Krupp Sonja, Kasper Jennifer, Hermes Anne, Balck Friedrich, Ralf Christina, Schmidt Thorsten, Weisser Burkhard, Willkomm Martin
Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Rabenhorst 1, 23568, Lübeck, Deutschland.
Abteilung Sport- und Bewegungstherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Mar;62(3):274-281. doi: 10.1007/s00103-019-02881-6.
There are few standardized and evaluated intervention programs for elderly people in need of care that consider motor, cognitive and social aspects. Therefore, the "Lübeck Worlds of Movement Model" was developed by the Lübeck Geriatrics Research Group as a multidimensional standardized intervention program for continuous use in the nursing home.
The model was evaluated for its effects over the course of one year in the areas of self-care competence (primary endpoint), mobility, coordination, flexibility, strength, endurance, and cognition. The results are presented in this article.
The sample recruitment took place in 6 nursing homes in Kiel (control group) and 10 in Lübeck (intervention group). Care-dependent senior citizens from the neighborhood were also allowed to participate. Inclusion criteria were the ability to walk at least 6 m independently and the cognitive and sensory capacities to follow the group training. The evaluation study had 255 subjects. To verify the effects of the intervention, various tests were performed at baseline and after 3, 6, 9, and 12 months: Barthel Index, Timed Up and Go, 4‑meter walk test, Romberg stand, one-leg stand, 20-Cents Test, 8‑Point Reach Test, hand force, 5‑Chair-Rise Test, 2‑Minute Step Test, and Six-Item Screener.
Comparison of the control group with the subjects who had participated in at least half of the training sessions (per-protocol analysis) showed the highest effect size in the multivariate analysis of variance after one year for the Barthel index, followed by the Timed Up and Go, cumulated over all times for the Romberg stand and 5‑Chair-Rise Test. The maximum effect measured over the entire assessment occurred after 6 months (partial eta square ηp = 0.332).
The model developed preventive effects on all investigated dimensions over the course of a year, but with differences in intensity and time of maximum effect. The motivation for long-term participation was high.
针对需要护理的老年人，考虑到运动、认知和社交方面的标准化且经过评估的干预项目很少。因此，吕贝克老年医学研究小组开发了“吕贝克运动世界模型”，作为一种多维标准化干预项目，供养老院持续使用。
对该模型在自我护理能力（主要终点）、 mobility、协调性、灵活性、力量、耐力和认知等领域进行了为期一年的效果评估。本文展示了评估结果。
样本招募在基尔的6家养老院（对照组）和吕贝克的10家养老院（干预组）进行。附近依赖护理的老年人也可参与。纳入标准为能够独立行走至少6米，以及具备跟随小组训练的认知和感官能力。评估研究有255名受试者。为验证干预效果，在基线以及3、6、9和12个月后进行了各种测试：巴氏指数、计时起立行走测试、4米步行测试、罗姆伯格站立测试、单腿站立测试、20美分测试、8点伸展测试、握力测试、5次起坐测试、2分钟踏步测试和六项筛查测试。
将对照组与至少参加了一半训练课程的受试者进行比较（符合方案分析），方差分析显示，一年后巴氏指数在多变量分析中的效应量最高，其次是计时起立行走测试，罗姆伯格站立测试和5次起坐测试在所有时间的累积效应量也较高。在整个评估过程中测得的最大效应在6个月后出现（偏eta平方ηp = 0.332）。
该模型在一年的时间里对所有研究维度都产生了预防效果，但在最大效应的强度和时间上存在差异。长期参与的积极性很高。
