Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK.
Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester M13 9PL, UK.
Physiotherapy. 2019 Jun;105(2):262-274. doi: 10.1016/j.physio.2019.01.019. Epub 2019 Feb 7.
Neurogenic claudication due to spinal stenosis is a common cause of disability in older adults. Conservative treatments are a favourable treatment option. This paper describes the development and delivery of the BOOST (Better Outcomes for Older adults with Spinal Trouble) intervention, a physiotherapist-delivered physical and psychological intervention for the management of neurogenic claudication in older adults. The BOOST intervention is being tested in a multi-centre, randomised controlled trial in UK National Health Service Trusts; delivered by physiotherapists registered with the Health and Care Professionals Council. Participants are aged 65 years or older, registered with a primary care practice, and report symptoms consistent with neurogenic claudication. Intervention content and delivery was initially informed by clinical and patient experts, research evidence, and behaviour change guidelines; and refined following an intervention development day attended by researchers, health professionals, and Patient and Public Involvement representatives. The BOOST intervention comprises 12 group sessions, promoting sustained adherence with a long term home and physical activity programme. Each session includes education and group discussion, individually tailored exercises, and walking. Initial exercise levels are set at a one-to-one assessment. Continued home exercise adherence and increased physical activity following completion of the sessions is facilitated through support telephone calls. Trial registration ISRCTN12698674.
由于椎管狭窄导致的神经源性跛行是老年人残疾的常见原因。保守治疗是一种有利的治疗选择。本文介绍了 BOOST（针对脊柱问题的老年患者的更好结果）干预措施的制定和实施，这是一种由物理治疗师提供的针对老年人神经源性跛行的身体和心理干预措施。BOOST 干预措施正在英国国民保健系统信托的多中心随机对照试验中进行测试；由注册健康和保健专业人员理事会的物理治疗师提供。参与者年龄在 65 岁或以上，在初级保健诊所注册，并报告有符合神经源性跛行的症状。干预内容和实施最初是由临床和患者专家、研究证据和行为改变指南提供信息；并在研究人员、卫生专业人员和患者和公众参与代表参加的干预措施制定日之后进行了改进。BOOST 干预措施包括 12 个小组会议，旨在促进长期家庭和体育活动方案的持续坚持。每个会议包括教育和小组讨论、个性化的锻炼以及散步。初始锻炼水平是在一对一评估中确定的。通过支持电话来促进完成会议后在家继续锻炼和增加身体活动。试验注册号 ISRCTN61515447。
