Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand.
Int J Environ Res Public Health. 2020 Apr 29;17(9):3102. doi: 10.3390/ijerph17093102.
Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.
针对衰弱老年人，需要采取有效的干预措施来预防跌倒。本研究旨在确定多系统体能锻炼（MPE）预防跌倒和健康相关生活质量（HRQOL）的有效性。这是一项采用分配隐藏法的随机对照试验，纳入了 72 名年龄在 65 岁及以上、被认定为衰弱前期且生理概况评估（PPA）评分显示有轻度和中度跌倒风险的老年人。采用区组随机化分组，将参与者随机分为 MPE 组（n=36）和对照组（n=36）。干预主要包括本体感觉、肌肉力量、反应时间和平衡训练，每周进行 3 天，共 12 周。主要结局指标为 12 周和 24 周时使用 PPA 评估的跌倒风险。与对照组相比，MPE 组在 12 周和 24 周时跌倒风险、本体感觉、肌肉力量、反应时间和姿势摆动以及跌倒恐惧评分的改善情况均有显著差异。此外，与对照组相比，MPE 组的 HRQOL 显著提高。MPE 方案显著增加了肌肉力量，改善了本体感觉、反应时间和姿势摆动，从而降低了衰弱前期老年人的跌倒风险。因此，建议在衰弱前期人群的日常初级保健实践中使用 MPE 方案。
