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住院期间实用运动方案(SPRINT)对老年患者健康照护和身体机能的潜在疗效:一项初步研究。

Potential Efficacy of Pragmatic Exercise Program (SPRINT) during Hospitalization in Older Adults on Health Care and Physical Performance: A Pilot Study.

机构信息

Mylène Aubertin-Leheudre, PhD, Département des Sciences de l'Activité Physique, Université du Québec à Montréal (UQAM), Pavillon des sciences biologiques (SB), 4th floor, 141 avenue Président-Kennedy, SB-4615, Montreal, Quebec, Canada H3C 3P8, E-mail address:

出版信息

J Nutr Health Aging. 2021;25(1):126-133. doi: 10.1007/s12603-020-1483-4.

Abstract

OBJECTIVES

Immobilization contribute to iatrogenic decline in hospitalized older adult. Implementing physical activity (PA) seems to be one of the best and easy solution. However, PA interventions are poorly integrated into usual care and those available are either non-specific, need supervision or requested human/material resources. Thus, we aimed to assess the effect of a pragmatic, unsupervised, and specific PA program (SPRINT) on health care practice and functional capacities in hospitalized older patients.

DESIGN

Single arm interventional pragmatic pilot study.

SETTING

Geriatric Assessment Unit (GAU).

PARTICIPANTS

Of the 39 patients (> 65 years) hospitalized in a GAU and eligible, 19 agreed to participate (AP) and 20 declined (N-AP).

INTERVENTION

One of the 4 PA programs, developed by our team, was allocated according to mobility profile. Individual functional capacities (i.e. balance, walking speed, functional mobility profile (PFMP)), active time (METS> 1.5: min), length of hospitalization (LOS), discharge orientation were assessed at admission and discharge of GAU.

RESULTS

Baseline characteristics of the 2 groups were comparable. At discharge, the AP group improved more on walking speed (0.57 ± 0.21 vs. 0.64 ± 0.19; p = 0.013), Berg balance scale (41.8 ± 13.7 vs. 45.1 ± 9.7; p = 0.017) and PFMP (54.0 ± 7.1 vs 55.1 ± 5.5; p = 0.042) than the N-AP group. The LOS was significantly shorter in AP group compared to the N-AP group (5 vs. 36 days; p = 0.026) and more subjects in the AP group were oriented at home without health or social services (89.5 vs. 60%; p=0.065).

CONCLUSION

SPRINT appears effective to counteract iatrogenic decline and decreased the LOS. Moreover, this simple pragmatic PA tool seems to improve the life trajectory and healthcare practice in aging population. Further researches are needed to confirm these promising pragmatic results.

摘要

目的

固定会导致住院老年患者产生医源性衰退。实施身体活动(PA)似乎是最好和最简单的解决方案之一。然而,PA 干预措施并未很好地融入常规护理中,现有的干预措施要么不具体,要么需要监督或需要人力/物力资源。因此,我们旨在评估实用、非监督和特定的 PA 计划(SPRINT)对住院老年患者的医疗实践和功能能力的影响。

设计

单臂干预性实用试点研究。

设置

老年评估病房(GAU)。

参与者

在 GAU 住院且符合条件的 39 名(>65 岁)患者中,有 19 名同意参与(AP),20 名拒绝参与(NAP)。

干预

根据活动能力状况,为参与者分配我们团队开发的 4 个 PA 计划之一。个体功能能力(即平衡、步行速度、功能性移动能力概况(PFMP))、活跃时间(METS>1.5:min)、住院时间(LOS)、出院方向在 GAU 入院和出院时进行评估。

结果

两组的基线特征相当。出院时,AP 组在步行速度(0.57±0.21 与 0.64±0.19;p=0.013)、伯格平衡量表(41.8±13.7 与 45.1±9.7;p=0.017)和 PFMP(54.0±7.1 与 55.1±5.5;p=0.042)方面的改善均优于 NAP 组。AP 组的 LOS 明显短于 NAP 组(5 天与 36 天;p=0.026),且 AP 组更多的患者能够在家中无需健康或社会服务的情况下进行康复(89.5%与 60%;p=0.065)。

结论

SPRINT 似乎能够有效对抗医源性衰退并缩短 LOS。此外,这种简单实用的 PA 工具似乎改善了老龄化人群的生活轨迹和医疗实践。需要进一步的研究来证实这些有前景的实用结果。

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