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促进社区中易受伤害的老年人在日常生活活动方面的独立性:一项比较“三步生活锻炼法”与抗阻运动的随机对照试验试点研究

Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise.

作者信息

Liu Chiung-Ju, Xu Huiping, Keith NiCole R, Clark Daniel O

机构信息

Department of Occupational Therapy, Indiana University School of Health and Rehabilitation Sciences.

Indiana University Center for Aging Research.

出版信息

Clin Interv Aging. 2017 Jul 19;12:1141-1149. doi: 10.2147/CIA.S136678. eCollection 2017.

Abstract

BACKGROUND

Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone.

METHODS

A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50-60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.

RESULTS

At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, =0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, =0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =-0.25, =0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, <0.01).

CONCLUSION

Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.

摘要

背景

抗阻运动对增强老年人肌肉力量有效;然而,其对日常生活活动结果的影响往往有限。本研究的目的是检验“生活三步锻炼法”(结合抗阻运动、功能性运动和日常生活活动锻炼)是否比单纯的抗阻运动更有益。

方法

进行了一项单盲随机对照试验。52名不活动的社区居住老年人(平均年龄 = 73岁),存在肌肉无力和日常生活活动困难,被随机分配接受“生活三步锻炼法”或仅进行抗阻运动。“生活三步锻炼法”组的参与者除了抗阻运动外,还进行功能性动作和在家中选择的日常生活活动。仅抗阻运动组的参与者仅进行抗阻运动。两组在运动强度(中等)、持续时间(每次50 - 60分钟,共10周)和频率(每周三次)方面具有可比性。在基线、干预后以及干预完成后6个月,进行了日常生活活动的标准性能测试——运动和过程技能评估。

结果

干预后,“生活三步锻炼法”组在结果测量方面有所改善(与基线相比的平均变化 = 0.29,P = 0.02),但改善程度不大于仅抗阻运动组(组间平均差异 = 0.24,P = 0.13)。然而,仅抗阻运动组在干预完成后6个月出现了显著下降(与基线相比的平均变化 = -0.25,P = 0.01)。与此同时,观察到“生活三步锻炼法”具有更显著的效果(组间平均差异 = 0.37,P < 0.01)。

结论

与单纯的抗阻运动相比,“生活三步锻炼法”可改善老年人日常生活活动的表现,并减缓失能进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e9b/5529091/d86c85464256/cia-12-1141Fig1.jpg

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