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为功能受限的老年人实施社区步行计划(“继续前行!”)

Implementation of a Community Walking Program (Walk On!) for Functionally-Limited Older Adults.

作者信息

Nicklas B J, Chmelo E A, Sheedy J, Moore J B

机构信息

Barbara J. Nicklas, Section on Gerontology and Geriatric Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine Winston-Salem, NC, USA, 27157, 336-713-8569,

出版信息

J Frailty Aging. 2020;9(3):165-171. doi: 10.14283/jfa.2020.12.

Abstract

BACKGROUND

Walking interventions improve physical function, reduce fall risk, and prevent mobility disability-even in those with compromised walking ability. However, most prior studies have been conducted in controlled research settings, with no dissemination of an evidence-based walking program for older adults who have mobility limitations and/or are socially isolated.

OBJECTIVES

This study reports data on the feasibility and acceptability of a community-based walking program (Walk On!) for older adults who are functionally limited, and assesses changes in physical function among attendees. The program sessions focused on long-distance walking, and took place for one-hour, for two days/week, and for 12 weeks at a time.

DESIGN

Pilot implementation study.

SETTING

Local church in Winston-Salem, NC.

PARTICIPANTS

49 program participants; Measurements: Physical function battery and satisfaction survey data, as well as formative evaluation data from six attendees of a focus group, are reported.

RESULTS

The majority of the participants were >75 years (71%), female (65%), and presented with low levels of physical function (usual gait speed=0.79±0.16; 30.6% used an assistive device). Satisfaction with the program was high (100% would recommend it to others) and focus group results were overwhelmingly positive. Mean attendance to scheduled sessions was 77%±21%, and 63% of participants attended at least 75% of scheduled sessions (n=8 attended 100%). On average, participants improved their 6-min walk distance by 8.9%, their SPPB score by 15.4%, their timed-up-go time by 9.0%, and their usual gait speed by 11.4%.

CONCLUSION

The results of the initial evaluation of Walk On! show high feasibility and acceptability of the program, as well as efficacy for improving physical function. Further research is needed to evaluate a delivery method for wider implementation of the program and to definitively test its effectiveness for improving function and other health benefits.

摘要

背景

步行干预可改善身体功能、降低跌倒风险并预防行动能力障碍,即使是对于步行能力受损的人也是如此。然而,大多数先前的研究都是在受控的研究环境中进行的,并没有为行动能力受限和/或社会孤立的老年人推广基于证据的步行计划。

目的

本研究报告了一项针对功能受限老年人的社区步行计划(“继续前行!”)的可行性和可接受性的数据,并评估了参与者身体功能的变化。该计划的课程重点是长距离步行,每次持续一小时,每周两天,共进行12周。

设计

试点实施研究。

地点

北卡罗来纳州温斯顿 - 塞勒姆的当地教堂。

参与者

49名计划参与者;测量:报告了身体功能综合测试和满意度调查数据,以及来自一个焦点小组六名参与者的形成性评估数据。

结果

大多数参与者年龄超过75岁(71%),女性(65%),身体功能水平较低(通常步态速度 = 0.79±0.16;30.6% 使用辅助设备)。对该计划的满意度很高(100% 会向他人推荐),焦点小组的结果绝大多数是积极的。预定课程的平均出勤率为77%±21%,63% 的参与者参加了至少75% 的预定课程(n = 8人参加了100%)。平均而言,参与者的6分钟步行距离提高了8.9%,简短体能状况量表(SPPB)得分提高了15.4%,计时起立行走时间提高了9.0%,通常步态速度提高了11.4%。

结论

“继续前行!”初步评估的结果表明该计划具有很高的可行性和可接受性,以及改善身体功能的效果。需要进一步研究以评估该计划更广泛实施的交付方法,并明确测试其改善功能和其他健康益处的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f068/12275800/2d6ff3d4e5a2/gr1.jpg

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