Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.
Department of Family Practice, The University of British Columbia, Vancouver, Canada.
J Geriatr Phys Ther. 2019 Apr/Jun;42(2):E32-E38. doi: 10.1519/JPT.0000000000000193.
Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified secondary outcomes) and provide descriptions of activity patterns over 1 year for men and women.
We conducted a parallel-group, single-blinded randomized controlled trial comparing a multidisciplinary clinic and usual care (intervention) with usual care (control). We recruited 53 community-dwelling older adults aged 65+ years who were 3 to 12 months postfracture and collected data at baseline, 6, and 12 months; study staff were blinded to group allocation. The clinic included a geriatric assessment by the geriatrician, physiotherapist, and occupational therapist. Referrals were made to other professionals, when indicated. We collected the accelerometer-measured sedentary behavior and physical activity at 3 time points. We used linear mixed-effects models to compare groups at 6 and 12 months and mixed models to compare outcomes between men and women.
Participants were sedentary for more than 10 hours of a 13-hour day, and there were no significant differences between the study groups at 6 months (2.4 [95% confidence interval: -22.4 to 27.2] minutes) or 12 months (-3.7 [95% confidence interval: -33.6 to 26.1] minutes). Compared with women, men spent 47.2 min/d more in sedentary time (P = .052) and 43.8 min/d less in light physical activity (P = .047).
Older adults after hip fracture spend prolonged periods of waking hours sedentary with very little activity.
久坐时间延长和身体活动有限会对健康和行动能力产生有害影响，尤其是对于与跌倒相关的髋部骨折的老年人。因此，本研究旨在检查多学科诊所对久坐行为和身体活动的影响（预设的次要结局），并为男性和女性提供 1 年内活动模式的描述。
我们进行了一项平行组、单盲随机对照试验，比较了多学科诊所和常规护理（干预组）与常规护理（对照组）。我们招募了 53 名居住在社区的 65 岁以上、骨折后 3 至 12 个月的老年人，在基线、6 个月和 12 个月时收集数据；研究人员对分组分配情况不知情。该诊所包括老年医生、物理治疗师和职业治疗师进行的老年评估。如有需要，向其他专业人员转介。我们在 3 个时间点收集了加速度计测量的久坐行为和身体活动数据。我们使用线性混合效应模型比较了 6 个月和 12 个月时的组间差异，并使用混合模型比较了男性和女性之间的结果。
参与者每天在 13 小时的清醒时间中有超过 10 小时处于久坐状态，在 6 个月（2.4 [95%置信区间：-22.4 至 27.2] 分钟）或 12 个月（-3.7 [95%置信区间：-33.6 至 26.1] 分钟）时，两组之间没有显著差异。与女性相比，男性每天多坐 47.2 分钟（P =.052），少做轻体力活动 43.8 分钟（P =.047）。
髋部骨折后的老年人在清醒时间中有很长一段时间处于久坐状态，几乎没有活动。
