School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA.
School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA.
J Am Med Dir Assoc. 2018 Feb;19(2):185.e7-185.e13. doi: 10.1016/j.jamda.2017.11.004. Epub 2017 Dec 27.
This study examined the benefits of and differences between 12 weeks of thrice-weekly supervised balance training and an unsupervised at-home balance activity (using the Nintendo Wii Fit) for improving balance and reaction time and lowering falls risk in older individuals with type 2 diabetes mellitus (T2DM).
Before-after trial.
University research laboratory, home environment.
Sixty-five older adults with type 2 diabetes were recruited for this study. Participants were randomly allocated to either supervised balance training (mean age 67.8 ± 5.2) or unsupervised training using the Nintendo Wii Fit balance board (mean age 66.1 ± 5.6).
The training period for both groups lasted for 12 weeks. Individuals were required to complete three 40-minute sessions per week for a total of 36 sessions.
The primary outcome measure was falls risk, which was as derived from the physiological profile assessment. In addition, measures of simple reaction time, lower limb proprioception, postural sway, knee flexion, and knee extension strength were also collected. Persons also self-reported any falls in the previous 6 months.
Both training programs resulted in a significant lowering of falls risk (P < .05). The reduced risk was attributable to significant changes in reaction times for the hand (P < .05), foot (P < .01), lower-limb proprioception (P < .01), and postural sway (P < .05).
Overall, training led to a decrease in falls risk, which was driven by improvements in reaction times, lower limb proprioception, and general balance ability. Interestingly, the reduced falls risk occurred without significant changes in leg strength, suggesting that interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) may have positive benefits for the older adult with T2DM at risk for falls.
本研究旨在探讨 12 周每周三次监督平衡训练与非监督家庭平衡活动（使用任天堂 Wii Fit）对改善 2 型糖尿病（T2DM）老年患者平衡和反应时间、降低跌倒风险的益处和差异。
前后试验。
大学研究实验室，家庭环境。
本研究招募了 65 名年龄较大的 2 型糖尿病患者。参与者被随机分配到监督平衡训练组（平均年龄 67.8 ± 5.2）或使用任天堂 Wii Fit 平衡板的非监督训练组（平均年龄 66.1 ± 5.6）。
两组的训练期均持续 12 周。要求个人每周完成三次 40 分钟的课程，共 36 次。
主要结果测量是跌倒风险，这是由生理概况评估得出的。此外，还收集了简单反应时间、下肢本体感觉、姿势摆动、膝关节屈曲和膝关节伸展力量的测量值。参与者还报告了前 6 个月的任何跌倒情况。
两种训练方案均显著降低跌倒风险（P <.05）。风险降低归因于手部（P <.05）、脚部（P <.01）、下肢本体感觉（P <.01）和姿势摆动（P <.05）反应时间的显著变化。
总体而言，训练导致跌倒风险降低，这是由于反应时间、下肢本体感觉和整体平衡能力的提高所致。有趣的是，跌倒风险的降低没有导致腿部力量的显著变化，这表明针对与平衡控制相关的内在风险因素（而非肌肉力量）的跌倒风险降低干预措施可能对有跌倒风险的 T2DM 老年患者有积极的益处。
