本体感练习对机构化老年人群平衡和身体功能的影响：一项随机对照试验。

The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial.

机构信息

Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, Badajoz, Spain.

Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.

出版信息

Arch Phys Med Rehabil. 2020 Oct;101(10):1780-1788. doi: 10.1016/j.apmr.2020.06.010. Epub 2020 Jul 12.

DOI:10.1016/j.apmr.2020.06.010

PMID:32663479

Abstract

OBJECTIVES: To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. DESIGN: Randomized, single-blind, controlled trial. SETTING: A Spanish nursing home in the autonomous community of Extremadura, Spain. PARTICIPANTS: An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. INTERVENTIONS: Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. MAIN OUTCOME MEASURES: Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). RESULTS: Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). CONCLUSIONS: A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.

摘要

目的：评估本体感觉运动方案对机构老年人的功能性移动能力、肌肉骨骼耐力、动态和静态平衡、步态和跌倒风险的疗效。

设计：随机、单盲、对照试验。

地点：西班牙埃斯特雷马杜拉自治区的一家西班牙疗养院。

参与者：通过招募 148 名老年志愿者创建了初始样本。最终样本（N=42）随机分为 2 组。

干预措施：对照组和实验组均接受物理治疗，包括适应运动和其他物理治疗技术的组合（物理治疗干预方案），为期 12 周。该方案每周包括 45 分钟（小组干预）和 100 分钟（个体干预），共 36 节课（29 小时）。实验组在同一干预期间接受本体感觉训练方案，每周进行两次（24 节课），每次持续 55 分钟。

主要观察指标：计时起立行走测试（TUG）、库珀测试、提内蒂测试、单腿站立和 Morse 跌倒量表（MFS）。

结果：方差分析显示 TUG 评分（F=10.41，P=.002）、库珀测试（F=5.94，P=.019）、提内蒂测试（F=6.41，P=.015）和 MFS 评分（F=5.24，P=.028）的时间×组交互作用。TUG 评分（d=0.76）、提内蒂评分（d=1.12）、单腿站立测试评分（d=0.77）和 MFS 量表评分（d=0.85）的组间差异有统计学意义。实验组的 TUG 评分（d=0.72）、库珀测试以米为单位的评分（d=0.18）、提内蒂评分（d=0.60）、单腿站立评分（d=0.55）和 MFS 评分（d=0.42）的组内分析显示治疗前后差异有统计学意义。

结论：与对照组相比，本体感觉运动方案在机构老年人的功能性移动能力、肌肉骨骼耐力、平衡、步态和跌倒风险等方面表现出显著改善。这项研究可能有助于我们更好地理解特定本体感觉康复方案的影响。