Burnie Brae Ltd, Brisbane, Queensland, Australia.
School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, Australia; Southern Cross Care (SA and NT), Adelaide, South Australia, Australia.
Arch Phys Med Rehabil. 2018 Aug;99(8):1525-1532. doi: 10.1016/j.apmr.2018.03.004. Epub 2018 Apr 5.
To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change.
Intervention study.
Community-based older adult-specific exercise clinic.
Older adults (N=245) with complex care needs who were receiving government-funded aged care support.
Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists.
The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level.
At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention.
This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults.
调查平衡信心与接受政府资助的老年护理服务的老年人的身体和认知健康标志物之间的关联，以及渐进式抗阻加平衡训练是否会产生积极影响。
干预研究。
以社区为基础的专门为老年人设立的锻炼诊所。
有复杂护理需求、正在接受政府资助的老年护理支持的老年人（N=245）。
每周两次、共 24 周的渐进式抗阻加平衡训练，由经过认证的运动生理学家监督进行。
主要指标是活动特异性平衡信心量表。次要指标包括短体适能测试、跌倒史（作为健康史问卷的一部分收集）、分层计时平衡测试、老年焦虑量表、老年抑郁量表、疲劳、抵抗、活动能力、疾病、体重减轻量表以及 EuroQoL-5 维度 3 级。
在基线时，更好的身体表现（r=.54；P<.01）和生活质量（r=.52；P<.01）预测了更好的平衡信心。相反，在基线时，更高的虚弱程度预测了更差的平衡信心（r=-.55；P<.01）。在运动干预后，平衡信心的变化伴随着身体表现的提高（提高 12%）和虚弱程度的降低（降低 11%）。基线平衡信心被确定为整个干预过程中变化分数最一致的负预测因子。
本研究表明，在有老年护理需求的老年人中，身体表现和生活质量下降以及虚弱程度增加预测了更差的平衡信心。然而，当实施一项针对抗阻和平衡运动的靶向干预措施，降低虚弱程度并提高身体表现时，平衡信心也会提高。鉴于平衡信心对一系列幸福感决定因素的影响，包括积极的身体和认知变化的能力，本研究为那些希望减少老年人跌倒的人提供了重要的见解。
