联合运动与认知训练降低老年跌倒者的跌倒风险
Reducing Fall Risk with Combined Motor and Cognitive Training in Elderly Fallers.
作者信息
Barban Francesco, Annicchiarico Roberta, Melideo Matteo, Federici Alessia, Lombardi Maria Giovanna, Giuli Simone, Ricci Claudia, Adriano Fulvia, Griffini Ivo, Silvestri Manuel, Chiusso Massimo, Neglia Sergio, Ariño-Blasco Sergio, Cuevas Perez Raquel, Dionyssiotis Yannis, Koumanakos Georgios, Kovačeić Milo, Montero-Fernández Nuria, Pino Oscar, Boye Niels, Cortés Ulises, Barrué Cristian, Cortés Atia, Levene Peter, Pantelopoulos Stelios, Rosso Roberto, Serra-Rexach José Antonio, Sabatini Angelo Maria, Caltagirone Carlo
机构信息
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy.
Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin 10117, Germany.
出版信息
Brain Sci. 2017 Feb 10;7(2):19. doi: 10.3390/brainsci7020019.
BACKGROUND
Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL.
METHODS
In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an -Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition).
RESULTS
Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention.
CONCLUSIONS
This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.
背景
跌倒在老年人中是一个重大临床问题，需要有效的解决办法。目前，唯一有效的干预措施是平衡和力量的运动训练。根据显示执行功能与步态异常之间存在关联的证据，基于执行功能的训练（EFt）可能在预防跌倒方面有效。目的是评估在欧盟共同资助的“我不会跌倒”项目中开发的运动治疗和认知治疗的有效性。
方法
在这项多中心随机对照试验招募的481名有跌倒风险的老年人样本中，评估了通过 -Walker进行的24次一小时运动治疗（纯运动或与EFt混合）与非运动治疗（纯EFt或对照条件）的有效性。同样，将通过触摸屏电脑进行的24次一小时认知治疗（纯EFt或与运动训练混合）与非认知治疗（纯运动或对照条件）进行了比较。
结果
运动治疗，特别是与EFt混合时，显著降低了跌倒恐惧（F(1,478) = 6.786， = 0.009），尽管程度有限（效应量 -0.25），且仅限于干预后的时期。
结论
本研究表明，EFt增强的运动治疗在降低跌倒恐惧方面是有效的。
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