School of Health Medical and Applied Sciences, Central Queensland University, Melbourne, Australia.
Ramsay Health Care, Donvale Rehabilitation Hospital, Donvale, Australia.
Disabil Rehabil. 2020 Jun;42(12):1727-1735. doi: 10.1080/09638288.2018.1535630. Epub 2019 Jan 17.
To examine the efficacy of an occupational therapy activity pacing intervention with deconditioned older adults in rehabilitation. Randomised, single-blind controlled trial of deconditioned older adults admitted for rehabilitation following treatment of an acute medical condition, allocated to intervention [ = 51, males = 14, mean age = 80(8)] or control [ = 49, males = 12, mean age = 81(7)] group. The intervention group received individual and group activity pacing education with practice and application of techniques to daily activities and the home environment, while the control group received a typical occupational therapy program, which included brief activity pacing education. Outcomes included participation in daily living skills, health status (including pain and fatigue symptoms), self-efficacy in daily activities and activity pacing techniques using the Australian Therapy Outcome Measures-Occupational Therapy (AusTOMs-OT), Short Form-36 Health Survey (SF-36), Self-Efficacy Gauge and Activity Pacing Assessment. No differences in groups at admission. Comparison at discharge and three months post discharge using 2 × 2 mixed ANOVA demonstrated small differences in only one scale of the activity limitation domain of the AusTOMs-OT. No significant differences were found in other scales or domains of the AusTOMs-OT, nor secondary outcome measures. Activity pacing in addition to typical occupational therapy during inpatient rehabilitation did not demonstrate benefits to participants in the management of their daily activities on returning home post hospitalisation.Implications for rehabilitationActivity pacing has been identified as one of the commonly used occupational therapy interventions utilised with deconditioned older adults in rehabilitation.An activity pacing intervention in conjunction with typical occupational therapy demonstrated no benefits for deconditioned older adults over typical occupational therapy which included basic education on this topic.Continuation of the activity pacing intervention into the outpatient setting may be of benefit to older adults and requires further investigation.
考察一种职业治疗活动节奏干预对康复中失能老年人的疗效。一项针对因急性医疗状况接受治疗后入住康复病房的失能老年人的随机、单盲对照试验，将患者分为干预组（n=51，男性 14 人，平均年龄 80（8）岁）和对照组（n=49，男性 12 人，平均年龄 81（7）岁）。干预组接受个体和小组活动节奏教育，并练习和应用于日常活动和家庭环境的技术，而对照组接受典型的职业治疗方案，其中包括简短的活动节奏教育。结果包括日常生活技能的参与、健康状况（包括疼痛和疲劳症状）、日常活动自我效能和使用澳大利亚治疗结果测量-职业治疗（AusTOMs-OT）、简短形式 36 健康调查（SF-36）、自我效能量表和活动节奏评估的活动节奏技术。入院时两组无差异。使用 2×2 混合方差分析比较出院时和出院后三个月的结果，仅在 AusTOMs-OT 的活动受限领域的一个量表中显示出微小差异。在 AusTOMs-OT 的其他量表或领域以及次要结果测量中均未发现显著差异。在住院康复期间，除了典型的职业治疗之外，活动节奏干预并未显示对参与者在出院后管理日常活动方面有任何益处。
对康复的启示
活动节奏已被确定为康复中失能老年人常用的职业治疗干预措施之一。与典型职业治疗相结合的活动节奏干预对失能老年人没有益处，而典型职业治疗包括该主题的基本教育。将活动节奏干预延续到门诊环境可能对老年人有益，需要进一步研究。
