Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.
Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Donostia, Spain.
J Am Geriatr Soc. 2019 Jun;67(6):1145-1151. doi: 10.1111/jgs.15824. Epub 2019 Mar 19.
To determine the effect of multicomponent exercise on frailty and related adverse outcomes in residents of long-term nursing homes (LTNHs).
A single-blind randomized controlled trial.
Ten LTNHs in Gipuzkoa, Spain.
The study sample comprised 112 men and women aged 70 years or older who scored 50 or higher on the Barthel Index, 20 or higher on the MEC-35 test (an adapted and validated version of the Mini-Mental State Examination in Spanish), and who were capable of standing up and walking independently for at least 10 m.
Subjects in the control group (CG) participated in routine activities. The intervention group (IG) participated in a 6-month program of individualized and progressive multicomponent exercise at moderate intensity.
Frailty was assessed by four different scales at baseline and at 6 months. The Barthel Index was measured at baseline and at 12 months. Frailty-related adverse outcomes were recorded from 12 months before to 12 months after starting the intervention.
A lower prevalence of frailty was observed in the IG compared with the CG according to Fried's frailty phenotype, Short Physical Performance Battery, and Tilburg Frailty Indicator after 6 months (p < .05). There was a decline in the CG on the Barthel Index after 12 months (p < .05), whereas score was maintained in the IG. Both groups experienced a similar number of falls before and after the intervention (p > .05), but during the 6-month intervention period, fewer falls were observed in the IG than the CG (p < .05). Lower overall mortality was observed 12 months after starting the intervention for the IG than the CG (1 vs 6, respectively; p = .05).
Individualized and progressive multicomponent exercise at moderate intensity seems to be effective to prevent falls and reduce frailty and mortality.
确定多成分运动对长期护理院（LTNH）居民虚弱及其相关不良结局的影响。
单盲随机对照试验。
西班牙吉普斯夸省的 10 家 LTNH。
本研究样本包括 112 名年龄在 70 岁及以上、巴氏量表评分 50 分及以上、MEC-35 测试（西班牙语版改良简易精神状态检查）评分 20 分及以上、且能够独立站立和行走至少 10 米的男性和女性。
对照组（CG）参与者参加常规活动。干预组（IG）参与者参加为期 6 个月的个体化、渐进性、中等强度多成分运动计划。
在基线和 6 个月时使用 4 种不同量表评估虚弱。在基线和 12 个月时测量巴氏量表。在开始干预前 12 个月至干预后 12 个月记录与虚弱相关的不良结局。
与 CG 相比，IG 按照 Fried 虚弱表型、简短体能测试和蒂尔堡虚弱指数，在 6 个月时观察到虚弱的患病率较低（p<.05）。CG 在 12 个月时的巴氏量表评分下降（p<.05），而 IG 的评分保持不变。两组在干预前后发生跌倒的次数相似（p>.05），但在 6 个月的干预期间，IG 发生跌倒的次数少于 CG（p<.05）。IG 在开始干预后 12 个月的总死亡率低于 CG（分别为 1 例和 6 例；p=.05）。
中等强度的个体化、渐进性多成分运动似乎可以有效预防跌倒，减少虚弱和死亡率。
