Aviles Jessica, Porter Gwenndolyn C, Estabrooks Paul A, Alexander Neil B, Madigan Michael L
Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA.
Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE.
Transl J Am Coll Sports Med. 2020 Mar 15;5(6):51-58. doi: 10.1249/tjx.0000000000000120.
The purpose of the study was to evaluate the feasibility of implementing reactive balance training (RBT) in continuing care retirement communities, as a part of typical practice in these facilities.
RBT, a task-specific exercise program, consisted of repeatedly exposing participants to trip-like perturbations on a modified treadmill to improve reactive balance, and subsequently reduce fall risk. Semi-structured interviews were conducted with retirement community residents (RBT participants) and administrators, to assess the organizational context, perceptions of evidence for falls prevention, and facilitation strategies that could improve the likelihood of implementing RBT as a falls-prevention program.
Contextual factors such as leadership support, culture of change, evaluation capabilities, and receptivity to RBT among administrators and health leaders at the participating retirement communities could facilitate future implementation. The cost associated with RBT (e.g. equipment and personnel), resident recruitment, and accessibility of RBT for many residents were identified as primary barriers related to the intervention. Participants perceived observable health benefits after completing RBT, had increased awareness toward tripping, and greater confidence with respect to mobility. Across interviewees potential barriers for implementation regarding facilitation revolved around the compatibility and customizability for different participant capabilities that would need to be considered before adopting RBT.
RBT could fill a need in retirement communities and the findings provide areas of context, characteristics of the intervention, and facilitation approaches that could improve uptake.
本研究的目的是评估在持续照料退休社区实施反应性平衡训练（RBT）作为这些设施常规做法一部分的可行性。
RBT是一项特定任务的锻炼计划，包括让参与者在改良跑步机上反复经历类似绊倒的扰动，以改善反应性平衡，进而降低跌倒风险。对退休社区居民（RBT参与者）和管理人员进行了半结构化访谈，以评估组织背景、对预防跌倒证据的看法以及可提高将RBT作为预防跌倒计划实施可能性的促进策略。
参与研究的退休社区管理人员和健康负责人的领导支持、变革文化、评估能力以及对RBT的接受度等背景因素有助于未来的实施。与RBT相关的成本（如设备和人员）、居民招募以及许多居民参与RBT的可及性被确定为与该干预措施相关的主要障碍。参与者在完成RBT后察觉到了明显的健康益处，对绊倒的意识有所提高，并且在行动能力方面更有信心。在所有受访者中，实施促进方面的潜在障碍围绕着不同参与者能力的兼容性和可定制性，在采用RBT之前需要对此加以考虑。
RBT可以满足退休社区的需求，研究结果提供了背景领域、干预措施的特点以及可提高采用率的促进方法。
