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行走、交谈和倾听:一项针对听力损失老年人功能性健康和孤独感的试点随机对照试验。

Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss.

机构信息

Medicine, University of British Columbia, Kelowna, British Columbia, Canada.

Nexgen Hearing, Kelowna, British Columbia, Canada.

出版信息

BMJ Open. 2019 Apr 14;9(4):e026169. doi: 10.1136/bmjopen-2018-026169.

Abstract

BACKGROUND

Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied.

OBJECTIVES

Explore the impact of a group exercise and socialisation/health education intervention and GAR on physical function and loneliness among older adults with HL.

TRIAL DESIGN

A Young Men's Christian Association (YMCA)-based, 10-week, single-blind, pilot randomised controlled trial (RCT).

PARTICIPANTS

Ambulatory adults aged 65 years or older with self-reported HL.

INTERVENTIONS

Seventy-one participants were screened. Thirty-five were randomised to intervention (strength and resistance exercise, socialisation/health education) and GAR (hearing education, communication strategies, psychosocial support) or control (n=31): GAR only.

OUTCOMES

Ninety-five per cent of eligible participants were randomised. GAR and exercise adherence rates were 80% and 85%, respectively. 88% of participants completed the study. Intervention group functional fitness improved significantly (gait speed: effect size: 0.57, 30 s Sit to Stand Test: effect size: 0.53). Significant improvements in emotional and social loneliness (effect size: 1.16) and hearing-related quality of life (effect size: 0.76) were related to GAR attendance and poorer baseline hearing-related quality of life. Forty-two per cent of participants increased social contacts outside the study.

DISCUSSION

Walk, Talk and Listen was feasible and acceptable. Exercise and socialisation/health education improved loneliness and key fitness measures but provided no additional benefit to GAR only for loneliness. This is the first preliminary evidence about the benefits of exercise on fitness and GAR on loneliness among older adults with HL.

IMPLICATIONS

This pilot trial provides key information on the sample size required for a larger, longer term RCT to determine the enduring effects of this holistic intervention addressing the negative psychosocial and musculoskeletal downstream effects of HL among older adults.

摘要

背景

与孤独、隔离、认知和身体功能下降以及过早死亡相关的与年龄相关的听力损失(HL)是一种普遍存在的残疾。团体听觉康复(GAR)和听力技术可解决沟通和认知能力下降的问题。然而,在患有 HL 的老年人中,孤独感、身体功能与 GAR 之间的关系尚未得到研究。

目的

探讨基于基督教青年会(YMCA)的 10 周、单盲、试点随机对照试验(RCT)中,团体锻炼和社交/健康教育干预以及 GAR 对 HL 老年人身体功能和孤独感的影响。

试验设计

一项基于基督教青年会(YMCA)的、为期 10 周、单盲、试点随机对照试验(RCT)。

参与者

自我报告有听力损失的 65 岁或以上的可走动的成年人。

干预措施

对 71 名参与者进行了筛选。35 名参与者被随机分配到干预组(力量和阻力训练、社交/健康教育)和 GAR 组(听力教育、沟通策略、心理社会支持)或对照组(n=31):仅 GAR。

结果

95%的合格参与者被随机分配。GAR 和锻炼的依从率分别为 80%和 85%。88%的参与者完成了研究。干预组的功能性体能显著提高(步态速度:效应量为 0.57,30 秒坐站测试:效应量为 0.53)。GAR 参与度与基线听力相关生活质量较差相关,情绪和社交孤独感显著改善(效应量:1.16)和听力相关生活质量(效应量:0.76)。42%的参与者增加了研究以外的社交联系。

讨论

Walk,Talk and Listen 是可行和可接受的。锻炼和社交/健康教育改善了孤独感和关键的体能指标,但对 GAR 仅对孤独感没有额外的益处。这是第一项关于锻炼对健身和 GAR 对 HL 老年人孤独感影响的初步证据。

意义

这项初步试验提供了关于更大、更长时间 RCT 所需样本量的关键信息,以确定这种全面干预措施对 HL 老年人的负面心理社会和肌肉骨骼下游影响的持久效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db60/6500300/fe237a48b2a4/bmjopen-2018-026169f01.jpg

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