Davis Jennifer C, Hsu Chun Liang, Cheung Winnie, Brasher Penny M A, Li Linda C, Khan Karim M, Sykes Jonathan, Skelton Dawn A, Liu-Ambrose Teresa
Centre for Clinical Epidemiology and Evaluation, University of British Columbia & Vancouver Coastal Health Research Institute (VCHRI) , Vancouver, British Columbia , Canada.
Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.
BMJ Open Sport Exerc Med. 2016 Feb 4;2(1):e000059. doi: 10.1136/bmjsem-2015-000059. eCollection 2016.
We assessed the feasibility of delivering the Otago Exercise Programme (OEP) via an interactive DVD (ie, OEP-DVD) in combination with monthly physical therapist phone calls to older adults.
This pre-post (baseline and 6-month follow-up) study included an intervention group (n=61) based in a rural location and a control group (n=21) based in a city.
Sechelt and Vancouver, British Columbia.
82 community-dwelling adults ≥75 years.
Individuals in the intervention group received the OEP-DVD and were instructed to do the exercises 3 times a week after their initial home physical therapist visit for 6 months.
Feasibility was ascertained by withdrawal rate and compliance to the OEP-DVD. The number of participants and the frequency (ie, number of times weekly) they performed the OEP exercises and walking were used to estimate compliance. The potential benefit of the OEP-DVD on falls risk profile (Physiological Profile Assessment (PPA)) and mobility were examined by comparing the change in the intervention group compared with the control group. Self-reported compliance to the exercise programme was assessed by monthly returned diary.
Of the 82 participants, 2 withdrew from the OEP-DVD group and none withdrew from the control group. We obtained compliance data on 72% of participants in the intervention group. The mean OEP-DVD compliance was 87% and the mean walking compliance was 166%. After adjusting for baseline PPA, baseline age, sex, baseline comorbidities, baseline cognitive status and baseline falls-related self-efficacy, there was a significant between-group improvement in the overall PPA score (OEP group pre-PPA to post-PPA score: 0.79±1.2 to 0.7±0.9; p<0.05) at study completion.
Although the OEP-DVD resulted in significant reductions in falls risk among community-dwelling older adults, there was a notable loss to follow-up limiting the feasibility of this approach.
我们评估了通过交互式DVD(即奥塔哥运动计划DVD,OEP-DVD)并结合物理治疗师每月一次的电话随访,向老年人提供奥塔哥运动计划(OEP)的可行性。
这项前后对照(基线和6个月随访)研究包括一个位于农村地区的干预组(n = 61)和一个位于城市的对照组(n = 21)。
不列颠哥伦比亚省的锡谢尔特和温哥华。
82名年龄≥75岁的社区居住成年人。
干预组的个体接受OEP-DVD,并被指示在首次接受家庭物理治疗师访视后的6个月内,每周进行3次锻炼。
通过退出率和对OEP-DVD的依从性来确定可行性。参与者的数量及其进行OEP锻炼和步行的频率(即每周次数)用于评估依从性。通过比较干预组与对照组的变化,研究OEP-DVD对跌倒风险状况(生理状况评估,PPA)和活动能力的潜在益处。通过每月返还的日记评估自我报告的对锻炼计划的依从性。
82名参与者中,2名退出了OEP-DVD组,对照组无人退出。我们获得了干预组72%参与者的依从性数据。OEP-DVD的平均依从率为87%,步行的平均依从率为166%。在对基线PPA、基线年龄、性别、基线合并症、基线认知状态和基线跌倒相关自我效能进行调整后,研究结束时,总体PPA评分在组间有显著改善(OEP组从PPA前评分到PPA后评分:0.79±1.2至0.7±0.9;p<0.05)。
尽管OEP-DVD显著降低了社区居住老年人的跌倒风险,但随访中有明显失访情况,限制了这种方法的可行性。