社区中老年人跌倒者进行离心运动与传统阻力运动的比较：多成分跌倒预防计划中的一项随机试验。
Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.
作者信息
LaStayo Paul, Marcus Robin, Dibble Leland, Wong Bob, Pepper Ginette
机构信息
Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84109, USA.
College of Nursing, University of Utah, Salt Lake City, UT, USA.
出版信息
BMC Geriatr. 2017 Jul 17;17(1):149. doi: 10.1186/s12877-017-0539-8.
BACKGROUND
Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period.
METHODS
Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis.
RESULTS
The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up <50% had experienced a fall or near fall.
CONCLUSIONS
There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival.
TRIAL REGISTRATION
NCT01080196 ; March 2, 2010 (retrospectively registered).
背景
在多成分运动跌倒预防计划中解决肌肉功能缺陷是一项优先任务，特别是对于风险最高的老年人，即那些既往有过跌倒经历的老年人。离心阻力运动以其产生高力量的潜力和低能量消耗，可能非常适合解决该人群的肌肉损伤问题。本研究的目的是比较通过负向、离心诱导的工作进行的阻力运动（RENEW）与传统（TRAD）阻力运动对活动能力、平衡信心、肌肉力量和横截面积的影响，以及高跌倒风险老年人在1年期间无跌倒事件存活的天数。
方法
作为为期3个月的多成分运动跌倒预防计划（MCEFRP）的一部分，进行随机、两组、四个时间点（超过1年）的临床试验，比较RENEW与TRAD。使用混合效应模型分析活动能力、平衡信心、肌肉力量输出和横截面积的主要结局。使用生存分析分析跌倒天数和接近跌倒天数的次要结局。
结果
MCEFRP确实对运动干预可逆转的跌倒风险因素有影响，尽管RENEW与TRAD在活动能力、平衡信心、肌肉力量和横截面积方面没有差异效应（p = 0.896）。在无跌倒（p = 0.565）或接近跌倒（p = 0.678）存活的天数方面也没有组间差异。尽管100%的参与者在MCEFRP之前的一年中至少有一次跌倒，但经过3个月的运动和9个月的随访，<50%的人经历了跌倒或接近跌倒。
结论
作为MCEFRP的组成部分，RENEW或TRAD对主要或次要结局没有差异效应。两种阻力运动模式对跌倒风险和无跌倒生存具有相同的影响。
试验注册
NCT01080196；2010年3月2日（追溯注册）
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