居家锻炼计划改善轻度阿尔茨海默病社区居住老年人的平衡能力及跌倒恐惧：一项试点研究

Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer's Disease: A Pilot Study.

作者信息

Padala Kalpana P, Padala Prasad R, Lensing Shelly Y, Dennis Richard A, Bopp Melinda M, Roberson Paula K, Sullivan Dennis H

机构信息

Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.

Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

J Alzheimers Dis. 2017;59(2):565-574. doi: 10.3233/JAD-170120.

DOI:10.3233/JAD-170120

PMID:28655135

Abstract

BACKGROUND/OBJECTIVE: Balance problems are common in older adults with Alzheimer's disease (AD). The objective was to study the effects of a Wii-Fit interactive video-game-led physical exercise program to a walking program on measures of balance in older adults with mild AD.

METHODS

A prospective randomized controlled parallel-group trial (Wii-Fit versus walking) was conducted in thirty community-dwelling older adults (73±6.2 years) with mild AD. Home-based exercises were performed under caregiver supervision for 8 weeks. Primary (Berg Balance Scale, BBS) and secondary outcomes (fear of falls and quality of life) were measured at baseline, 8 weeks (end of intervention), and 16 weeks (8-weeks post-intervention).

RESULTS

At 8 weeks, there was a significantly greater improvement (average inter-group difference [95% CI]) in the Wii-Fit group compared to the walking group in BBS (4.8 [3.3-6.2], p < 0.001), after adjusting for baseline. This improvement was sustained at 16 weeks (3.5 [2.0-5.0], p < 0.001). Analyses of the secondary outcome measures indicated that there was a significantly greater improvement in the Wii-Fit group compared to walking group in Activity-specific Balance Confidence scale (6.5 [3.6-9.4], p < 0.001) and Falls Efficacy Scale (-4.8 [-7.6 to -2.0], p = 0.002) at 8 weeks. However, this effect was not sustained at 16 weeks. Quality of life improved in both groups at 8 weeks; however, there were no inter-group differences (p = 0.445).

CONCLUSION

Home-based, caregiver-supervised Wii-Fit exercises improve balance and may reduce fear of falling in community-dwelling older adults with mild AD.

摘要

背景/目的：平衡问题在患有阿尔茨海默病（AD）的老年人中很常见。目的是研究以Wii Fit交互式视频游戏为主导的体育锻炼计划与步行计划对轻度AD老年人平衡指标的影响。

方法

对30名社区居住的轻度AD老年人（73±6.2岁）进行了一项前瞻性随机对照平行组试验（Wii Fit组与步行组）。在护理人员的监督下进行为期8周的居家锻炼。在基线、8周（干预结束时）和16周（干预后8周）测量主要结局指标（伯格平衡量表，BBS）和次要结局指标（跌倒恐惧和生活质量）。

结果

在调整基线后，与步行组相比，Wii Fit组在8周时BBS有显著更大的改善（组间平均差异[95%CI]）（4.8[3.3 - 6.2]，p<0.001）。这种改善在16周时持续存在（3.5[2.0 - 5.0]，p<0.001）。对次要结局指标的分析表明，与步行组相比，Wii Fit组在8周时特定活动平衡信心量表（6.5[3.6 - 9.4]，p<0.001）和跌倒效能量表（-4.8[-7.6至-2.0]，p = 0.002）有显著更大的改善。然而，这种效果在16周时未持续。两组在8周时生活质量均有所改善；然而，组间无差异（p = 0.445）。