care. Results from this study support the safety and feasibility of conducting a larger randomized controlled trial of progressive multicomponent intervention in this population. A more definitive study would require 150 patients to verify these conclusions given the effect sizes observed.
确定在家庭环境中进行的渐进式多组分物理治疗干预能否改善急性住院后身体状况不佳的老年人的功能活动能力。
随机对照试验。
科罗拉多州丹佛市大都市区的患者家中。
共有22名65岁及以上的居家老年人（均值±标准差；85.4±7.83）；12人被随机分配到干预组，10人被分配到对照组。
渐进式多组分干预包括以家庭为基础的渐进式力量、活动能力和日常生活活动训练。对照组接受常规护理康复。
4米步行速度、改良身体性能测试、简短身体性能量表、6分钟步行试验。
在60天时间点，与常规护理组相比，渐进式多组分干预组在步行速度（平均变化：0.36 m/s对0.14 m/s，p = 0.04）、改良身体性能测试（平均变化：6.18对0.98，p = 0.02）和简短身体性能量表评分（平均变化：2.94对0.38，p = 0.02）方面有显著更大的改善。渐进式多组分干预组在60天时的6分钟步行试验中也有显著改善的趋势（平均变化：119.65 m对19.28 m；p = 0.07）。未记录到与干预相关的不良事件。
渐进式多组分干预比常规护理更能改善急性住院后患者的功能活动能力。本研究结果支持在该人群中进行更大规模的渐进式多组分干预随机对照试验的安全性和可行性。鉴于观察到的效应大小，更确切的研究需要150名患者来验证这些结论。
