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[三种干预方案对跌倒恐惧及功能的影响。一项随机临床试验]

[Effect on fear of falling and functionality of three intervention programs. A randomised clinical trial].

作者信息

Dueñas Eliana Patricia, Ramírez Liliana Patricia, Ponce Elizabeth, Curcio Carmen Lucía

机构信息

Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia; Departamento de Medicina Familiar, Universidad del Valle, Valle del Cauca, Colombia.

Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia.

出版信息

Rev Esp Geriatr Gerontol. 2019 Mar-Apr;54(2):68-74. doi: 10.1016/j.regg.2018.09.013. Epub 2018 Nov 24.

Abstract

INTRODUCTION

The fear of falling has a high prevalence in the community, and intervention programs for this condition are scarce, making it is necessary to strengthen this type of therapy in order to prevent adverse consequences in the elderly population.

OBJECTIVE

To establish the effectiveness of three intervention programs in reducing the fear of falling and increasing functionality in elderly people in the city of Manizales.

PARTICIPANTS AND METHODS

A randomised trial was conducted on ambulatory elderly patients with fear of falling and functional limitation of the city of Manizales. A total of 125 individuals were randomised to one of three interventions: Tai Chi (TCh), cognitive behavioural therapy (CBT), and postural control (CP) exercises. The primary outcomes were: fear of falling (evaluated by the Falls Efficacy Scale [FES-I]), and functionality using the Short Physical Performance Battery (SPPB). The data was collected before initiating the interventions and after the 8 weeks intervention.

RESULTS

An intention-to-treat analysis was conducted on 119 elderly patients. The three interventions reduced the fear of falling and increased physical performance, with no significant differences observed between them (P=.13). As regards gait speed, differences were only found between the pre- and post-intervention with CP (P<.001).

CONCLUSIONS

The results suggest that the TCh, CBT and CP interventions helped the elderly to reduce their fear of falling. Only CP demonstrated an improvement in the speed of walking at the end of the eight weeks of intervention (identifier NCT03211429).

摘要

引言

在社区中,害怕跌倒的情况非常普遍,而针对这种情况的干预项目却很稀缺,因此有必要加强这类治疗,以防止老年人群出现不良后果。

目的

确定三种干预项目在降低马尼萨莱斯市老年人跌倒恐惧和提高其功能方面的有效性。

参与者与方法

对马尼萨莱斯市有跌倒恐惧和功能受限的门诊老年患者进行了一项随机试验。共有125人被随机分配到三种干预措施之一:太极拳(TCh)、认知行为疗法(CBT)和姿势控制(CP)练习。主要结局指标为:跌倒恐惧(采用跌倒效能量表[FES-I]评估)和使用简短身体机能测试电池(SPPB)评估的功能。在开始干预前和干预8周后收集数据。

结果

对119名老年患者进行了意向性分析。三种干预措施均降低了跌倒恐惧并提高了身体机能,且三者之间未观察到显著差异(P = 0.13)。关于步速,仅在CP干预前后存在差异(P < 0.001)。

结论

结果表明,太极拳、认知行为疗法和姿势控制干预有助于老年人降低跌倒恐惧。只有姿势控制干预在八周干预结束时显示出步行速度有所改善(标识符NCT03211429)。

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