Turunen Katri, Salpakoski Anu, Edgren Johanna, Törmäkangas Timo, Arkela Marja, Kallinen Mauri, Pesola Maija, Hartikainen Sirpa, Nikander Riku, Sipilä Sarianna
Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland; GeroCenter Foundation for Aging Research and Development, Jyvaskyla, Finland.
Research and Development, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland.
Arch Phys Med Rehabil. 2017 May;98(5):981-988. doi: 10.1016/j.apmr.2017.01.004. Epub 2017 Jan 27.
To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture.
Secondary analysis of a randomized, controlled, parallel-group trial.
Home-based rehabilitation; measurements in university laboratory.
Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital.
A yearlong intervention included evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacologic pain management, a progressive home exercise program, PA counseling, and standard care.
The outcome was the level of PA, which was assessed with the questionnaire (a modified Grimby scale) at baseline, and 3, 6, 12, and 24 months after baseline. Three PA categories were defined: inactivity, light PA, and moderate to heavy PA. Physical function was assessed using the Short Physical Performance Battery (SPPB) at baseline. The effects of the intervention were analyzed with generalized estimating equations.
In the intervention group, a significant increase was observed in the level of PA after the intervention (interaction P=.005) and after 1-year follow-up (P=.021) compared with the standard care only. The benefit was particularly evident among the participants with a baseline SPPB score of ≥7 (interaction P<.001).
The 12-month individualized multicomponent rehabilitation program increased PA among older patients with hip fracture. The increase was found to be maintained at the 1-year follow-up.
探讨为期一年的多组分康复计划对近期髋部骨折康复的老年人身体活动（PA）水平及1年随访期内PA水平维持情况的影响。
一项随机对照平行组试验的二次分析。
居家康复；在大学实验室进行测量。
年龄≥60岁、从髋部骨折中康复的社区居民（N = 81）。参与者在出院后平均42±23天被随机分配到干预组（n = 40）或对照组（n = 41）。
为期一年的干预包括评估和改善环境危险因素、安全行走指导、非药物性疼痛管理、渐进性家庭锻炼计划、PA咨询以及标准护理。
结局为PA水平，在基线时以及基线后3、6、12和24个月通过问卷（改良的格里姆比量表）进行评估。定义了三类PA：不活动、轻度PA和中度至重度PA。在基线时使用简短身体功能测试电池（SPPB）评估身体功能。使用广义估计方程分析干预效果。
与仅接受标准护理相比，干预组在干预后（交互作用P = 0.005）和1年随访后（P = 0.021）PA水平有显著提高。在基线SPPB评分≥7的参与者中，这种益处尤为明显（交互作用P<0.001）。
为期12个月的个体化多组分康复计划增加了髋部骨折老年患者的PA。在1年随访时发现这种增加得以维持。
